1. You don’t want to fight “the fight” anymore. Fighting decline is ultimately a losing battle. With every fight, we need to sense when to let go. It may seem like the savvier choice to try to outwit death by fighting it right up until the last minute, just before transitioning takes hold, but this isn’t true. For so many patients, so much valuable time is lost in continuing a draining fight well past when they’re able, instead of carefully managing the decline. In fact, it’s very much unknown by most that managing the decline of illness yields more control and vitality than fighting it. Hospice is there to manage the decline of illness and the process of dying itself.
2. You hurt. Or you can’t breathe. Or your nausea is unrelenting, and you just don’t feel well enough to do anything. When the burden of your symptoms has become too much because the burden of your disease has become too much, it’s time to consider turning to hospice, where symptom management is a priority over trying to fix what cannot be fixed.
3. It’s the benefit you worked for. We all know Social Security. We all know Medicare. But one of the still-quieter benefits that we as US citizens qualify for if we qualify for Medicare, is hospice. It’s a wonderful thing at the end of life to have the net of hospice, including physician and nursing oversight, CNA care, and psychosocial support. It really is an underutilized benefit due to patients (and clinicians) not understanding what it is and when to put it in place.
4. Your family needs help. Hospice is not just for the patient. It’s for the patient’s caregiving network. Hospice greatly increases the support caregivers receive. It can help the caregiver with actual physical caregiving, from wound care to medication administration; it can help the caregiver with understanding what is going to happen, so that the grief of losing a loved one is not compounded by a lack of closure; and it can help caregivers deal with the ongoing grief after their loss.
5. You are ready to accept death. This is the statement which inspires the most fear. But many who have walked the walk of burdensome, distressful illness, realize in their own time, that they are ready to let go. Through the powerfully transformative process of illness, they come to the realization that they are ready for death when it should come, and they choose hospice and its philosophy of smoothing the passage of dying instead of expending precious energy to battle the inevitable. It isn’t a morbid choice to accept death; when the divine dictates it’s your time, it’s a noble choice.