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Hospice and Montana Winters

by Gail Rubin
November 4th, 2011

November is Hospice and Palliative Care Month. The conversation about choosing hospice care is as hard to start as the funeral planning conversation.

I’m pleased to present this guest blog post by Thomas Patrick Donovan. He is the community liaison for Rocky Mountain Hospice in Bozeman, Montana and a faculty fellow in the MSU freshman honors program.

Does choosing hospice mean giving up?

There is a story going around that when a person chooses hospice care at the end of life, this choice represents giving up.

In a society that values eternal youthfulness, it is hardly surprising that there is anxiousness about how to approach end-of-life concerns. For many, anything short of waging a heroic, all-out battle against death represents giving up and signifies a failure on the part of the patient and his or her family and caregivers.

While this is quite understandable, given our society’s focus on masking the process of aging and hiding completely the process of dying, it is also quite misguided and unhelpful.

To look at the choice of hospice care as a failure along the journey of life is like looking at winter as a failure on the part of nature. Yet as every Montanan knows deep in their bones, rather than winter being a failure it is a vital part of the cycle of the seasons, the cycle of life. As such it brings with it its own unique qualities, challenges and beauty.

Here in Montana winters can be long or longer, harsh or relatively easy. Montana winters are unpredictable, with mysterious rhythms, and one never knows when the helping hand of a friend or neighbor will be required to navigate what winter brings.

Conceptually we all know that death will come knocking on our doors at some point in our lives. Yet how often do we engage in discussions about preparing for the end-of-life season within our own families, much less consider the reality of death as part of an important community-wide conversation?

It is like ignoring all the signs and pretending winter will not come this year — where would that leave most Montanans? Would anyone, in the midst of a hard winter, look at asking for a neighbor’s help as a failure, or consider accepting a friend’s assistance to be an act of giving up?

On the contrary, we would likely welcome their willingness to pitch in and lighten our load a bit. Why then, when we reach the season of winter in the cycle of our own lives, would we reject or fear the helping hand of hospice?

Imagine, for a moment, the possibility that qualified hospice care can turn the end of life into a time of decreased worry and anxiety. Hospice, with an interdisciplinary team of doctors, case-manager nurses, social workers, chaplains, home aides and volunteers, creates the possibility that patients can stay wherever they consider home and, therefore, age in place with comfort and dignity.

Working closely with a patient’s primary care physician, family members and other caregivers, the hospice team adds another layer of care that can take tremendous pressure off the shoulders of overwrought loved ones and overstretched caregivers.

Specializing in palliative care, alleviating pain and providing symptom management, the hospice team is dedicated to compassionately crafting an individualized plan of care to meet each patient’s specific needs. With the relief provided by hospice care, the potential for creating quality time for patient and loved ones to share the beauty and mystery of life’s wintertime can be realized.

To hold fast to the belief that choosing hospice means admitting that one has failed is, in truth, a failure of our ability to imagine the end of life being anything other than a hard, possibly painful, winter that we have to suffer through.

Perhaps it is time to re-imagine the end of life: rather than giving up, hospice is the successful embrace of community, a way of being there for each other. Hospice offers the caring arms of hospitality to patient, family, and friends and, as a result, creates a way to meet the winter of life that has comfort and dignity at its foundation.

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