Dying in good health

Dying in Good Health, what? That sounds like an oxymoron. If you’re dying, how can you be in good health? What I mean is making your finals days, weeks and months the best that they can be.

We are all born into this physical world and we are all going to leave it. We have no control over our births, but fortunately, we frequently can exert control over how we pass away.

To give you a little background about me, I moved to Fort Dodge from Denver, Colorado about two months ago, to take the position of the UnityPoint at Home Hospice medical director. I’ve been a hospice physician for more than 10 years. One of the reasons this position was attractive to me, is that UnityPoint Health is very supportive of their hospice program and UnityPoint at Home Hospice provides many more services than the previous for-profit hospices with which I have been affiliated.

The care and compassion shown by the UnityPoint Health hospice staff is second to none that I’ve experienced. At the same time, it is concerning to me how few of the patients in the Fort Dodge area, take advantage of hospice.

Many individuals wait until the last days of life to elect hospice care. In July of this year, 57 percent of the patients who entered our hospice, passed away in seven days or less. The national average is 71 days. While I am glad that these patients received some benefit from hospice, they or their families, haven’t even come close to receiving the full benefit that hospice has to offer. I suspect that this late entry into hospice may be due to lack of knowledge of how hospice works. To that end, I want to discuss common hospice myths and try to dispel them.

Hospice Myth No. 1 — Hospice is a place.

UnityPoint Health — Fort Dodge, through amazing community support, is blessed with one of the nicest hospice houses that I’ve ever seen. The Paula J. Baber Hospice Home is a beautiful facility that rivals those in cities 10 times the size of Fort Dodge. While this facility is used for some hospice patients, the vast majority of hospice care is given where the patient lives, whether at home or in a nursing facility. Hospice providers come to the patient and assist them in being able to stay where they are comfortable.

Hospice Myth No. 2 — Hospice means you are giving up.

While medicine has made great strides in treating disease, it has not been able to stop the cycle of life and death. At some point in our lives, the quality of our lives becomes more important than the quantity of life. The field of medicine sometimes loses sight that treatments can be more uncomfortable than the disease itself. Patients frequently accept those treatments, without asking their health care providers about alternatives or telling their health care providers how they feel on a day to day basis. Hospice allows you to look at an alternative. It’s not about prolonging life, but trying to ensure that the days, weeks or months are the best quality you can experience.

Hospice Myth No. 3 — My doctor will talk to me when they believe that hospice should be considered.

Unfortunately, this is sometimes not the case. Multiple studies have shown that patients believe that their physician will bring up hospice, while many physicians wait for their patients to bring it up. The end result is that it’s not brought up in a timely manner. Patients and families need to be proactive in bringing up this topic to their health care providers.

Hospice Myth No. 4 — Once I go on hospice, I can’t come off.

This is totally false. Patients can elect hospice and if they decide that it is no longer needed, they can opt out. In fact, we “graduate” about 10 percent of our hospice patients, because they’ve improved so much, they no longer meet Medicare’s hospice criteria. Patients can rejoin UnityPoint at Home Hospice in the future if their health declines.

Hospice Myth No. 5 — If I go on hospice, I will have to give up my health care provider.

You can retain your health care provider when you enter hospice and our team works closely with them in providing your care. In fact, we prefer this if possible, as your health care provider is very knowledgeable about your illnesses and you likely have a good trusting relationship. Hospice will assist your health care provider as needed to provide a team approach to your care. Members of the hospice team may include a physician, nurse, nurse aide, chaplain, social worker, volunteer, music, massage and pet therapist as well as bereavement services for a patient and their families and friends left behind.

I have about a dozen more myths I could tell you about, more than can be fit into this article, so I encourage you or your family to gather more information. There are numerous informative web sites, or feel free to contact UnityPoint at Home Hospice for more information. We would be delighted to provide you information over the phone or in person.

If you know of someone who has used hospice services for a loved one, talk to them about their experience. You will almost never have someone tell you that they think they started hospice services too soon. Almost all of them will tell you that they “wished they had started hospice sooner.”

Rod Gottula, M.D., is affiliated with UnityPoint Hospice — Fort Dodge.

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