This is Part IV in a seven-part blog series analyzing a resolution coming to the PCUSA General Assembly on the end of life. The paper titled, “Abiding Presence: Living Faithfully in End of Life Decisions,” forms the rationale of the resolution and is offered to the church as a pastoral guide to end of life conversation.
By Marie Bowen, Presbyterians Pro-Life.
IV. Hospice and Palliative Care: Two Evolving Options
As use of technology increases at end of life patients spend longer periods of time in medical facilities at the end of life. At the same time 80% of people, according to the pastoral guidebook for end of life ministry being proposed to the 222nd General Assembly of the PCUSA, express a preference for dying at home. Hospice makes that possible.
The goal of medical care is to “cure illness or extend life.” The guidebook points out that in efforts to achieve that goal sometimes medical treatments mean that quality of life in the present is sacrificed for more time later on. Hospice, as an alternative, helps those with terminal illness enjoy life to the fullest in the present while relieving pain and promoting awareness for as long as possible. This is helpful information, not only for pastors, but for families seeking to understand what it means to put a loved one into hospice.
“Hospice is a program not a place.” Is another piece of critical information noted in the guide. A hospice program can take place at home or in a residential facility. Medicare and most insurance plans cover it although room and board charges may be additional. Hospice programs do not include treatment aimed at curing an underlying terminal illness (e.g. chemotherapy). Other things I have learned about hospice by by reading this paper include:
- It is a team effort and the patient may choose either a personal physician or a hospice physician to guide their care.
- One can be referred by a physician or self refer
- Access to hospice programs is limited to those expected to live 6 months or less
- Hospice teams provide emotional and educational support to patient and family and even help with paperwork, funeral planning and ongoing bereavement support following death.
- The median stay in U.S. hospice programs is less than one month.
- Hospice can be a time of personal and family growth.
In differentiating between ‘hospice’ and ‘palliative care’ it is important to note that hospice programs may include palliative care, but palliative care can also be provided in conjunction with treatment (e.g. chemo or radiation). Palliative care provides support to patient and families, seeks to manage symptoms of chronic or terminal illness and to improve quality of life.