Talking about death and dying is difficult for family members and caregivers alike. However, a conversation about comfort care is essential if you want to know the wishes of your loved ones.
It’s perfectly fine to discuss your loved one’s end-of-life wishes and whether they want hospice care. It doesn’t have to mean that death is imminent or that there is no hope. In fact, your loved one may derive some comfort from the conversation, knowing that someone cares enough to want to understand their wishes. You can also use the discussion as an opportunity to cover details such as what kind of funeral service they would like and any life-prolonging treatments they may or may not want.
But when is the right time to begin these talks, and how should you go about bringing up the subject? The following guide offers some tips for how to talk to your loved one about comfort care options.
What is comfort care?
To begin with, it’s a good idea to get a picture of what comfort care looks like. The term “comfort care” can be used interchangeably with “palliative care” or “hospice care.” It usually comes into play when a patient has already been hospitalized on several occasions, and further medical intervention is thought to be unlikely to achieve a cure or recovery. In these circumstances, according to the National Institute on Aging, people at the end of life require care in four specific areas:
- Physical comfort
- Mental and emotional needs
- Spiritual issues
- Physical tasks
To address these needs, hospice care providers such as Wings of Hope employ teams of professionals, including physicians, nurses, social workers, therapists, home health aides, spiritual and grief support counselors, and trained volunteers. The care is centered around the patient and their family, anticipating, preventing, and treating suffering so the patient’s quality of life can be optimized.
During the comfort care phase of a patient’s life, any medical treatments that cause them further discomfort will generally be discontinued. However, others that reduce pain will still be used. For example, radiation treatment might still be used on terminal cancer patients to treat symptoms from inoperable tumors, but chemotherapy, which can be extremely uncomfortable, will usually not be administered.
To learn more about what is involved in comfort care, you can reach out to professional team members at Wings of Hope.
Who should be involved in the conversation?
Although the patient is central to discussions around comfort care, there are others who might need to be involved. For example, it’s probably best to talk to professionals at your local hospice, so you know your options in advance. You may also want to involve family members such as spouses, parents and children as appropriate. However, you should always be sensitive to the wishes of the person in question. For example, they might prefer a one-on-one conversation or having all the family around to talk together. It’s also possible they might want to keep discussions completely private.
When should you start discussing comfort care?
There are a number of life events that might trigger a discussion around comfort care. Some of these are:
- A loved one is diagnosed with a terminal illness
- Repeated trips to the ER or multiple hospitalizations
- Your loved one’s medical condition has significantly deteriorated, or they have been declining over a period of time
- Your loved one requests that medical care is discontinued or has said they are tired of it or discouraged by it
- Their physician has suggested hospice care during a routine appointment
It’s easy to let these events slip by if the conversation seems too difficult to initiate, but don’t let the opportunity slide. Your loved one might be waiting for you to begin the discussion.
What’s the best way to begin talking about comfort care?
Picking the best time and place to talk about comfort care is far from easy, but it’s vital to get it right. Once the right conditions are in place, it should become easier.
Choose a place and time that puts your loved one at ease. It’s best to ensure that there won’t be any distractions and that your conversation won’t be cut short. For example, don’t start a difficult conversation if you have to leave for work in an hour. Weekends and holidays are a good time and make it easier to gather more family members if needed.
Take your time, and don’t rush in with a sharp change of subject. Instead, look for cues from your loved one, such as mentioning that they are too tired to carry on or sick of so many trips to the hospital. Once the conditions are right, try to push your discomfort aside and start the conversation, perhaps with an opener such as:
- “You seem to be struggling more with walking and breathing lately.”
- “Maybe there’s a better way to manage your pain. Have you considered hospice care? They have experts in pain management.”
- “Would you like me to call the hospice for you? We can see if they might be able to help.”
- “That last hospital visit took a lot out of you. I think I know a way to avoid more stays in the hospital.”
At this point, your loved one might not be ready to accept that they need comfort care. If that’s the case, you may be met with resistance, and it’s best to accept their position and not judge. Your loved one, family and friends will not always share your position on such a sensitive subject. Give all parties the time they need to come to a decision that works for them.
Of course, if you are still struggling at this point, it’s ok to get help and advice. Your physician or local hospice are the best places to go for this. The dedicated staff at Wings of Hope are experts in comfort care and will be able to assist with any questions you may have. Contact details are available through our website at https://wohhospice.com/contact/.