Providing Comfort at the End of Life [Dr. Cathy Leadabrand]

I am Dr. Cathy Leadabrand. I'm a hospitalist here at Brookings Hospital and I take care of patients from the beginning of the time they're admitted through their hospital stay and the time they're discharged.

How do you care for a patient at the end-of-life?

Traditional medicine is often focused at trying to treat a disease or modify the disease, but there's a lot of instances where as time goes by, perhaps they aren't getting better. And despite all the testing, all the medications and the x-rays, they just continue to decline. And there's a whole other side of medicine, where your focus is not on the disease and fixing it, but more on the symptoms and helping controlling the symptoms. And so, it's not a giving up, but patients often don't know that palliative care or hospice can be a wonderful tool to help them enjoy the time that they have left, try to get the symptoms out of the way so they can enjoy their life. And if they're at the very end of life, help them to have a peaceful death.

What options are available for hospice care?

We can also do hospice in a nursing home or sometimes we'll even do it in the hospital. But it's not so much a giving up, but changing your focus from the disease process to the symptoms. With every treatment on hospice and palliative care, you ask yourself, "Will it help them feel better? Will it help the patient feel better?" And if it doesn't, then you don't do that treatment.

How can hospice help end-of-life patients?

Many people fear the end-of-life, but often it's a huge relief or a weight off their shoulder when they have pursued palliative care. At the end-of-life, hospice can be a great tool, so a patient can not spend all their time in an ER or in the hospital or at a doctor's office, but spend more time at home. The nurse can come to them and help them with their symptoms so they can visit with their family, maybe reminisce, maybe say the things they want to say to their family members and have a peaceful, dignified death at home in a familiar surrounding.