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Many of my colleagues believe that every terminally ill patient needs the professional care provided by hospice. I think it's a wonderful program, but I believe that some patients and families don't need it. What do you think?-J.B. MASS.
I think the following experience provides an answer.
I was asked to see the family of a 68-year-old Greek woman with heart failure, pulmonary edema, and renal failure requiring dialysis 3 days a week. She'd been hospitalized for treatment of an infection and had responded well.
This family adored their matriarch and were committed to giving her the best possible care in her remaining weeks or months of life. Her physician thought my role was to convince them to enroll her in a hospice program after discharge. I entered the room to find an elderly man holding a photograph of a handsome young man to my patient's face.
"Nicky loves you," he said.
The woman smiled. I introduced myself and explained to Mrs. Demos that I was there to find out what her wishes were regarding care during her serious illness.
"She wants to live," her husband responded quickly. She nodded firmly.
Suddenly, six boisterous visitors poured into the room. Joyously noisy, they clearly delighted my patient. They laughed and hugged, medicine that no specialist could possibly provide.
Later, I spoke with these glorious sons, daughters, nieces and nephews and learned of their commitment to be round-the-clock nurses for her return home. It was all she needed.
The family was taught to manage her enteral feeding tube, and she went home without hospice.
Her physician thought I should have been more forceful about getting them to agree to hospice. But I knew that Mrs. Demos was going to be greatly loved and valued in the care of her family. And isn't that what connects us to each other?
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