Over the years, I have given inservice trainings on a variety of hospice-related topics to various hospitals, Grand Rounds, or monthly physician’s meetings.
I talked about end of life care and the ways hospice does and does not fit into the medical model. It was always a hard sell. It seemed at every meeting a physician would state that the medical model is "never stop trying." By never admitting defeat we learn to help others, to cure disease. The medical model of always treating is how disease is conquered.”
I agree with that philosophy. We learn from each situation. We learn what to do and what not to do. What works, helps, and what doesn’t. What I don’t agree with is making it an across the board, "we never stop trying" policy.
Everyone dies. Death will not be conquered. It can be forestalled and that is where the medical model comes in. We learn through trying. The medical rounds physician is correct -- BUT (I knew you were waiting for the BUT) I think the patient has the right to make that decision, not the physician.
I think the patient has the right to be told the possibility of cure, the likely outcomes of a specific treatment. They have a right to be told their chances and really that we, the medical profession, are trying but may not succeed in curing.
There are many people that will try every possible treatment to forestall death. It feels like we are “giving up” if we don’t try.
Here is what I am trying to address: we have a right to be told our chances of a cure. Physicians have that responsibility. Palliative care and an early hospice referral is part of healing. A different kind of healing: a healing of the mind and of the emotions. It also provides the opportunity to heal relationships. By recognizing not every person or disease is an opportunity to advance medicine, we are caring for people, not just diseases.
Something More… about Not Every Patient Is a Battle to Win
If you or someone you love is facing a serious illness, I encourage you to ask the hard questions. What are the chances of cure? What are the goals of treatment?
Hospice isn’t about giving up. It’s about caring for the whole person with honesty and compassion.
I offer you support with Gone From My Sight and By Your Side, which gently guides patients and families through the final months, weeks, and days of life.
7 comments
Julie Geyer
My husband died October 2024 after one week in the hospital after a gall bladder attack and surgery. He had kidney failure and arrangements were made to bring him home. The hospitalist said he believed in doing everything possible until the end but my husband did not want dialysis at 90 years. I said I would not go against his wishes. He passed that night.
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BK Books replied:
Julie, thank you for sharing with us. Blessings! Barbara
My husband died October 2024 after one week in the hospital after a gall bladder attack and surgery. He had kidney failure and arrangements were made to bring him home. The hospitalist said he believed in doing everything possible until the end but my husband did not want dialysis at 90 years. I said I would not go against his wishes. He passed that night.
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BK Books replied:
Julie, thank you for sharing with us. Blessings! Barbara
Traci Eaton
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BK Books replied:
So well said, Traci. Thank you for sharing. Blessings! Barbara
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BK Books replied:
So well said, Traci. Thank you for sharing. Blessings! Barbara
Michelle list
My very aged father is recently enrolled in home hospice. He has always had a hearty constitution, but I still work very diligently, 24/7, to keep him healthy. I am often tired but an aide comes twice per week to shower him—which saves my spine. Dad has no terminal diagnosis, and he is not sick, incontinent, or entirely immobile—he uses a rollator for the short distances to the bathroom. Some days it seems he is going into a steep decline, other days he seems to be ‘status quo’— that is: quite stable, even if increasingly frail, yet some days he actually seems to be improving . He is ready to ‘go’ into the great beyond if he must, but is also quite ready to enjoy his next day in my loving care, and welcome the occasional visits of family or friends—even if they are exhausting and he nods off after a half hour.
He ingests liquid nutrition and hydration entirely through a stomach peg tube, without which he would not survive (due to severe swallowing issues,); lately, his intake capacity has significantly decreased. Medication is also mostly administered enterally.
Dad is entirely deaf without his excellent hearing aids. Sometimes he is confused and disturbed and cannot meet intellectual challenges that formerly would have been a breeze for him, but still enjoys significant conversation and is savvy and relaxed about his choice to relinquish most of his legal and other responsibilities to me. His Last Will and Advance Directives are ‘in place,’ and Hospice arrangements should assure that he will not be stuck in a hospital during his ‘final emergencies.’
Rarely, an ache or pain will arise these days, but they abate after a very short while. Dad pooh-poohs the idea of using morphine which he said he wouldn’t want to utilize unless his pains or discomfort were to become dire.
What I’m saying is, Hospice ‘care’, until this point, has been unused and invisible. I expect to continue to handle Dad’s care, at home, and mostly by myself, (with my husband who has taken on more household responsibilities) in order to keep Dad feeling comfortable, healthy, and as happy as I can, for as long as can manage it. I know that death will come sooner or later, but I will help Dad pursue LIFE, until that is no longer his preference.
