Hospice For Utah's Medical Director, Dr. Gary Holland, is trained in pain management and end of life care. Fluent in English and Spanish, Dr. Holland consults with the patient's primary physician in caring for the patient and visits patients where ever they reside to care for the patient's medical needs. Following are common questions he has encountered and his expert answers.
Q: What do you say to Hospice patients and their families who are worried about addiction to narcotics?
A. This is a frequent concern of our patients who often come from a very conservative religious background. The last thing they would ever want their loved one or themselves to struggle with is drug addiction. So this is a very real concern. I try to explain the difference to families between drug dependence and drug addiction as they are very different processes. I reassure my patients that after a lifetime of using no medication, having a disease that requires strong pain medication will not make them a drug addict. Two things need to exist in order for a person to have an addiction. The first being an addictive personality. The second is availability to increase the narcotics one is taking. First off, our patients have significant pain and a real disease. They usually do not have an addictive personality disorder and if they do, we are aware of that and control the medications they get. Our primary concern is always pain control. If someone is taking a medication for pain control at the levels they are prescribed, while they may develop a dependence on the pain medicine in order to feel normal, they will not develop an addiction. This is usually reassuring to families as their first priority is to want their loved ones comfortable.
Q: Does my loved one have to have a terminal diagnosis to be on hospice services?
A: Many of our hospice patients don’t have a specific terminal diagnosis such as cancer or heart failure. Frequently, elderly patients have grown tired of our aggressive health care system and they just want to be home and be comfortable. These patients may not have a specific diagnosis, but they are getting weaker, falling and having more difficulty with activities of daily living. Often hospice can help a loved one stay in their home during these difficult times and die with dignity surrounded by their family.
Q: Do I have to have cancer to be on hospice?
A: Absolutely not! While we often think of cancer as being the only terminal disease. There are many disease processes that can take your life. In order to sustain life all our organ systems must be functioning; These organ systems and the diseases that affect them include 1) the brain with dementia 2) the gastrointestinal tract with weight loss and malnutrition 3) the heart with congestive heart failure 4) the lungs with asthma or emphysema 5) the kidneys with renal failure from diabetes or high blood pressure. The failing of any of these organ systems can qualify you for hospice care.
|
