ASK THE DOC: Where to turn for help with end-of-life care?

QUESTION: I’m concerned that my parents are nearing the end of their lives. Who can I talk to about end of life care?

ANSWER: If concerned that your parents are nearing the end of their lives, my first recommendation is to always talk to your parents and their primary care provider about your concerns.  As a family medicine physician, I personally prefer to take a team approach to their care.  This includes listening to the patient about their wishes regarding their future healthcare, as well as listening to family members about the patients’ current struggles.  Together, we then determine if the patient both desires and is appropriate for a referral to palliative or hospice care services.  At a minimum, it is critical to make sure that all patients in this stage of their lives have a medical power of attorney and living will in place.

In addition to being a family medicine physician, I have also spent the last several years serving our community as a local hospice physician.  I have found that palliative care and hospice services are vastly underutilized due to a misconception that hospice is just for one’s final days of life or only for diagnoses, like cancer.  In actuality, these services are most beneficial when utilized early during a patient’s decline.  Many people assume hospice is mainly for end-of-life cancer care, however we also help to care for patients with worsening heart conditions, lung conditions, kidney disease, liver disease, dementia and many others.  Hospice care is designed for anyone in the last 6 months of their lives, while palliative care has no estimated time frame. Palliative care services can take place over years and are designed to ease the suffering of patients in all stages of a disease process, allowing patients to continue with medications and life sustaining treatments if desired.  Hospice, however, is specifically designated to help patients when life sustaining treatments have not worked or the patient desires to discontinue treatments to sustain their life. Both services can offer a lot of benefits to your loved ones, like symptom control, skilled nursing support, spiritual support, and grief/bereavement counseling.   

 This question from a reader was answered by Chelsea Feger, DO. She practices at Robert C. Byrd Clinic in Lewisburg.


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