Dear Carol: My mother, who has advanced dementia, went into a nursing home six months ago. She’s received excellent care but is now declining quickly so that she no longer swallows any type of food. Her doctor has determined that she is ready for hospice and that makes sense to me. Hospice took her off of medications that didn’t seem to be helping and then prescribed some occasional Ativan for agitation and low-dose morphine for pain. Her response has been satisfying to watch since she’s more alert and far more peaceful than she has been. Here’s the problem. I’ve gone to a support group for several years and there are a couple of people in the group that completely anti-drug for Alzheimer’s so they are adamantly against the use of both Ativan and morphine for my mom. I don’t get it. Mom is dying. She was jerking around in pain and crying and now she’s responsive and comfortable. How do I get through to them that when people are dying everything changes? – HY Read more →

Dear Carol: Six months ago, my husband, 83, broke his hip and was admitted to the hospital. His time there was emotionally exhausting and the stay took a terrible toll on him. Eventually, he was released to a local nursing home and things were going well until he developed pneumonia. The nursing home was well equipped to care for him there which is what we both wanted, but I alerted his adult children, as we’ve agreed to do in a health crisis. Even though my step-kids rarely visit, they have rights since we share Power of Attorney which is set up so that any one of us can make decisions. At first, I thought that their coming would be a comfort but they took over and effectively negated their father’s health care documents - FC Read more →

Life changing, yes! And perhaps a moment of divine intervention. An elderly man with COPD (chronic obstructive pulmonary disease) was rushed to the cardiac cath lab after being diagnosed with an acute myocardial infarction (MI). He was struggling to breathe, yet pleaded with me to not insert the breathing tube and to let him die. The cardiologist was scared to do it. With a voice coming from above saying, “Let My People Go!” I honored the man’s wishes. I tremble every time I read this passage. Read more →

For some, it signals the beginning of a more perfect life. For others, it is the end. Ultimately, for everyone, death is part of the life cycle and no amount of medical intervention will change that. Filmmaker Cathy Zheutlin became fascinated by the way that different cultures and religions view the death experience, and in the processs, she has made a remarkable film titled Living While Dying, which features people who are going through that process and their varying emotions. Read more →

Family caregivers provide many functions for their older adults or spouses, from transporting them to a social event to encouraging healthy habits. Caregivers can also find themselves in a cycle of bouncing from one emergency to the next. Juggling crises is a significant part of what we do, so learning how to handle these situations is helpful. Emergency physician Kevin Haselhorst, M.D., an expert in advance care planning, speaks to patients, family members, and healthcare providers about advance directives, palliative, and end-of-life care. Here are some of his tips. Read more →

Dear Carol: There’s probably no right answer to what I’m asking but I felt the need to write, just for comfort. My mother died when I was in my teens so Dad has been the only parent that I’ve had for more than 20 years. I have no siblings. Dad’s now in his seventies and has been diagnosed with prostate cancer. He’s beaten both melanoma and lung cancer in the past, but he tells me that this cancer should be slow growing and that he’ll probably die before it’s a problem so he doesn’t want to treat it. I want him to go full-on with every treatment possible. I watched both of my parents fight cancer, so I know that it’s horrible to go through treatment, but I don’t want to lose him! How do I accept that fact that he’s taking this route? – LM Read more →

Our culture is steeped in language that makes accepting the terminal diagnosis of ourselves or a loved one more difficult to accept than it needs to be. Doctors say, “I’m sorry, there’s nothing more we can do. You might want to look into hospice care.” Patients tell their doctors that they want “aggressive treatment,” until there is nothing else that can be done, then they will go on hospice care. The crux of these conversations is that medicine will do everything possible and then when you give up you will go on hospice care. Read more →

For many, music from certain eras can bring back memories of better times. For others, music soothes anxiety or gets them pumped up for a workout. When it comes to people living with dementia, music can help in all of those ways, but it can also help cognition. Hospice organizations are keenly aware of the soothing power of music. Sometimes the music may be used casually, by the facility or the family, knowing that this is a type of music that the person who is in the dying process had always enjoyed. Increasingly, though, employing trained music therapists has been favored. Read more →

Many people have heard of hospice care but they mistakenly think that it’s just a way to help cancer patients be more comfortable at the end of their lives. Fewer people have heard of palliative care, and they may have no idea what it is. The truth is that hospice and palliative care are related but used for different reasons at different times, and everyone should be well-versed in what they offer. Here, we’ll clarify some points of confusion. Read more →

“Carol!” The hospice nurse’s voice was quiet but urgent. I instinctively knew what was happening. She had been shifting Dad’s position so that he wouldn’t develop bed sores, but as she was laying him back on the bed, something changed in his respiration. This was it. His body was preparing for him to take his last breath. I slid back in my spot beside Dad and took him in my arms. His head drifted to my shoulder and that last, gentle breath slipped by unnoticed by me. What I felt was the positive force of Dad’s spirit leaving his body. And then — joy! Read more →