Hospice: Good Idea If Done Right

Daily Observer

August 4, 1980

 

Hospices, places where death can be institutionalized, are gaining favor. Not because of heartfelt sympathy for the dying, but because the cost-conscious social “scientists” have decided that it is cheaper to die in a hospice than in a hospital.

 

It is hoped that the hospice will provide a nicer atmosphere for the dying than does the hospital; that the patient and family will be psychologically prepared for the impending death and that allo can accept this somewhat intimidating reality with faithy, grace and a sense of cosmic fulfillment.

 

Why is it that we feel we can plan everything remains a mystery? So far most of what wse have “planned” has not worked out too well. Maybe hospices will be an inmprovement over what exists. But I am not sure. It sounds like sort of a nursing home for the terminally ill, and a Disneyland for the yet to be bereaved. I guess the place will be filed with psychologists and social workers explaining how it is to die and what to expect and how to handle it.

 

I don’t know how pain will be handled. Whether doctors will be encouraged to use narcoticsx to relieve it. I don’t know whether morphione will be alowed to assuage the mental pain of impending separation or will this be dealt with by enforced psychotherapy with or without religious embellishments.

 

The whole thing may be a great idea and may work out wonderfully. Perhaps there will be long lines waiting to get in. But it would seem that the privacy and indivuality of death and dying will have been lost.

 

Lingering death is a personal and difficult episode, indeed the last episode of life. The first prerequisite for going to a hospice is top be aware that youy are dying. Some peopole never want to know that, nor want to think about death.

 

There is much pretense in the final  days, and often doctor and family sensing the nature of the patient’s defenses against knowledge, protect the secret and go alonbg with the deception. That sort of gamesmanship in deference to death could not occur in a hospice. In a hospice it will all hang out. We are all dying and had better learn to create an ambience which makes the best out of a bad deal. So far so good. The patients may help each other in agonal moments. They will observe death and perhapos lose their fear of it. Perhaps.

 

Also, left totheir own devices they dying might want to ease their mental and physical pain with drugs, alcohol or even a little pot. That’s not a bad idea. Let the last moments be free of the restrictions of society. Have an open bar. Leave the narcotics closet unlocked.. Give all the guests a syringe and teach them how to use it. Prepare an excellent cuisine Let the motto resound, “eat drink and be merry for tomorrow we may die”.

 

But I don’t think that’s to be. I think that the hospice will be a tightly budgeted closely administered place staffed by young health health-care professionals holding “health-education” classes teaching that drink, smoking, pot and narcotics are really bad for their health. I can see them short on expensive proteins and long on cheaper carbohydrates. I can see a costly $40,000 a year administrator checking on all this.

 

In my view a hospice should offer Disney Land, Reno or religion in any combination the dying patient wants. But I fear it will be more a prison than a fun place, a jail than a chapel/.