‘A good death’: Hospice care is about finding peace in the journey’s last steps
Gina Price, a hospice nurse working out of Ogden, has seen a lot in 25 years of care. The goal of hospice is to comfort patients and ease pain and symptoms, she said. But there’s also room to address emotional, spiritual and social needs — improving the quality of days even as the quantity dwindles.
“We want to try to help them in all of those aspects of their end-of-life journey,” she said.
Even if some of those aspects are the last thing you’d imagine would be on someone’s mind. One of Price’s memorable patients was a man confined to his bed as he neared the end. He was worried about who would look after the lawn after he died. He wanted to know that his wife could handle the lawn mower maintenance on her own.
The hospice team brought the lawnmower into his bedroom so he could show his wife how to check and change the oil, where to put the gas and how to start it.
“It gave him peace of mind knowing that he had taught her, and he felt like he would at least pass that on to her,” she said.
To Price, out-of-the-box thinking like that can bring peace to patients and help them meet their individualized final wishes.
“I think a good death is really very personal,” she said. “Every patient is going to decide that.”
Nurses like Price ask questions to help patients find a balance of pain management and alertness level that feels right to them. For example, someone might be willing to forgo some pain medications in order to better interact with grandchildren at their bedside.
Even though she’s seen many deaths throughout her career, being a hospice nurse has been an “amazing experience” for Price.
“I think some of the hospice employees are probably some of your happiest health care employees out there because we get to experience that journey with these patients and with these caregivers, with these special life moments,” she said. “And it's such a sacred, sacred time of their life.”
This interview has been edited for length and clarity.
Pamela McCall: What are the misconceptions about hospice care?
Gina Price: I think a lot of the misconceptions is that hospice comes in and we give them a pill and they're gone or that we're just for the last days of life. That's really not when we can do our very best work. [Up to six months out is] when we can do our very best work with our patients and their families.
PM: If there's family involved, what is their role and how does hospice help them?
GP: Hospice is about taking care of the whole family, the patient and the family. We want the daughters and the sons and the wives and the husbands to be just that. When we come in, we're going to talk to them about their goals of care. Some people may want holistic care, some people want medications, some people want non-medications. Sometimes there are family dynamics, and some families disagree with other family members. We try to help pull them together.
PM: Do some people ever leave hospice care?
GP: Absolutely. We do have patients that leave for multiple reasons. Sometimes we have patients that come on and they realize that maybe they do want to seek further aggressive treatment, so they go off for that reason. Or they come on and they start to improve and so then they go off.
PM: Why do some patients improve with hospice?
Many times when patients are not doing well and you get a nurse involved and a doctor involved and people coming in and seeing them on a regular basis, pretty soon that person's health is now going to improve. When you have a doctor that's coming into the home and is adjusting medication very frequently, you'll see their health improve. Now, they may come back after six months or a year later, but we do sometimes discharge them. We tell them all the time, “Graduation from hospice is a great thing.”