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Categories > Aging Well > Life transitions

Balancing hope and truth
Plan for peace of mind
How hospice can help

Care at the end of life
Care at the end of life

The type of care you receive at the end of life depends on how well you plan ahead. To do that, you need to create an advance directive—a legal document that states what kind of care you want if, for example, you’re in a coma and can’t make decisions for yourself.

Your healthcare provider will help you sort through the options:

  • A living will is an advance directive that describes the kind of life-sustaining treatments you would want if you become seriously or terminally ill.
  • A durable power of attorney is an advance directive in which you choose someone, such as your spouse, a close friend or a relative, to make healthcare decisions for you when you’re unable to.
  • A do-not-resuscitate (DNR) order is a type of advance directive that states you do not want cardiopulmonary resuscitation if your heart stops or you stop breathing.

You can change or cancel an advance directive at any time as long as you’re competent and able to do so.

No one really wants to talk about death or make difficult decisions about care, particularly when they’re not feeling sick. But if you have a serious diagnosis, like cancer or heart failure, you must have such discussions to make realistic choices about your treatment options before an emergency arises.

Thinking through end-of-life care issues and taking the time to have a plan in place will spare you and your loved ones the anguish of making decisions about your care when things become critical.

Plan for peace of mind

One of the most difficult issues to plan for is when to end curative care and continue with only palliative measures, the type of care focused on reducing pain and helping you feel comfortable. It’s hard to fathom that the goal of care should ever change. But when cancer or another serious illness progresses despite surgery, chemotherapy or other attempts to fight it, you may want a plan in place that emphasizes what’s most important to you.

To find that out, ask yourself what you would do if you had only a few hours left to live. Many people say they would spend their time with family and friends or doing things they like to do instead of undergoing another treatment that offers little chance of survival and may make them feel sicker.

Does this mean you give up hope? No, but treatments that are no longer effective may prevent you from feeling well enough to enjoy spending time with family and friends.

How hospice can help

Hospice is an alternative approach to care aimed at maximizing your quality of life by relieving pain and suffering. Hospice programs employ a multidisciplinary team of professionals, including physicians, nurses, hospice aides, social workers, spiritual caregivers, therapists and volunteers who are available to you around the clock.

Hospice patients may be treated in any environment: your home, an assisted living facility, a skilled nursing facility or a hospital. Having hospice at home means nurses will serve as the liaison between you and your family and the rest of the care team. They’ll also help you obtain medical equipment, such as a hospital bed, a commode, a wheelchair or oxygen, and help coordinate aides and volunteers to bathe and dress you if needed, cook and provide respite to your family.