Hospice is not a place but a philosophy of care. Hospice cares for people wherever they are located: their home, a nursing or assisted living facility, or a hospital.
This special kind of care focuses on improving the quality of life for people who are experiencing a life-limiting illness for which there is no conventional curative treatment. Hospice care is usually offered for people with a terminal diagnosis who are expected to live six months or less.
Hospice care focuses on managing pains and symptoms associated with the end of life while providing emotional and spiritual support. Hospice care looks at how the illness is affecting the person as a whole and tries to relieve stress and suffering. The focus of medical care transitions to pain and symptom management and away from major curative treatments, which are deemed as inappropriate interventions that cannot provide a cure and may increase pain and agony.
Many Jews are hesitant regarding hospice care because of two major misconceptions:
Misconception #1: It is always wrong to “give up.”
This perspective misunderstands the motivation and approach of hospice care.
Undoubtedly, it is frequently advisable for patients or their families to get additional opinion(s), sometimes at another medical institution, about a given diagnosis or prognosis, or to explore additional therapeutic options. Yet once curative treatments have been exhausted, focus should turn to maintaining the best quality of life as possible.
This is not “giving up.” Instead, it accepts mortality and tries to help the patient to live as meaningful a life as possible until the very last breath. This includes not only managing pain but also providing emotional and spiritual care, allowing for the patient to have meaningful interactions with friends and family and engage in introspection, prayer, and reflection.
Misconception #2: A Jew does everything they can to prolong life under all circumstances.
This misperception can cause much unnecessary suffering. Yes, Judaism believes in the sanctity of life and obligates us to save life whenever possible. Yet if you or a loved one has been diagnosed with a terminal illness, there may come a time when efforts to slow the illness are not working and become more harmful than helpful.
Many studies show that people under hospice care live just as long, if not longer, than people with similar conditions who are undergoing aggressive interventions to slow the disease. These interventions come with risks and painful side effects that can have a detrimental impact on one’s health. Under hospice care, these additional risks are avoided while people dedicate their last months of life with family and friends or in the comfort of their home.
Hospice care does not always fit everyone’s needs or preferences, but it is a very good option for those seeking to minimize pain and preserve dignity and comfort, all of which are Jewish values.
Hospice options vary in different states and countries and are contingent on one’s physical and emotional state as well as resources. It’s important to talk to your healthcare and social service providers about which programs have the best reputations and can offer the best services for your needs.
When considering hospice programs, we highly recommend inquiring about policies regarding:
- Provision of nutrition, hydration, or oxygen necessary for comfort and basic sustenance.
- Checking for vital signs and other basic medical tests.
- Treatment of medical complications (unrelated to the underlying disease) that might arise during hospice care, especially when they are causing discomfort.
- Provision of sufficient nursing care for other needs.
The answers to these questions will help you select a provider that fulfills the values mandated by Jewish law, matches your expectations, and fits your healthcare goals and preferences. It is important to remember that if a patient’s condition should change or one rethinks their decision, they can unenroll from hospice at any time.
The benefits of hospice care are typically most appreciated when people utilize it before the patient is in very critical condition. Ematai’s conversation guide helps you clarify with loved ones your healthcare goals so that this option can be explored in a timely manner, if so desired.