Thursday, August 19, 2010
Over the past few decades, hospice care has become a more common choice for people who have a terminal illness. These patients forgo life-prolonging treatments and instead get help to make their final days as comfortable and pain-free as possible.
SAN DIEGO Over the past few decades, hospice care has become a more common choice for people who have a terminal illness. These patients forgo life-prolonging treatments and instead get help to make their final days as comfortable and pain-free as possible.
The San Diego Hospice is the only one in the nation that has a psychiatric program for patients and their families.
Judith Stutz has colorectal cancer. It has spread to her lungs and spine, and she has no idea how long she has left.
"I could be sitting here and something could go wrong, but you could be sitting here and something could go wrong with you," says Stutz. "We just don't know."
Stutz says not knowing has caused her a lot of anxiety. So when she became a patient at the San Diego Hospice, she wanted some relief.
"I felt that initially when I was admitted," Stutz says, "That I need a little help with mood elevation, and that kind of evening that out would actually improve the overall process that I'm going through now, in terms of saying goodbye to family and friends."
Stutz says hospice staff have been great at listening to her fears about when the end might come.
"And that's the kind of thing I think human beings block out; I just can't right now," says Stutz. "And family and friends and the staff here, have all been extremely helpful in helping me to sit with that, and still get the joy out of every day."
Hospice care not only focuses on relieving patients' physical symptoms -- it also helps patients and their families with their spiritual and mental health needs.
That's where the psychiatric team at San Diego Hospice comes in. When it's appropriate, doctors give patients fast-acting medications that control depression and anxiety.
Hypnotherapist Michelle Lamarie says that's not all.
"The people who have a lot of emotional and spiritual pain really need something more than the medicine," she says.
Lemarie is a member of the psychiatric staff. She teaches patients relaxation and visualization techniques so they can control their own pain and discomfort.
"After a while, when you're in pain all the time, the body doesn't know anything else," Lemarie points out. "So, they don't even know what it feels like to be comfortable. So when they're able to go to this place of pain-free, and know that they did it for themselves, it really empowers them. And then they start to retrain body and mind to just feel in harmony, and just relax and feel good."
Besides hypnotherapy, the hospice offers something called dignity therapy.
Clinicians ask patients to tell them when they felt most alive, and talk about their proudest accomplishments. Over a number of weeks, their answers are expanded and amplified into a short autobiography. The story is put in a leather binder and given to family members as a keepsake.
Patient Stephen Letourneux has emphysema. He uses bottled oxygen to help him breathe.
Letourneux says after going through dignity therapy, he came to a conclusion.
"Life is basically a series of y's, meaning y's in the road, where you go left or right," Letourneux says. "And that series of y's actually ends up making you who you are."
Dr. Scott Irwin heads up the psychiatric care program. He says the mission at San Diego Hospice is to help patients and family members.
"So not only have we changed the patient's experience of their end of life, but we've changed the experience of the family, at a very significant time for them," says Irwin. "And they’re going to remember that experience for decades, and it's going to effect how they go through it when their time comes. So I think we make a tremendous impact both on the patients and the families."
Ultimately, the goal of hospice care is to help people make the most of each moment, for as long as life lasts.
When you think about it, that's not a bad philosophy.