How to plan hospice

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Deep down, most of us have at least a vague idea of ​​wanting a good death. But what does that mean for you, and how can you plan for hospice? What does hospice care include?

1. What is hospice?

It may not be easy thinking about death and what you want at the end of your life. You may have a lot of hard choices to make. But if you have a hospice plan, it can give you peace of mind knowing that your wishes will be fulfilled.
It also relieves stress for your loved ones. They won't have to guess about what they think you'll want. Hospice care is support for people who are in the last months or years of their lives.
Hospice will help you live the best you can until you die and die a decent death. Those who provide your care should ask you about your wishes and preferences, and take these into account as they work with you to plan your care. They should also support your family, carers, or other people important to you.
You have the right to express your wishes about where you want to be cared for and where you want to die. You can get hospice care at home, or in a care home or hospital, depending on your needs and preferences.

2. Hospice services for patients

An important question to ask yourself: What treatment do you want at the end of your life? This mainly involves life support measures such as artificial respiration, feeding tubes and ventilators.
Doctors use life support when certain parts of your body cannot function as they should. It can ease the pain or keep you alive until you start to get better. But in some cases, the same treatment may just lead to a slower death and a lower quality of life.
If you choose the option of opting out of life-saving measures (No Recovery or DNR), you will still receive medical care. The doctors will still manage your pain and provide the other support you need.
CPR: Doctors use CPR (cardiopulmonary resuscitation) if your heart or breathing stops breathing. They can:
Press hard on the chest several times Blow air into the lungs Use electric shock, called “defibrillation” and medicine to start the heart. CPR works best when you are mostly in good health and someone starts doing it right away. But if you are seriously ill, it may not work. You can also get injured from too much force on your chest.
If you do not want CPR and you are in the hospital, your doctor needs to put a do not resuscitation order in your medical record. If you're at home, some places allow your doctor to write a "no admission order" so emergency personnel know they don't have to give you CPR.
Feeding tube: If you are unable to feed or drink on your own, doctors may want to use a feeding tube to give you nutrients. In some cases, a feeding tube can save your life. It provides your body with food and fluids until you get better. It is also needed for some long-term illnesses.

Near the end of life, a feeding tube may be less useful. It does not cure or cure any illness. And it can cause even more problems than not eating at all.
Doctors and families may disagree on this, so it is important that your loved ones know your wishes.
Ventilator: A ventilator is a machine that pushes air into your lungs to help you breathe. You may need it for a short time until you can breathe on your own. In some cases, such as a spinal injury, you can use it longer.
However, when you are at the end of life, a ventilator can do more than save you from death. As with other life support treatments, it gives you more time, but is not a cure.
Organ donation: You may also want to consider whether you would like to donate your organs. Whatever your choice, it's best to let your loved ones know so they can support your decision. If you want to donate, you can register in the hospital's organ donation register.

3. What is palliative care?

Hospice includes palliative care. If you have an incurable illness, palliative care will make you as comfortable as possible, by managing your pain and other symptoms.
Palliative care also involves psychological, social and emotional support for you and your family or carers. This is called a holistic approach, because it deals with you as a "whole person," not just your illness or symptoms.
Palliative care isn't just for the end of life, you can get palliative care earlier when you're sick, while you're still receiving other therapies to treat your condition.
Many healthcare professionals provide palliative care as part of their job. An example would be the care you get from your GP or community nurse.
Some people need additional specialist palliative care. This may be provided by consultants trained in palliative medicine, specialist palliative care nurses, or therapists or physical therapists.
Palliative care teams consist of different health care professionals and can coordinate the care of people with terminal illnesses. As therapists, they also advise other specialists on palliative care.

4. Your representative

While it's important to think about what you want and make choices, you can't plan for every possibility. And you may not be healthy enough to make decisions for yourself. This is why you may want to have a health care agent.
This is someone you choose first to make health care decisions for you. This person could be almost anyone: Family, friends, a lawyer, or someone from your faith group. You'll want to be clear with them about your wishes.

5. How to Make Hospice Choices

End of life choices can be difficult to make. Not only do you have to think about your own death, but there are medical and legal decisions that aren't easy.
One way to understand what you really want is to talk about it. You can ask family and friends, your doctor or your lawyer. All can help in different ways.
Family and friends: When you're talking to your loved ones, getting started can be the hardest part. Here are a few ways to approach it:
Bring up a relevant topic, such as if you just made or updated your wish. Share your values ​​about the good life: What gives you meaning, what are your beliefs, how do you feel about dying. Let them know what you think about it, such as an event, an article, or the death of someone close to you. When and where to best discuss your wishes depends on you and your family. You may want to speak in person or perhaps with a small group. If you talk before you get sick, it can help you and your family feel at ease.
Doctor: When you see a doctor, you naturally focus on taking care of your health in order to live as long as possible. But it's never too early to question your doctor's end-of-life options. In fact, it can be easier to think when you're not facing a serious illness. Your doctor can guide you through the pros and cons of the most common problems.
Attorney: To make your wishes clear, you can use two different legal forms known as “advance directives”. The first is a living will, which tells the doctors how you want to be cared for at the end of your life.
The second power of attorney is called a health care power of attorney, which names your health care agent. This is a person or people who can speak for you if you lose the ability to make decisions. In addition, it can be canceled or changed at any time.
Sometimes, families need to make decisions for a loved one who is no longer conscious. They may not know what the dying person wants; for example, if someone has an accident or other emergency.

If you need to make these choices for someone close to you, you can try to put yourself in their shoes. What is important to them? What do you think they want? How did they live, and what can this tell you?
Another idea is to try to think of the person's best interests. If you let the person go first for treatment, will they be in pain? What will their quality of life be like in the future?
You can also talk to your family. If your family members can't agree, you may need to talk to a mediator. This is someone who helps people find common ground. You can also check with the hospital to see if they have someone who can help you decide as a support group.
No matter how well people know you, your wishes about how you want to die may not be clear. When you make choices before that time, put them in writing, and talk to your family, you can bring relief to yourself and those who love you.

6. Plan ahead for hospice

This is sometimes called advance care planning, which involves thinking about and talking about your wishes for how you will be cared for in the final months of your life. This may include treatments you don't want to have.
Such advance planning can help you let people know your desires and feelings while you still can. Letting your family know about your wishes can help them if they have to make decisions about your care.
Tips to help you make hospice choices:
Why plan ahead: How you and your family, friends and carers can benefit from planning Plan ahead for your future care. Pre-report: Learn what a pre-report is and how you can create it to let people know what you're looking for. Advance decision (living will): If you do not want certain forms of treatment in the future, you can make an advance decision that is legally binding. Enduring Power of Attorney: Learn how you can legally appoint someone to make decisions about your care in the future if you are unable to make decisions yourself.

7. When does hospice care begin?

Hospice care should start when you need it and can last a few days, or months or years before death.
People in a variety of situations can benefit from hospice. Some of them may die within the next few hours or days. Others receive hospice care for months.
Humans are considered to be nearing the end of their lifespan when they are likely to die within the next 12 months, although this is not always predictable. This includes people who:
Have a terminal illness, such as cancer, dementia or motor neuron disease. People who are frail and have co-morbid conditions mean they are expected to die within 12 months. People are in danger of dying from a sudden crisis in their condition. Person with an acute life-threatening condition caused by a sudden catastrophic event, such as an accident or stroke

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Reference sources: webmd.com, nhs.uk