BY RABBI BARRY COHEN
In February, we learned that President Jimmy Carter, his health declining, chose to receive hospice care in his Georgia home. In the final stages of his life, Carter continues to teach us.
His choice is teaching many Americans about the nature of hospice care and the crucial role it can play. He chose to end medical treatments for the cancer that has spread throughout his body. That being said, he will still receive medications to lessen his pain and maintain his quality of life as much as possible.
With his remaining time, he can live as he wishes so that he experiences as much joy and meaning as possible. Most people experience hospice at home. They sleep in their own bed, wear their own clothing and spend time where they are the most comfortable. If they have enough strength and stamina, they can eat what they want, get outside or even travel to favorite local places.
They have peace of mind knowing that a care team is there for them for regular visits, to address their needs and to manage their pain.
This makes the timing of when one enters hospice care crucial. I have worked with too many people who began hospice with only days to live. At that point, they are often unconscious, incapacitated or cannot communicate. They spend their remaining time in bed, often disconnected from their loved ones and from the world.
A sweet spot exists with hospice care. This sweet spot begins when individuals know that obtaining a cure for their disease is highly unlikely. It begins when they have had enough of painful treatments that sap their strength, restrict them and only enable them to live additional pain-filled weeks or months. It begins when they know that if they keep chasing a cure, they will die in a hospital bed.
Individuals can enter hospice care when doctors determine they have six months left to live (though this is often an approximation).
Choosing hospice care enables people to have greater control over how they die and where they die. And this choice benefits more than just the person who is dying. It benefits family and friends. During their remaining time, they can foster amazing memories. They can have beautiful conversations. They can resolve much of the past and achieve a sense of closure.
In this way, though a hospice patient will not obtain a cure, he or she can experience healing. Time spent in hospice can enable them to heal psychologically and spiritually, despite the fact that the body is dying.
I encourage you to take this time in the aftermath of President Carter’s entering hospice to learn more about hospice care and how, when the time is right, you can make a similar decision to control your own health care. However, we must choose wisely. There are some hospice organizations that advise us to enter too early and encourage us to accept treatments that benefit their bottom line more than the quality of our lives.
Choosing the nature of hospice is a way to strategize our final weeks or months. The older we get, the more we learn that we slowly, steadily lose control. Hospice care gives us back control. A critical aspect of our decision is that it is not final. We have control to end hospice care if we want to make one last attempt to receive curative treatments. And then, if necessary, we can choose to go back on hospice.
Please do not wait until it is too late to have a hospice plan. We have at our fingertips a means to maximize the quality of our final weeks or months. What a precious opportunity for those who are dying and for their loved ones to heal – personally and privately.
Rabbi Barry Cohen is the Jewish community chaplain of the Greater Portland area. chaplain@jewishportland.org
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