Tips on How to Have the Hospice Conversation with a Lucid Patient

Hospice is a service that is geared toward making the final days of one's life more comfortable and fulfilling. Employees work to ensure that the patient is in minimal pain, that final legal and financial arrangements have been made, and that the patient eases into their final moments as peacefully as possible. In many cases, the family is more comforted than the patient, as the patient is generally to the point in their illness that psychological sharpness has begun to fade. However, some fatal diseases affect the body severely, yet never affect the mind. Even medication for pain can leave such patients still fully aware of their surroundings. Therefore, explaining to the sufferer that hospice is to come in, which is a service reserved for those who are generally expected to pass on within a year's time, can prove quite difficult. Family members worry that telling an ailing but mentally sharp loved one that the service will be provided may mean appearing to have given up. If that situation sounds similar to your own, take heart. Consider the following tips on how to have the hospice conversation with a lucid patient.

Tip #1: Focus on increased comfort rather than final preparations. While hospice does come in to help patients make final legal and financial arrangements, they may be able to do so with legal guardian or appointee. Rather than focusing on this aspect of the situation, it may be best to open the conversation with a focus directed at increasing the patient's level of comfort as well as increased quality time with loved ones when the burden of care is removed from them.

Tip #2: Try to determine the patient's psychological stage of death acceptance. Upon learning that one has a fatal disease, most of us go through different mental stages. These stages generally include denial, anger, a negotiation with fate, depression, and finally, acceptance. While one may not appear to go through all stages or may not go through them in that specific order, understanding where the lucid, mentally clear patient stands in the process may aid family members when deciding how and when to approach the hospice conversation.

Tip #3: Consider describing hospice gently as an alternative to an institutional end. Most of us will pass away in hospital rooms, perhaps alone with no familiar people or material possessions to comfort us. Such a death is often referred to as being "institutional." Rather than being a sign of an impending death, hospice can be a welcoming alternative to being ill in a hospital room for an extended period of time.

Tip #4: Rather than using the term "hospice," consider replacing it with the phrase "home care." Hospice can be a scary word for the lucid patient to hear, especially if they are still trying to fight a disease that is currently winning the war against them. Instead of using a word that has become synonymous to the terminally ill with giving up, focus on stressing phrases that they may be more comfortable with.

Tip #5: Consider carefully who should be present for the initial hospice conversation. Sometimes a lucid patient will want to be told about changes in their situation in an intimate setting by a spouse or very close loved one, but others may feel that hearing such news alone with a single family member or friend would be overbearing emotionally. Having several people in the room to offer support may be helpful. However, every patient is different, so make the choice accordingly.

Finally, consider having the family doctor, a pastor, and/or a trusted counselor on hand when explaining to a lucid patient that hospice care will be in their near future. Also consider consulting with a professional before utilizing the tips above, as all situations will vary. Stay calm during your conversation, and remember to prepare yourself for it ahead of time as well. Every family member or friend involved with this difficult process may benefit greatly from advice and counsel from a caring professional.