Family Medicine Residency Program

Published Articles by CMH Residents

Hospice: Keeping our Dignity in Dying
By Dr. Maisha Pesante, CMH Regional Health System

Sometimes an unexpected terminal illness, or simply the length of years, catches us in a condition that medical science can not cure. Yet, medical care can provide comfort through hospice. Do no harm is the call of every physician, and easing needless suffering is the call of hospice. Hospice may sound like a scary place, but hospice represents a concept of comfort more than a place.

Of course, the concept has to have a physical manifestation. In the case of hospice, that would usually be your own home, although both inpatient and nursing home options exist.

When you reach the point at which only comfort and, not cure, can be offered, wouldn’t you much prefer your own environment, near those that love you? Aggressive care can often result in an agonizing death without truly prolonging life. Hospice avoids patients dying in the intensive care unit of the hospital, surrounded by machines and tubes.

Hospice services seek to bring more dignity to the dying process, palliating the pain as much as possible. In the end of life, controlling the pain of debilitating illnesses such as end stage cancer, or inoperable heart disease, require high doses of pain medicine, often inappropriate in the traditional hospital setting.

Hospices have skilled staff, experienced in the management of end of life issues for patients, caretakers, and families. Care is available 24 hours a day, seven days a week, by way of an on call nursing staff.

Nurses, physicians, social workers and all members of the team stay in close communication. As nurses and physicians manage symptoms, social workers assist the family with resources and emotional support. Chaplains tend to the spiritual needs. Nutritionists help with diet to improve the patient’s appetite. Volunteers provide relief for families and caretakers. Some area hospices even have a respite program to relieve the caretakers in times of need, while the family or usual caretaker rests and recuperates.

The prospect of death can create inexplicable emotions. Hospice helps to ease this process, assessing patients’ wishes. Often, advance directives or living wills are involved.  The hospice team honors the spiritual concerns of the family and the patient. Importantly, the team also addresses financial problems to create the best opportunity for effective management. To hospice, the family and the patient constitute a complete unit.

Essentially, hospice creates support in the last phases of incurable disease whether those phases endure for weeks, months, or years.

Dying constitutes a normal process. Still, hospice guides the physical, emotional, social and spiritual needs arising from that process. Patients, families, and caregivers keep control while benefiting from strong support services.

Tailored for those in the advanced stages of incurable illness, hospice does not refuse anyone because of race, religion, or ability to pay. It represents a compassionate helping hand during a fatiguing and trying time. When that time comes we know we are not alone.

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Dr. Pesante is a second year resident physician in the CMH Family Medicine Residency. Healthy Outlook, a periodic offering of CMH, includes information from several resources including the writer’s professional experience.

And Now By Dr. Maisha Pesante As I take my last breath Don’t cry for me, don’t weep See me smile and know That I stayed for a while And now, It’s time, child, time to be the child I once was and love the lord Up close Time to be free of my earthly pain And rejoice as the angels sing As I take my last breath Don’t cry for me, don’t weep See me sing and know That my soul rests deep And now It’s time for a sleep time to sleep like I never could before And caress the pillow of heaven’s canopy Time to let go of me And still see as you go live life and love As I take my last breath Don’t cry for me, don’t weep See me soar and know That I danced my dance in key And now It’s time for me, time to watch over you As in my last days You watched over me See me smile I am free Dedicated to GB. Thank you for letting me be a part of it. I am honored. God bless you always.