Hospice

The terms "palliative care" and "hospice" mean different things to different people. Here, "hospice" is taken to mean a facility that provides an alternative home for people living with a terminal illness. These people need a community, home-like environment and specialized care, yet their care isn’t so complex that it requires a hospital.

Decisions about admission to a hospice depend on the care a person needs and the specific hospice setting. For example, someone may enter a hospice when care can’t be provided at home or when other options have been ruled out. The admission criterion varies among areas and among individual hospices. Palliative care providers or programs in your area may help you determine the best timing for admission to a hospice.

Your current situation must seem overwhelming. So it’s natural to want to take control. In hospice, you can have a lot of control over your own health care.

Before you enter hospice, it’s a good idea to meet with your health care team. They are the doctors and nurses who will provide your care. Review how you are feeling now and what might happen as your illness progresses. Tell them how you wish to have your future care provided. For example, discuss how you want your pain controlled. Once you have talked about your wishes, write them down in a health care directive, a personal directive, or a living will. This process is called advance care planning. Talking about and writing down your wishes is very helpful in case you can’t communicate with your health care providers later.

When people explore options for an early death, they are often concerned with how things will go. Will pain become more difficult to manage as their illness progresses? Will they have control over their pain medication amount? Our experience is that there are many options available to manage your pain.

There are limits to what you can ask from your health care providers. They must follow the law and uphold the standards of their professional practice when providing your care. But it’s important to talk openly and honestly with your nurses and doctors. Ask them the difficult questions on your mind. Then they will know what worries you and can explain options for your care.

Your doctor can’t suggest how much morphine might cause your death. But he or she can discuss the issues raised by your question. So be open with your concerns about pain. Tell your doctor if you feel unsure about what lies ahead, or if you are afraid of losing control. Mention if you are feeling depressed or are in spiritual distress. This is an opportunity to explore these issues and find some peace of mind.

We encourage you to seek support to help you through this difficult time. This can include getting information and finding help with care and other tasks. Talking to someone, sharing your concerns and asking questions are all important ways to feel heard. Begin by finding out about support services in your area. Some good places to start are cancer care clinics, hospice palliative care centres and your regional Cancer Society. They have staff and volunteers who can offer a “listening ear.” These specially trained people can offer emotional and spiritual support, as well as practical assistance.

It’s normal to turn inward when we are suffering or scared. Becoming informed and doing some advance care planning can help you maintain control and reduce the desire to have death come sooner.
Some people find it helpful to share with others who are travelling a similar road. You might like to take part in our Discussion Forums.