In the midst of all the conversations surrounding daily life, it’s healthy for families to talk about end of life.
That’s what Cathy Kellogg, RN, Avera@Home Hospice Manager believes, because she sees many families struggle with end-of-life decisions – simply because they never started a conversation. “Healthy communities talk about dying. It is such a gift to your family to discuss what really matters to you at the end of life.”
Kellogg speaks with patients, families and community groups about starting the conversation, and offers a tool known as The Conversation Project to help families broach this often difficult topic. The Conversation Project was founded by Pulitzer-prize winning writer, Ellen Goodman, as she went through the end-of-life journey alongside her mother.
Kellogg is often surprised at how willing and even eager people are to join the discussion. “We think people don’t want to talk about it. We assume that talking about death with our parents or grandparents is not honoring to them. But this is not true.”
According to Consumer Reports, 86 percent of people want to spend their final days at home. That compares to about 70 percent of people who die in a hospital, nursing home or other institution. “There’s a huge disconnect,” Goodman says.
When people express their wishes in advance through a living will, it lifts a burden from caregivers, who often feel “blind-sighted and unprepared” when it comes to making these decisions, Goodman said. “This experience is far too common. People are not dying in the way they would choose, and survivors are feeling guilty, depressed and uncertain of whether they did the right thing.”
A living will is not complicated. It’s a simple statement concerning your wishes about life-prolonging treatment if death is imminent.
When patients receive a prognosis that their condition is terminal, it’s often a crossroads between deciding whether to have traditional treatments to try to prolong life, or palliative care to feel as comfortable as possible at end of life.
Traditional treatment at end of life can be costly, and it may or may not actually lengthen life or improve quality of life. According to the Medicare Newsgroup, Medicare spends about $39,000 during the last year of a patient’s life, compared with about $6,000 per year for other beneficiaries.
The care and support at end of life offered by hospice programs is underutilized nationwide.
People qualify for hospice care during the last six months of life, either in their own home or in a hospice facility, like the Dougherty Hospice House on the Avera Prince of Peace campus in Sioux Falls. Yet the average hospice length of stay nationwide is 40 to 60 days. “People are eligible for 180 days, but they’re only getting 40 to 60 days,” Kellogg said.
If families believe their loved one might benefit from hospice care, they can talk to their loved one’s physician about a referral, or contact Avera@Home to learn more.
Hospice care can help make the remaining days of a loved one’s life more peaceful. Families can concentrate on spending quality time together, rather than worrying about caregiving tasks.
“Anytime someone knows they have a limited amount of time to live, time becomes very precious,” Kellogg said. “These sacred days are an opportunity for growth; an opportunity to heal strained relations or say your ‘thank yous’ and ‘I love yous.’ These words will linger with those you love for years to come.”
November is National Home Care and Hospice Month. To learn more about these services, go to AveraAtHome.org. To learn more about the Conversation Starter Kit published by the Institute for Healthcare Improvement, go to theconversationproject.org