We make decisions every day of our lives. Some are big and life-changing, while others
are less impactful. Should I have that
second brownie, or should I not? Should
I wear blue or green today? Should I
quit my job, or should I stay? While the
magnitude of these questions obviously carry wildly different significance, the
degree to which we struggle to determine an answer is usually oddly
similar. The reason – it is hard to know
what to do most of the time. It is hard
to know for sure what the right answer is.
It is always the right decision to take the second brownie.
One question most all of us will face at some point is what
to do when facing a life-limiting illness?
The good news is, you have options and it is your right to choose. Continuing aggressive treatments for your
illness is one avenue that you can take.
For example, a feeding tube to supplement nutrition and external
ventilation can be utilized. Also, chemotherapy
or other aggressive pharmaceutical interventions may be used. Another route may be palliative care. Palliative care is a combination of
continuing certain aggressive treatments, while treating the symptoms that go
along with end-of-life scenarios. When
terminal illnesses progress to end-stage levels, hospice becomes the best
alternative.
While no one can give you the perfect answer for your
end-of-life situation, there are definite criteria that can point towards
knowing if it is time to seek a hospice consultation.
Here are some of the most common hospice diagnoses and the
indications that hospice is appropriate:
Cancer
- Curative treatment unlikely to improve quality
or length of life
- Metastasis to multiple sites
Heart Failure
- Chest pain and/or shortness of breath with and
without activity
- Taking multiple cardiac medications
- Patient and/or physician believe heart surgery
is not a preferred option
Chronic Obstructive
Pulmonary Disease (COPD)
- Shortness of breath at rest and with any
activity
- Recurring respiratory infections
- Using multiple inhalers with poor response
Dementia
- Speaks few intelligible words
- Needs help to sit up
- Unable to walk without assistance
Stroke/CVA
- Difficulty swallowing, unable to take in
adequate nutrition
- No feeding tube (current or planned)
Liver Failure
- Ascites despite use of diuretics
- Serum albumin 1.5
Renal Failure
- Considering stopping dialysis
- Serum creatinine >8.0 (>6.0 for diabetics)
HIV
- CD4+ count 100,000
- Secondary conditions (Kaposi’s sarcoma,
pneumocystis pneumonia, fungal infections, etc.)
Amyotrophic Lateral Sclerosis
(ALS)
- Barely intelligible speech
- Significant shortness of breath
- Difficulty swallowing accompanied by rapid
weight loss
- No feeding tube or ventilator (current or
planned)
You have to decide the best answer for your situation, but
it is good to know that you have options.
We find that people usually tell us that they wish they knew about
hospice sooner. If you or a loved one
are facing a life-limiting illness, give us a call and let us help you navigate
your options when it matters most.