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The 'H' in AseraCare Hospice Stands for Hope
The hope for a cure is a natural one. Initially, it is a healthy belief, which can result in a positive attitude and nurture healing. But fales hopes- once seen for the illusions or mirages that they are- can devastate the patient and family. It may alienate the patient from the doctor, cause loss of trust, precipitate depression and set off a chain of events that can negatively affect the patient's family for years. Some, who sincerely believe that they are doing something good, act in collusion with patients as they cling to false hopes. This allows patients to believe that they will be cured, will live five more years, will be helped by that fourth chemo regimen or will be healed by God. They are fearful that the patient will get discouraged and lose hope. And they are right. Initially hearing the words incurable" or "hospice" is difficult. The patient may become anxious or depressed. Our job as physicians and healthcare workers should be to rebuild and redirect the patient to a new hope. But this hope must be based on truth- not falsehoods and unrealistic expectations. Robert Frost said it well: Hope does not lie in a way out, but in a way through." the way through for the terminally ill is the way of truth- with compassion, empathy and hope. True hopes are based on the truth that there is always more to do for the patient- even when there is nothing more to do from medical standpoint. Redirecting hope should be an end-oflife goal for both the physician and the patient. It helps for the physicians to understand the three stages of hope. Thus, hope can be changed, realigned, refocused and redefined. True hope for a patient who is dying can take many forms. There is the hope of being reconciled with one's past. I have witnessed countless families brought back from estrangement during the final months. At AseraCare Hospice we often do life review - allowing a patient to find meaning and set goals from the past. There is the hope to love and be loved. Many want to see their friends and family to give and receive forgiveness, thankfulness and love. This may require time and planning. Sadly, I have seen many patients not experience this healing because false hopes led them to be unaware of how sick they truly were and they simply ran out of time. Some have the hope of attaining specific goals. At hospice one of our initial questions is, "What goals do you have for your remaining days?" These are the types of answers we often hear: "I hope to attend the wedding of my granddaughter, Juli." "I hope to see Joseph, my new grandson." "I hope to see another Christmas." At AseraCare Hospice, we encourage the patient to set realistic goals. Some patients simply hope they will be able to remain at home and die with family and friends around. Others hope to get their financial affairs in order for their spouse and children. Others have a strong desire to transmit wisdom and words of knowledge to their children. Don't forget spiritual hopes. I have seen many patients talk excitedly about heaven and what expectations they have. And there is the hope that, just as one might find meaning in life, one might find meaning in the mystery of death. As a hospice physician, I have witnessed a truth that was not as apparent to me when I was in private practice: As patients near the end of life, their spiritual and religious concerns are often awakened and intensified and this gives hope. The hopes that I listed above are true hopes- rooted in the strong soil of integrity. Vaclav Havel said, "Hope is not the conviction that something will turn out well, but the certainty that something makes sense, regardless of how it turns out." All of the above hopes help a person make sense of life and sickness and death. AseraCare Hospice is based on physician, nursing, counseling and spiritual care. Studies have shown that hospice care fosters hope - and hope actually increases as death approaches. Many have voiced disbelief at such a notion. Interestingly, in my experience, this increase in hope as death approaches is a common occurrence - provided that adequate care and comfort are provided in all the dimensions of a person's life. I think of a recent patient of mine who, before he died, visited all of his children in Indiana, celebrated his last wedding anniversary on a cruise ship, reconciled with an estranged brother, took communion for the first time and died in his home surrounded by family and friends and hospice. All too often, I have seen patients undergoing futile therapy, clinging to false hopes, avoiding hospice and never finding the true hopes that give death its dignity and meaning. Soren Kierkegaard, the great philosopher, said, "To die well is the height of wisdom." I believe that one of our most important "callings" is to help our patients die with hope. AseraCare Hospice can help patients do that. For more information call
251-246-4113 or 877-208-4113
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