Choosing a path to the end

Advocating for hospice amid the talk of the ‘end-of-life’ law

The author has been a physical therapist at Enloe Hospice for nearly 30 years.

Your recent feature “A Better Way to Die” (see Cover story, Feb. 19) provides an opportunity to begin a dialogue about the end of life, a circumstance that we all will face with family, friends and ourselves.

Dying is an inevitability. How we live until then is a more difficult conundrum. The shock of a terminal diagnosis stops us in our tracks; how do we do the things most important, express forgiveness and appreciation, and say goodbye to those closest to us?

One possibility is the “end-of-life choices” law. It’s the one that led Brittany Maynard to Oregon, and four other states have similar legislation. It’s also now proposed in the California Legislature. Hospice is another path. More information is essential to discern one’s choice of life course.

Hospice provides comprehensive patient- and family-centered care to address the many problems and concerns that arise near the end of life. Physicians and nurses provide help with symptom management; a social worker offers support with resources and coping; physical therapy helps maximize mobility, independence and safe care; hospice aides assist with personal care; and volunteers and spiritual care are also available.

This comprehensive team visits clients in their homes. Bereavement support is available for a year after death for loved ones. While essential in the final days of life at home, hospice is available for at least six months before an anticipated death. Unfortunately, hospice is often underutilized due to fear and misconception.

Can we make life tolerable? Remarkably. We see people grow and experience the richness and love that come from the challenges and intimacy of receiving and providing care during the dying process. Care is both human and humane; that process of transformation, which initially may not seem possible, quite often occurs.

While the right to self-determination is a mainstay of our society, it is important not to overlook our obligation to care for one another, especially in such difficult circumstances. These are not mutually exclusive. Studies have shown both palliative care and hospice become more accessible and better utilized as we openly discuss and debate end-of-life options. Both can make for a better way to die.

In the words of modern hospice founder Dame Cicely Saunders: “You matter because you are you. You matter to the last moment of your life, and we will do all we can not only to help you die peacefully, but also to live until you die.”