What is Comfort Care? End of Life Decisions

 April 18, 2018

This week Barbara Bush valiantly decided to forego active treatment and only receive comfort care during her last days. With this choice she has brought end of life decisions to the forefront of the public eye. As a chaplain at a retirement community for twelve years and teaching death and dying courses, talking about such decisions is somewhat second nature to me. I can forget that the vast majority of people are not as familiar with the topic. I’m not Dr. Death, but I am comfortable with the topic.

Dealing with these crucial decisions can be essential to the well-being of the individual and their loved ones. Yet far too many of us avoid these discussions, thereby hoping to evade the inevitable. There is much misunderstanding over what comfort care entails, how it differs from palliative care, and the role of hospice in this.

Comfort Care, Palliative Care and Hospice

Comfort care is care provided to keep the individual comfortable. It includes what would be considered ordinary measures such as providing food, water, and other treatment options to relieve pain and keep the patient comfortable. What it doesn’t include is treatment to cure or prolong life, or to hasten death. The objective is to prevent or relieve suffering once a person has decided to no longer seek a cure.

Palliative care includes comfort care but may include procedures to treat or cure the illness. The patient is kept comfortable while undergoing treatment.

For a person to receive hospice care there needs to be a terminal diagnosis and the decision to no longer seek treatment. Many misunderstand this to mean the patient is left to die a painful death. With all of the means for pain relief available today, there is no reason for a person to die in discomfort. Others think their loved ones will be medicated to the point of death. Actually the doctors involved with the care of patients under hospice walk a fine line. They balance the need for pain relief with providing the optimum quality of life for however many days a patient has remaining.

End of Life Decisions

There is so much more that goes into decisions related to a person’s final days. If we avoid asking our loved ones these difficult questions, we may find ourselves making decisions while under duress.  Thus we may not make the best choices for ourselves or our loved ones.

Most of us want a peaceful death, preferably in our sleep after a long and fulfilling life. We may not be able to control how we die. However, there are steps we can take to make our last days some of our best days.

If interested in learning more, my book, Walking with Families through the Dying Process, includes information on death and dying and how to maneuver this final journey. It is packed full of practical information for families.

Let’s continue the discussion started by Barbara Bush.

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