YES NO

Our agency has a hospice and a palliative care program.  “John”, ninety-three, has suffered from Alzheimer’s Disease for over seven years.  I first met John, and his daughter, “Tammy”, one year ago when we admitted him to our hospice program.   Initially, John had been in a slow decline to where he was becoming weaker, sleeping more and eating less.  In the past few months, that decline slowed down to where John is now stable in his disease process. 

When Tammy was informed that hospice will be discharging her father secondary to hospice’s guidelines, she became very angry.  Her anger grew out of frustration as she knows the tremendous support hospice offers.   John has full time caregivers and is receiving excellent care, but with hospice, families do not call 911, but call hospice.  Hospice phones are picked up and answered twenty-four hours a day. 

After transferring John from our hospice to our palliative care program, the hospice nurse and I went out to do our second admission.  “Elizabeth”, eighty-seven, also suffers from Alzheimer’s Disease.  Prior to the admission visit, “Lynda”, Elizabeth’s daughter, asked that we not say the word “hospice” in front of her mother.  Lynda says it makes her mother shaky and afraid; while then adding, “Mom would then likely say no to coming onto hospice.”   Talking with Elizabeth, I have a strong sense she knows what is going on.  Our goal is to support all of our patients and families the best way we can.  Nothing more.

YES NO

 

I first met he and his daughter

over fourteen months ago.

We admitted him to hospice

secondary to Alzheimer’s Disease.

 

Hospice follows Medicare guidelines.

If we didn’t, we could lose our license.

His decline has been so very, very slow;

whereby no longer meeting those regulations.

 

She was so frustrated; so angry.

“How could you be doing this to my father?

We don’t want to call 911.

It’s an absolute YES, we want to stay on hospice!!”

 

She, too, has Alzheimer’s Disease.

“Please don’t say hospice in front of her.

It makes her anxious; it makes her afraid.

We need your support, but don’t say that word”.

 

She wants to protect her mother too.

She doesn’t want her to be frightened,

although she knows she needs the support.

We then signed her up to our program “quietly”.

 

I asked Mom if she had any fears; any concerns.

“No, I know where I am going”

I believe, she likely would say yes to hospice,

but her loving daughter believes she would hear a “No”.

 

We want to offer every patient and family

the best support that is available.

We will continue to do our blessed work

whether it is a strong “yes”

                    or a very quiet “no”.