Hospice not all about sadness: Phelps

By CHRISTY ARMSTRONG Staff Writer
Posted 8/11/17

It is something families don’t much like talking about, and it is something about which there are plenty of misconceptions. That something is hospice care.

Dr. Greg Phelps, medical director …

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Hospice not all about sadness: Phelps

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It is something families don’t much like talking about, and it is something about which there are plenty of misconceptions. That something is hospice care.

Dr. Greg Phelps, medical director for Hospice of Chattanooga’s Cleveland location, sought to clear up some of them while speaking to the Bradley Sunrise Rotary Club on Thursday.

Phelps said a lot of people think hospice is “really sad” and that some think hospice care involves nothing more than giving a person painkillers until they die.

“When time is short, we do the best we can for quality of life,” Phelps said. “It doesn’t have to be all sadness.”

Hospice care does include palliative care, health care designed to manage the patient’s symptoms and make them comfortable.

However, patients in hospice are often encouraged to take stock of their lives and enjoy the time they have left.

Phelps said he has personally been inspired by seeing some patients cross items off their “bucket lists,” including taking special trips. Oftentimes, people will find peace and happiness through these experiences.

The dying have a lot to teach the rest of us about living, he added.

He urged the Rotarians to think about their individual callings and make sure they begin pursuing them.

“We sometimes get so locked in to our daily lives that we forget why we’re here,” said Phelps.

The doctor quipped life itself is “a terminal illness” and that death is an eventuality for everyone. That is why it’s good to take stock sooner rather than later.

That is also true of end-of-life care such as hospice care. He said people should make sure their families know what their wishes are sooner rather than later.

Phelps gave the Rotarians a brief history of hospice care and what it can entail. The hospice care movement first got its start in England in 1967, and it was officially recognized with legislation by the U.S. Congress in 1982.

Hospice care is for patients who doctors think have six months or fewer to live, Phelps said. He explained there are various evaluations in place to make sure hospice is a good fit for the patient.

Once in hospice, the patient receives palliative care from a team of health care professionals. However, the focus becomes providing care to make the patient comfortable, rather than trying to cure the patient. For example, a hospice patient with cancer will have ended cancer treatments.

“There are a lot of patients who can benefit from hospice care — and not just those you might think,” Phelps said.

He said Hospice of Chattanooga has seen patients with heart disease, end-stage renal failure and more, in addition to cancer.

Hospice is beneficial for those nearing the end of life because their care is centered around making them comfortable, Phelps said.

In fact, he said some patients actually see some short-term improvement, in part because they stop undergoing aggressive treatments and no longer have their side effects.

Extra support, including visits with chaplains and bereavement counseling, is also offered to patients and their families.

“The question is not whether or not the patient is dying; we all die eventually,” Phelps said. “The question is, what do you do with the amount of time you have left?”

Phelps explained medical technology is continually allowing doctors to help prolong life in new ways. However, this means it is not uncommon for patients to spend their last days in hospitals hooked up to ventilators and numerous other machines.

When a patient makes the decision to enter hospice care, he or she is making a decision about his or her end-of-life wishes. Hospice staff go over this with patients, so their deaths will be on their own terms.

While dying may be an unpleasant topic to think about, Phelps stressed the importance of people figuring out what their preferences might be, and informing their loved ones.

“We plan births; we plan weddings; we plan for everything except dying,” Phelps said. “However, dying is as much a part of life as anything else.”

He encouraged the Rotarians to be thinking about what they would want the ends of their lives to be like, and to consider creating advanced care plans, or living wills. A lot of times, people don’t have that figured out until they are actually close to death.

He showed a copy of an advanced care plan which can legally be filed in Tennessee.

It asks about things like whether or not one wants to be resuscitated after his or her heart stops. No lawyers are needed; it just requires the signatures of a couple witnesses.

Though this plan might not be needed for a long time, Phelps said having one can provide both the patient and his or her family a little extra peace of mind during a life-threatening health emergency.

“The important thing is that you talk with your family,” said Phelps.

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