With advances in healthcare and medication at our disposal, healthcare professionals are skilled at controlling physical pain at end of life. However, how are we doing with controlling other components of pain? Dame Cicely Saunders stated, “Of all the components of pain within the total pain module, spiritual pain is the least diagnosed cause of pain, and yet is a main contributor to the most painful deaths I have witnessed.” This quote depicts that the other side of pain is pushed aside, forgotten, or missed. We seem to forget about other components in the total pain module until we have exhausted all options in treating physical signs of pain. Only then do we start questioning, what is the root of pain? Is it physical, or is it being exacerbated or initiated by emotional, social, or spiritual conflicts in the patient’s life?
The national median length of stay on hospice is approximately 19 days. One of the reasons we educate on the importance of admitting sooner is not only for the physical symptoms, but for the other components of pain (emotional, social, and spiritual) associated with death that can increase the overall suffering of a patient. The earlier a patient is referred, the more we can do to help. Early referrals allow hospice time to teach families to provide care and educate them on patient-specific, end-of-life symptoms including spiritual and emotional pain. Early referrals also allow patients and families time to make informed decisions about the patient’s care. Families who receive hospice longer are more likely to use bereavement services offered by professionals they know and trust.
In hospice, we never hear patients or families comment about being on hospice too long, but what we always hear is, “We wish we would have done this earlier.” Hospice is not about giving up. Emotional, physical, and spiritual support are provided by hospice. Heart ‘n Home can help keep patients comfortable and give their loved ones the support needed so they can truly appreciate the time left that they have together.