America’s Death-Denying Culture
Kendra Hess, LGSW – Brighton Hospice Minnesota
American society is considered a death-denying culture. In general, we do not like to think about, talk about, or acknowledge death as an inevitable reality. While logically we understand that we will all die someday, it is generally a topic that is uncomfortable, and swept under the rug. Our beliefs about death and end of life are further chiseled by our families, friends, and personal experiences. The American death-denying culture affects the way that we react when faced with our own or a loved one’s physical decline and mortality. Denial is a strong defense mechanism and serves a great purpose, however, it has the ability to be harmful, and rob friends and families of special moments at end of life. Living in a death-denying culture can lead to misunderstanding about the importance and value of hospice care.
Isn’t Hospice Care Just Giving Up?” Goals of medical care towards end of life are unique to each individual. It is important to note that patients are only eligible for hospice after they have been diagnosed with a terminal illness, which includes a life expectancy of six months or less. Some individuals choose to continue with hospitalizations, frequent appointments and invasive procedures, even after being diagnosed with an incurable terminal illness. For many, continuing to pursue longevity of life is their only goal and will be pursued at all costs. This can sometimes include tube feeding, IV fluid administration, and CPR, although their body is shutting down. This path is absolutely the right path for some, but for others there is the option of hospice.
Hospice is Contrary to Our Death-Denying Culture
“We walk alongside our patients and families in this journey.”When meeting with patients and their families to discuss the option of hospice, I am often asked “Isn’t hospice care just giving up?” This question is reflective of the society and the time that we live in. With medical advancements, we can extend life longer than ever before. Our healthcare systems are geared towards curative measures and to “preserve life at all cost”. Within this context, it would be easy to assume that hospice, which is non-curative and focuses on symptom management, is “giving up”.
Hospice is really about a different mindset. Instead of longevity of life being the goal of care, the goal of hospice is quality of life and comfort. The hospice team cultivates a space where symptoms are controlled so that the patient can focus on what is important to them. Each patient and family is unique, and we tailor our services to the individual and their family. We empower our patients and their family by encouraging them to lead their own care. When meeting with families, I often describe hospice as the patient/family in the driver’s seat and we are in the passenger’s seat. We walk alongside our patients and families in this journey. Time on this earth is limited and hospice is dedicated to providing that space to enjoy life and family, while under the guidance of a specialized medical team. Hospice care is about honoring the natural dying process with dignity and integrity in a supportive, compassionate manner.
The Focus of Hospice Care
Hospice focuses not only on a physical being at end of life, but on the emotional and spiritual being as well. We understand each patient as a whole person and approach our care holistically. Contrary to typical healthcare, we view the entire family as our “unit of care” instead of the patient alone. We value relationships and understand that this can be a time of vulnerability, fear, and uncertainty. The hospice team consists of a nurse case manager, a certified nursing assistant, a chaplain, and a social worker. Additional services available in hospice care are massage therapy, volunteers and music therapy. This interdisciplinary approach highlights the goal of hospice to care for a complete person.
Although hospice is not focused on extending life after the diagnosis of a terminal illness, it is not giving up. It is allowing space to acknowledge the value of family, relationships, and comfort, in the patient’s place of residence. It is about living a full life near end of life, with a skilled interdisciplinary team for support and guidance. It’s about understanding our death-denying culture, but choosing to see the beauty, and reflecting deeply at this sacred time in life. While hospice is not the only option, Brighton Hospice is available to encourage peace, comfort, and unity at end of life, while still supporting our patient’s individual goals and wishes, to the very end.