Hospice is brought into a patient’s life because of impending death, she said. For the expense to be covered by Medicare, a physician is required to certify that the patient is pre-terminal with no more than six months to live.
But in some cases, hospice care may result in the patient living longer than expected.
Friesen said hospice approaches the patient differently than the doctors and nurses who have been working to save the person’s life at all costs.
“We are here to enhance life at the end of life,” Friesen said. “We have people who understand a lot of the dynamics at the end of life.
“We accept that death will be the end result of what we do. We realize that death is a part of life. We want the weeks and months left to be as comfortable and pain-free as they can be. It is a delicate balance, because we want the patient to be as alert as they want to be.”
Aiding the patient
Friesen said hospice can administer medication to enhance comfort.
“If there is extreme pain, we can give morphine,” she said. “We can give things (to aid) breathing so the person doesn’t have to choke to death or do the gurgling thing.
“Whatever gives comfort, we do it,” she said. “We may be giving home health care needs, personal hygiene, cutting the hair, painting the nails—the things that contribute to happiness. Our people are aware of the signs of pain or discomfort that aren’t easily detectable.”
Sometimes the added attention and happiness contributes to a person living longer than expected.
“They may go on past the six months, maybe for a couple of years, or they may go like expected,” Friesen said.
Hospice also serves the family of the patient by keeping them informed of what is happening and helping the family deal with grief. Friesen said family members may be involved in group grief sessions or counseling with her for as long as five years after a death.
“We live in a society that doesn’t want to talk about death,” Friesen said. “When a person wants to bring it up, many times the reaction is, ‘Oh, just get over it.’ Sometimes that person needs a place to talk. It doesn’t always take all of the grief away, but it helps.”
Friesen is a chaplain, a graduate of Tabor College and of North American Baptist Seminary. She has been on the pastoral staff of Mennonite congregations in Hillsboro. She lives in Hillsboro, but works out of a Newton office that serves Marion, Harvey, McPherson, Sedgwick and Butler counties.
Friesen said the Marion County grief and encouragement group sponsored by hospice meets in Hillsboro from 6:30 p.m. to 8 p.m. the third Monday of every month in the conference room at Hillsboro Community Medical Center.
Friesen said for a patient to receive hospice care three criteria must be met:
1. A life-limiting condition has been diagnosed.
2. A physician estimates the life of the patient is limited to six months if the condition runs the expected course.
3. The patient or family desires comfort care rather than aggressive curative care.
Friesen said signs that a person may be appropriate for hospice services include: change in ability to care for self, weight loss, change in mental status or confusion, wounds or skin breakdown, history of falls, increased lethargy and weakness, inability to control bowel or bladder functions, difficulty swallowing and diagnosis of life-limiting illness.
Friesen said Hospice Care of Kansas provides a minimum of two nursing visits and two home health aide visits per week from a staff member, including nurses and a physician.
A recent movement
Even though hospice is now familiar to most Americans, it began in London, England, in 1967 with the first American location in Connecticut in 1974.
Hospice, with its understanding of death being part of life, sometimes finds itself outside most of society. The organization quotes famed psychiatrist Elizabeth Kubler-Ross in her 1972 testimony to Congress: “We live in a very peculiar, death-defying society. We isolate both the dying and the old, and it serves a purpose, I guess. They are reminders of our own mortality.”