Sense & Sensitivity by Harriette Cole

Hospice Is Not Limited to the Final Days

DEAR HARRIETTE: I enjoy your column almost every morning in the Chicago Tribune. I find your advice on target, supportive, realistic and straightforward.

I'm writing in response to your comment that hospice care usually indicates someone is in the last weeks or days of life. Unfortunately, you are correct that people often seek hospice services when death is imminent. This is a tragedy, because hospice services are available (and paid for by Medicare and other payers) to individuals who have life-limiting illness and may not survive beyond six months.

The American Academy of Hospice and Palliative Medicine (aahpm.org) and the Hospice and Palliative Nurses Association (hpna.org) work hard to change the public perception that the benefits of hospice and palliative care are limited to the last weeks and days of life. In fact, these professional organizations encourage physicians and other health-care providers to introduce palliative care at the time of a life-limiting diagnosis. Hospice and palliative care offer symptom relief and support for quality of life when cure-oriented health-care services are no longer effective or desired.

Although my nursing specialty is not hospice and palliative care, I have been privileged to serve on the National Board for Certification of Hospice and Palliative Nurses since 2008 and complete my second and final term in 2013. During this time, I have learned so much about these valuable services and the dedicated professionals who provide them. Persons with life-limiting illnesses suffer needlessly because of the perception that hospice care means giving up hope and is reserved for the last hours of life.

Please acknowledge in your column that palliative and hospice services provide great comfort to individuals with life-limiting illnesses and their families and that they can access these services long before their final hours. An additional resource: getpalliativecare.org. -- Compassionate Nurse, Chicago

DEAR COMPASSIONATE NURSE: Your voice represents many who have written me to clarify the role and timeline associated with hospice care. I want to thank all of you for your input.

It is true that many people consider hospice as the last stop, as it often is. But, as you and others have pointed out, although it can be a vital support for families during a loved one's final days, hospice also can be a much longer-term experience than a few days or weeks.

Another point about hospice that some may not know is that this service is offered at a variety of facilities and also at home. I want to apologize for painting an incomplete picture of this vital service. I appreciate your clarifying comments.

DEAR HARRIETTE: When someone dies, it used to be traditional for people to give their family money in an envelope to help defray the costs. Is this still an acceptable practice? A co-worker's mother recently passed away, and I wasn't sure if it was in good taste to do that. -- Death Etiquette, Salt Lake City

DEAR DEATH ETIQUETTE: Yes, it is still common practice in some areas, especially in the South, to put cash in an envelope with a condolence card when someone dies. Amounts vary from as little as $10 to whatever one can afford. It is not a requirement, however.

If you think your co-worker would appreciate this gesture, go for it. If you think it could cause discomfort, give the card and flowers or a contribution to a charity of choice.