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BK Books replied:
Michelle, you are giving your father the kind of care, respect and love that I wish for everyone. Blessings to you, your dad, and your husband. Barbara
My very aged father is recently enrolled in home hospice. He has always had a hearty constitution, but I still work very diligently, 24/7, to keep him healthy. I am often tired but an aide comes twice per week to shower him—which saves my spine. Dad has no terminal diagnosis, and he is not sick, incontinent, or entirely immobile—he uses a rollator for the short distances to the bathroom. Some days it seems he is going into a steep decline, other days he seems to be ‘status quo’— that is: quite stable, even if increasingly frail, yet some days he actually seems to be improving . He is ready to ‘go’ into the great beyond if he must, but is also quite ready to enjoy his next day in my loving care, and welcome the occasional visits of family or friends—even if they are exhausting and he nods off after a half hour.
He ingests liquid nutrition and hydration entirely through a stomach peg tube, without which he would not survive (due to severe swallowing issues,); lately, his intake capacity has significantly decreased. Medication is also mostly administered enterally.
Dad is entirely deaf without his excellent hearing aids. Sometimes he is confused and disturbed and cannot meet intellectual challenges that formerly would have been a breeze for him, but still enjoys significant conversation and is savvy and relaxed about his choice to relinquish most of his legal and other responsibilities to me. His Last Will and Advance Directives are ‘in place,’ and Hospice arrangements should assure that he will not be stuck in a hospital during his ‘final emergencies.’
Rarely, an ache or pain will arise these days, but they abate after a very short while. Dad pooh-poohs the idea of using morphine which he said he wouldn’t want to utilize unless his pains or discomfort were to become dire.
What I’m saying is, Hospice ‘care’, until this point, has been unused and invisible. I expect to continue to handle Dad’s care, at home, and mostly by myself, (with my husband who has taken on more household responsibilities) in order to keep Dad feeling comfortable, healthy, and as happy as I can, for as long as can manage it. I know that death will come sooner or later, but I will help Dad pursue LIFE, until that is no longer his preference.
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BK Books replied:
Michelle, you are giving your father the kind of care, respect and love that I wish for everyone. Blessings to you, your dad, and your husband. Barbara
BK Books
Here is the correct link for the audio books: https://bkbooks.com/collections/all?filter.p.product_type=Audiobooks&sort_by=best-selling
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BK Books replied:
This link is in response to an earlier question about how to get our audio books.
Here is the correct link for the audio books: https://bkbooks.com/collections/all?filter.p.product_type=Audiobooks&sort_by=best-selling
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BK Books replied:
This link is in response to an earlier question about how to get our audio books.
Mary
I agree with this so much. If only most doctors would consistently agree with this too.
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BK Books replied:
I know. Blessings! Barbara
I agree with this so much. If only most doctors would consistently agree with this too.
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BK Books replied:
I know. Blessings! Barbara
Dan Murphy
I disagree based on my experience. Some hospices would and do let hospice patients die after electing not to treat a simple UTI. Instead the patient slips into sepsis resulting in death caused by an increasing infection left untreated. Sad but true
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BK Books replied:
I’m sorry to hear that. It is not the norm. Blessings! Barbara
I disagree based on my experience. Some hospices would and do let hospice patients die after electing not to treat a simple UTI. Instead the patient slips into sepsis resulting in death caused by an increasing infection left untreated. Sad but true
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BK Books replied:
I’m sorry to hear that. It is not the norm. Blessings! Barbara
Kathleen OLeary
Do you have an audio verion of your books?
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BK Books replied:
Yes, Kathleen most of my booklets have an audio version. Go to the website, bkbooks.com, and they will be listed. Blessings! Barbara
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BK Books replied:
Yes, thank you for asking!! We have two audio books available. You can find them on our website at this link https://bkbooks.com/collections/all?sort_by=best-selling&filter.p.product_type=Audiobooks&filter.v.price.gte=&filter.v.price.lte= 4
Do you have an audio verion of your books?
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BK Books replied:
Yes, Kathleen most of my booklets have an audio version. Go to the website, bkbooks.com, and they will be listed. Blessings! Barbara
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BK Books replied:
Yes, thank you for asking!! We have two audio books available. You can find them on our website at this link https://bkbooks.com/collections/all?sort_by=best-selling&filter.p.product_type=Audiobooks&filter.v.price.gte=&filter.v.price.lte= 4