By Rachel Seltman
The easy part of the answer is that accepting palliative care does not mean giving up hope for a cure. Palliative care addresses the symptoms of a disease. It does not address the underlying cause of the disease, but many people receive treatment for symptoms and treatment for the disease at the same time. Someone undergoing chemotherapy to try to cure their cancer may also receive palliative care such as medication to treat pain associated with the cancer.
Whether choosing hospice means giving up hope for a cure is a slightly more complicated answer. Hospice usually is restricted to patients expected to live six months or less (sometimes 12 months or less). So going to hospice means accepting that you will likely die within the year. However, some hospice programs (and insurance companies) allow a patient to continue to receive curative treatment while they are receiving hospice care.
All of the above is important to know, but it isn’t enough to answer the original question. The above all assumes that the only “hope” is for a cure. The first time I questioned that assumption was watching the Closure 101 module, “A Primer on Palliative Care.” As the narrator mentioned “hope of a peaceful dying process,” I realized how limited my understanding of hope had been. A person in hospice may or may not still hope for a miracle cure, but that is not the only kind of hope.
Imagine asking everyone you see, “What do you hope for?” A colleague might say, “To be promoted to head of our unit.” A cousin might say, “To have a marriage as happy as grandma and grandpa.” A baseball fan might say “For the Pirates to win the World Series.” A close friend might say, “To be able to make the world a better place.” A child might say, “For it to rain candy.” You never know what someone might answer. So why assume that we know what a dying loved one hopes for? The only way to find out is to ask.
Individuals receiving hospice care might have logistical hopes, like to die at home, to be buried in certain clothes, or to have a particular piece of music played at the funeral. The hopes may be more emotional, like making peace with an estranged family member, saying goodbye to a beloved pet, or contemplating how religion deals with death. Hopes can also have to do with medical care, such as not wanting to be put on a ventilator, wanting pain relief even if that means a loss of consciousness, or having a certain person make medical decisions. Hospice patients may feel strongly about certain details, or the important part may just be the opportunity to choose.
The bottom line is that hope comes in many forms throughout life, including at the end of life. If you have a loved one in hospice or considering hospice care, ask what they hope for, and listen to the answer. You may not be able to cure their disease, but with a little creativity (and a ladder), maybe you can make it rain candy.