Taking control of your end-of-life care through hospice

The Aging Inspired Advance Care Planning Coalition, an effort of the Aging Inspired Initiative of the Community Health Council of Lebanon County, encourages all community members to take control of your life with hospice care as you approach an end-of-life event from aging, terminal illness, or an extreme medical event or accident. Talking about the end of life is not an easy topic for most people. Knowing that hospice care is a topic very misunderstood throughout our community, we want to share this important review.

When patients choose hospice care they are not giving up, they are taking control. Hospice should be discussed with your healthcare provider or clergy member when you are faced with a life-limiting illness. It includes talking about the benefits of curative treatment vs comfort care. Some examples of life limiting illness are cancer, cardiac diseases, pulmonary diseases, renal disease, neurological illness, cirrhosis and Dementia diseases including Alzheimer’s disease. Hospice is appropriate when curative treatments are no longer effective, and the physician determines that a patient may have a life expectancy of 6 months or less.

It is important to note that the “6 months” is a guideline and patients can continue to receive hospice care for as long as the physician continues to re-certify the terminal illness. While we cannot predict the time of death, there are symptoms that often indicate that a person is declining. These may include the combination of all of these signs: pain, nausea, shortness of breath, repeated hospitalizations or trips to the emergency room, a decrease in activities of daily living such as bathing, dressing, toileting and eating, and unintentional weight loss of 10% of body weight over a period of 6 months.

Individuals have a choice of where and how they are going to leave this earth. Do they want to receive care at home? What kind of comfort and support do they need? These are important questions that can be answered when given the resources of advance care planning, palliative care and then hospice care services. Keep in mind that 70% of people who are dying are not conscious and do not have the capacity at that time to make decisions on their own.

Hospice is a term that is often confused with impending death. The reality is that hospice care focuses on your quality of life and focuses on the physical, emotional and spiritual needs of the patient and their families during the final months of life. Hospice care focuses on symptom relief and comfort. In comparison, typical medical care focuses on treating and prolonging life, which may not be the desire of the individual or may result in more discomfort.

The hospice care team often includes a medical doctor, nurses, social workers, chaplains, community liaisons, volunteers, aroma/massage therapists and therapy dogs. Special veteran programs can also be available through the Veterans Administration hospitals or local hospice providers. You can choose to have your primary care doctor or a hospice medical doctor provide care and oversight for your individualized plan of care. Hospice care can be provided in home or in a facility. Same day medical equipment can be provided, and often there are resources available for those that are in financial need.

Hospice is a choice. When a patient chooses hospice care they are not giving up, they are taking control.

The content of this article was provided by Valerie Tarmin, RN, MSN, NEA-BC, Program Director and Traci O’Brien, Community Liaison of Caring Hospice Services of Central Pennsylvania. Traci is a volunteer member of the Aging Inspired Advance Care Planning Coalition.

In recognition of National Health Care Decisions Day 2025, the Aging Inspired Advance Care Planning Coalition will be presenting “Caregiver: A Love Story” – Know Your Options at StoneRidge Retirement Community, 440 Lincoln Highway, Myerstown, PA 17046 on Monday, April 14 from 1:00 – 3:00 p.m. To register for this event, call Roberta Geidner at 410-207-8829. This presentation focuses on how a couple dealt with an end-of- life caregiving situation, and the stresses faced by the caregiver. It includes a realistic view of hospice and other care services available to the couple.

For more information about hospice care, the program being presented on April 14, or to schedule a presentation by members of the Aging Inspired Advance Care Planning Coalition, please call the Community Health Council of Lebanon County at 717-270-7935 or email at aging@communityhealthcouncil.com.