There are just two ways to die, fast and gradual. Gradual death has a process to it. If it were happenstance and just happened it would be a fast death. Gradual death occurs either because of old age or disease. With diseases the process begins months before actual death and in old age the process takes years.

Most people have never considered what has been written in the above paragraph. Yet everyone will be faced with the experience of death, someone they care about or their own. Through out most of American society the idea of dying is held in the back recesses of the mind. Only when life forces it upon us do most consider addressing the issues dying and death presents.

Funeral industry, hospice and the newest member Palliative Care are the few service providers that dare approach the subject of mortality. Funeral out of necessity, hospice and palliative care out of the perceived need for more support and information.

Many agencies, home health, churches as well as physicians are reluctant to recommend hospice services. It is sad and confusing why anyone would not give their friends, clients or customers the guidance and comfort that trained hospice professionals can offer. Maybe this reluctance to refer has to do with seeing death as a failure, maybe it is just ignorance as to the true value of hospice. It is perfectly acceptable to ask a physician for a hospice referral.

If the signs are there, get the referral and let a hospice professional determine if Hospice is appropriate. Three things I look for to tell me if it is time for Hospice are: 1. the patient’s condition is deteriorating in spite of the treatment that is being given. 2. You look at the person and say to yourself (and we have all done this but often not wanted to admit it) this person is not going to be here next year at this time. 3. the family and significant others are having difficulty coping with the seriousness of their loved one’s condition.

We generally give people more time then they have. I know it is scary to think of using hospice just as it is scary to make funeral arrangements. It says death will happen soon, but there is such guidance and support to help that at least ask for an information visit.

A hospice referral is a win win. You win if they say it is too soon and you are not appropriate for hospice care or you win by coming onto the hospice program and getting much needed guidance, information and support.

Sometimes patients rally once they are with hospice care. I think it is because hospice is the expert in pain management and comfort care and brings that to the patient and family. Everybody begins to relax a little. You feel less alone, less isolated and have more knowledge about what happens as death approaches.

I know people think of Hospice as caring for those people that are dying but remember we are all dying. Hospice guides and supports people who are in the final act of living.

Something More about WHY NOT HOSPICE, A Reluctance To Refer...

"Dad was showing these signs months ago" is a common response hospices hear from families after reading  GONE FROM MY SIGHT. The information provided in the book regarding signs of approaching death is what physicians need to offer families much sooner than they normally do.