Hospice and Palliative Care
I've written about my own experience with hospice in my book DYING: A BOOK OF COMFORT. When my father died, my family and I were able to help him do so with the help of a wonderful hospice in Southern California. When my mother died, at the home of my brother and his wife, they too -- Mom and Steve and Sue -- were able to get through a difficult death chiefly because a Utah hospice helped them deal with practical, emotional, and spiritual issues. I expect there are inadequate hospices somewhere, but that has not been my experience.

People often wait too long to call about hospice. What hospices know how to do is alleviate pain and suffering. As soon as pain is an issue, look into the option of hospice care or palliative care. Most of it is done in the home, with hospice volunteers helping families cope. If you aren't sure that that someone is dying, let hospice experts and your physician help you figure things out. Don't wait too long -- because what they are good at is helping people feel comfortable, and most professionals in the regular health care system are not nearly so good at that. Palliative care serves an important function.

Following are links to some resources. To find a good hospice near you, ask friends if they know of a good local hospice; ask the social workers at your local hospital for a referral; check the yellow pages under Hospices; ask for referrals through the local American Cancer Society, an Agency on Aging, Visiting Nurse Association, or house of worship. Check with the National Hospice and Palliative Care Organization (click on link below, or call NHPCO’s HelpLine at 1-800-658-8898). Check with the local state departments of health or social services to learn which hospices are certified (making them eligible for Medicare and in some states Medicaid). Or Google hospices and your zip code (which may turn up hospices that do not belong to NHPCO as well as those that do).

One gift you can offer a person in hospice care is the gift of life review--the gift of reminiscence. Helping the dying to capture their life story, whether written or recorded, is to let them know that they will not be forgotten. It's best not to wait till they're in hospice to offer this gift, as with waning strength they may not be able to say much, and their memories may be fading. But if they have not had that gift of life review at the point when the end is near, it can feel powerful to speak to someone who is truly listening and who will remember. And if you record their voice, often you will later find that that recording is the only one the family has, and it will mean a lot to them.

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Links to Hospice and Palliative Care

Jane Brody's Guide to the Great Beyond: A Practical Primer to Help You and Your Loved Ones Prepare Medically, Legally, and Emotionally for the End of Life -- a practical book, with explanations and to-do lists for everything from advance directives and why a living will is not enough to funeral plans, living with a bad prognosis and dealing with uncertainty, caregiving, hospice, communicating with doctors, assisted dying, organ donation, autopsy, and legacies.

Making Rounds with Oscar: The Extraordinary Gift of an Ordinary Cat by David Dosa (about a cat who senses death and stays to comfort the dying, but also about Alzheimer's and geriatric care and nursing homes and being there, at the end of life)