This content does not have an Arabic version. See more conditions. Healthy Lifestyle End of life. Products and services. Hospice care: Comforting the terminally ill Hospice care might be an option if you or a loved one has a terminal illness. By Mayo Clinic Staff. Thank you for Subscribing Our Housecall e-newsletter will keep you up-to-date on the latest health information. Please try again. Something went wrong on our side, please try again.
Show references Meier DE, et al. Hospice: Philosophy of care and appropriate utilization in the United States. Accessed Dec. Hospice care. American Cancer Society. Medicare hospice benefits. Centers for Medicare and Medicaid Services. National Hospice and Palliative Care Organization. Hospice care: A consumer's guide to selecting a hospice program.
Hospice FAQ's. Choosing a quality hospice for you or your loved ones. See also Caring for someone who is dying Home care services Living wills Terminal illness. Mayo Clinic Press Check out these best-sellers and special offers on books and newsletters from Mayo Clinic.
Communicate with family members. Choose a primary decision maker who will manage information and coordinate family involvement and support. If children are involved, make efforts to include them. In these situations, planning ahead is important. Hospice is typically an option for patients whose life expectancy is six months or less, and involves palliative care pain and symptom relief to enable your loved one to live their final days with the highest quality of life possible.
With the support of hospice staff, family and loved ones are able to focus more fully on enjoying the time remaining with the patient. The hospice team makes regular visits to assess your loved one and provide additional care and services, such as speech and physical therapy or to help with bathing and other personal care needs.
As well as having staff on-call 24 hours a day, seven days a week, a hospice team provides emotional and spiritual support according to the wishes and beliefs of the patient. Some questions to ask yourself when deciding to undertake end-of-life care of a loved one at home:.
While the symptoms in the final stages of life vary from patient to patient and according to the type of life-limiting illness, there are some common symptoms experienced near the end of life. However, some emotions are common to many patients during end-of-life care. Many worry about loss of control and loss of dignity as their physical abilities decline. As a late-stage caregiver, you can offer emotional comfort to your loved one in several different ways:.
Keep them company. Talk to your loved one, read to them, watch movies together, or simply sit and hold their hand. Instead, talk to someone else about your feelings. Allow your loved one to express their fears of death.
Try to listen without interrupting or arguing. Allow them to reminisce. Talking about their life and the past is another way some patients gain perspective on their life and the process of dying. Avoid withholding difficult information. Honor their wishes. End-of-life care for many people is often a battle to preserve their dignity and end their life as comfortably as possible.
The end-of-life period —when body systems shut down and death is imminent—typically lasts from a matter of days to a couple of weeks. Some patients die gently and tranquilly, while others seem to fight the inevitable. Reassuring your loved one it is okay to die can help both of you through this process.
Although this is a painful time in so many ways, entering end-of-life care does offer you the opportunity to say goodbye to your loved one, an opportunity that many people who lose someone suddenly regret not having. No one can predict when that last minute will come so waiting for it puts a huge burden on you. Just talk, even if your loved one appears unresponsive.
Hearing is the last sense to shut down, so even when your loved one appears comatose and unresponsive, there is a strong likelihood they can still hear what you are saying. Identify yourself and speak from the heart. Touch can be an important part of the last days and hours, too. You can say goodbye many different times and in many different ways. You can do it over days. After your loved one has passed away, some family members and caregivers draw comfort from taking some time to say their last goodbyes, talk, or pray before proceeding with final arrangements.
Give yourself that time if you need it. Research suggests that spousal caregivers are most likely to experience despair rather than any kind of fulfillment in their caregiving role.
Many caregivers struggle to make difficult treatment, placement, and intervention choices through the pain of these continuous losses.
While pain and suffering cannot be totally eliminated, you can help to make them tolerable. Even when your loved one cannot speak or smile, their need for companionship remains. They can no longer recognize you but may still draw comfort from your touch or the sound of your voice. When death is slow and gradual, many caregivers are able to prepare for its intangible aspects, and to support their loved one through the unknown. Talking with family and friends, consulting hospice services, bereavement experts, and spiritual advisors can help you work through these feelings and focus on your loved one.
Even if you have chosen not to use a full range of hospice services, some resources are often available. Ask a doctor to help. Some doctors can ask gently about fears, as well.
Some feel determined to try everything and view death as a failure. Being human, they have their own fears and discomfort to deal with, too. Let it go. Let your loved one end conversations that feel too difficult. Allow them to hold on to comforting thoughts and fantasies. A New England Journal of Medicine study reported that longer, more empathetic end-of-life conferences eased stress, anxiety, and depression in family members of people who died in intensive care units ICUs.
Conducted in 22 ICUs in France, this randomized trial divided families of patients into two groups; those in one group had short, standard conferences, and those in the other engaged in longer sessions and received a brochure on bereavement.
During the longer sessions, staff focused on listening, acknowledging and valuing feelings, encouraging and responding to questions, and gaining an understanding of the patient as a person. When the researchers contacted a representative in each family 90 days later, they found that those who attended longer end-of-life conferences had significantly lower scores on measures of stress, anxiety, and depression than did family representatives from the control group.
Few of us wish to think about practical matters at difficult times. The sections below address the topics of advance care directives which set forth how a person hopes to be treated medically toward the end of life , hospice services, and organ donation. These documents address how aggressively doctors should pursue life-sustaining measures and whether quality of life or comfort should be paramount concerns.
State laws vary, so it is important to make sure any advance directive complies with local regulations. Or have your loved one discuss this with a lawyer qualified in elder law. Rather than sidestepping this difficult issue, though, consider that mulling over wishes for end-of-life care can help people sort out values and feelings about medical measures often taken at the end of life. A frank talk with a doctor about possible medical scenarios can provide guidance.
It may help to know that if the person who wrote the advance directive has a change of heart at any time while under medical care, their spoken wishes override any written ones. These wishes should be communicated fully with everyone involved. Make sure you or your loved one takes the following steps:. This document is written only when these measures are unlikely to revive a dying person or to prolong meaningful life. Generally, during the last stage of a terminal illness, CPR is not very likely to result in successful resuscitation.
Hospice care—which encompasses physical, emotional, and spiritual needs—may take place at home or at a nursing home, assisted living center, or hospice residence. The hospice team works with the patient to develop a personal plan of care.
Family, partners, and close friends may be invited to help in many ways, such as by assisting with daily tasks like feeding and bathing and offering comfort by reading, sharing music, holding hands, and simply being present. As you consider hospice programs, the Hospice Foundation of America suggests you ask whether each is licensed and Medicare- or Medicaid-certified, or certified by other organizations.
Find out what services are available, whether insurance or Medicare or Medicaid covers these costs, and what out-of-pocket expenses are typical. Sometimes a sliding-scale payment plan is available for services that insurance will not cover.
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