Planning For Hospice & End Of Life Care

Planning for hospice and end-of-life care is never an easy conversation to have. The mental, emotional and physical exhaustion in loved ones in need of treatment and their caregivers is something that shouldn't be ignored. Even with a decision to end treatments and begin end-of-life planning, your loved one's quality of life shouldn't be left out of the equation.

Michelle Morrill, RN, hospice manager with Franciscan Health Hospice House in Indianapolis, explains how hospice works and why it can be a great fit for your loved one's end-of-life plan.

What Is The Goal Of Hospice?

"The primary goal of hospice is to celebrate life and to prepare people for ultimately death," Morrill said.

Hospice recognizes dying as a natural process that neither hastens nor postpones death. With Franciscan Health, hospice exists in the belief that loving care will help patients and families remain in control of their lives. It can emotionally and spiritually prepare one for death when curative treatment is no longer possible.

Hospice provides specialists who provide help and support during this difficult time. The hospice team works with the physician and family to develop a care plan that meets the patient’s and family’s needs and wishes concerning treatment and lifestyle.

The hospice care plan may include:

• Medical management
• Pain management
• Emotional and spiritual support
• Practical support with daily tasks

Morrill explained that the hospice team focuses on quality of life and educate family members on hospice.

"We all do a really good job of preparing people for the beginning of life, but not so great a job for the end-of-life, which we're all going to ultimately meet," Morrill said.

What Are The Options For Hospice Care?

Hospice care is about preserving your loved one's quality of life when they end their treatments. Since everyone has a different view on quality of life, having options for hospice care is essential.

"We get a lot of referrals from the hospitals," Morrill said. "Some options are set up where they provide hospice care in the hospital. With Franciscan Health, since we have a freestanding building, we provide hospice care here at the hospice house."

Morrill also explained that they provide hospice care in homes and nursing homes.

"Some people think that hospice is a place, but it's really about maintaining where you where you want to be," Morrill said. "Most people say they want to be at home with their family, pets, their grandkids or whoever is important to them. That's where they'll be."

What Are Some Misconceptions About Hospice?

"Hospice is a type of care, but people often think it's a place," Morrill said. "While Franciscan is blessed to have a freestanding hospice building, most people receive care in their home. So, that is one of the misconceptions."

Morrill explained that another misconception is how they care for a person in hospice.

"Some may think that deciding on hospice is giving up, or that the person doesn't want to stop treatment, even though they're tired because they don't want their family to think they're giving up. It's not an easy choice," Morrill said.

Morrill explained that while a doctor can suggest hospice care, families or the patients themselves can start the conversation themselves if they're ready to stop seeking curative treatment.

What Is Hospice Respite Care?

Caregiving for a loved one can be physically, mentally and emotionally exhausting. Hospice respite care is designed to help caregivers rest and recover.

"Respite care is a hospice benefit," Morrill said. "We provide five days of overnight care in our hospice house to families if they need a break. It's designed because it wears on a person. You're not only doing physical care for them. You're emotionally attached to the situation.

"You need to be able to know that your loved one is being cared for appropriately so that you can read a book, take a nap or get some groceries. That's what respite care allows."

How Does Franciscan Health Hospice Differ From Others?

Hospice care is a service in many healthcare spaces, but Franciscan Health prioritizes care, comfort and connection. This includes care options in the home and at the hospice house on the Franciscan Health Indianapolis campus.

"We have a beautiful 16-bed facility right here on the Indianapolis campus," Morrill said. "We're connected with the Franciscan system, so we provide continuity of care from those Franciscan doctors directly to our hospice house. We also take referrals from outside sources."

Morrill explained several services that are provided within hospice at Franciscan Health, including:

• Social workers
• Music therapy
• Pet therapy
• Massage therapy
• Spiritual care

"Our particular team is very kind, loving and gentle," Morrill said. "They really become an extension of the family and function. We want to take care of you, answer your questions and realize that this is such a special time of life to be honored."

The dedication of the staff makes their team unique and positively impacts the outcome of care, she said.

"Death is sad and we grieve," Morrill said. "Still, if you know that you did everything you could for a family member, which includes providing excellent care for both you and your loved one, it's a positive memory to leave."

Can Your Loved One Still Seek Treatment While In Hospice?

While hospice focuses on a comforting end-of-life surrounded by friends and family, some may wonder if treatment during hospice is still an option.

"At the time somebody has chosen hospice care, they've decided that they're no longer seeking curative treatment for whatever diagnosis brings them in," Morrill said. "So if their diagnosis is cancer, they're no longer seeking chemotherapy or radiation."

Morrill explained that hospice teams focus on symptom management. Still, if your loved one has other conditions unrelated to their primary diagnosis, they can receive treatment.

How Can A Caregiver Help A Loved One With End-of-life Planning?

Even with families putting their heads together, it can still be challenging to help a loved one with end-of-life planning. Still, there are options to help you find what makes sense.

"That's really a big piece of where our social workers come in," Morrill said. "We do talk to families and see if have advanced directives. This way, we can confirm and honor a person's choices at the end of their life."

Morrill explained that if caregivers don't have specific choices, social workers can direct them to the correct paperwork and a lawyer if they need to be involved.

"Something else that goes along with end-of-life planning that we don't often think about is a life review from the patient's point of view," Morrill said. "Sometimes documenting their experience and leaving that for family is just as valuable as official documents. It lets them leave a piece of themselves behind."