One of the most frequent decisions I find patients or their family members making is “When is the right time to consider comfort care or hospice?”  People have a difficult time with this decision because embedded with it is the realization that cure of the patient through medical intervention is no longer going to be the focus of treatment.  The focus of treatment will be keeping the patient comfortable.  Frequently this involves medicines to relieve pain.  Federal law requires that patients be given information on all treatment options including comfort care and hospice.  Many people don’t want to mention these options until they feel comfortable with the decision.  The problem with this tendency to wait to give the patient the option is that the right time to make the decision is when the patient is comfortable with making it.  Waiting for a provider or family member to become comfortable before giving the patient the choice is not appropriate both due to legal mandates the right all human beings have to have dignity, even to have dignity in the process of dying.

When I work with family members who are hesitant to even have the discussion I look for opportunities to point out that simply having the conversation does not mean a decision will be made today.  But having the discussion gives the patient the gift of independence by being able to consider all the options that are available.  I would never attempt to force comfort care or hospice on anyone.  On the other hand having the conversation is valuable because you often learn from the patient was is truly important to them at that stage of life.  If you are facing this struggle, please know having the discussion can bring peace to the patient and family members in ways you can’t imagine unless you have been a part of this discussion previously.