Before Seth Kalhagen got into hospice work, he was a missionary. As it turns out, that was good training. A missionary spirit comes in handy when dealing with a subject people are hesitant to talk about and often misunderstand.
Seth, who is Ecumen’s Director of Hospice, usually starts the conversation with this fundamental point: hospice is not just about dying.
It’s about living every minute to the fullest.
“When most people think about hospice, they think about life being over and giving up all hope,” Seth says. “The whole idea of hospice is to help people live as fully as possible for how ever much time is left.”
When hospice goes as it should, people pursue their dreams, say the things they’ve left unsaid, do the things they’ve left undone. In short, they find a peaceful closure in the final days of life.
Choosing hospice is a decision to end all life-extending or curative medical intervention, such as deciding to stop chemotherapy or forgoing another radical surgery. Ironically, studies show that people who take this route often end up living longer than those who continue curative medical care. Hospice tends to reduce stress and increases comfort, which can prolong life.
But that’s not really the point. “Hospice is not designed to shorten or lengthen life,” Seth says. “It’s designed to add quality. Hospice is about relieving physical and emotional pain and managing symptoms, so that patients can be as comfortable and as much at peace as possible. Dying does not need to be painful.”
But it’s also a myth that hospice just sedates people. “There’s a lot more to it,” Seth says. “Pain management is essential, but spiritual counseling and various therapies — like art, music and physical therapy — are an important part of the care. And spirituality is a big part of hospice.”
When a person chooses hospice, Seth says, it’s not a decision to go to a physical place. While there are a few dedicated hospice centers, most hospice care now takes place wherever a person calls home, and patients can remain under the care of their primary physician. “The whole idea of hospice is to give patients the care they need in the place they feel most comfortable,” Seth says. “Hospice is about comfort.”
Another misconception, Seth notes, is that hospice is too expensive. In fact, Medicare covers hospice, as do Medicaid, Medical Assistance, VA benefits, private insurance and charity care. Once a person is certified as hospice eligible by a physician, most all expenses are paid. Also, the benefits of hospice don’t end when a patient dies. Families get grief support in the form of bereavement care up to 13 months after the patient’s death.
About 50 percent of people in hospice are there less than three weeks, Seth says, but the time can be much longer. To be qualified for hospice, a doctor certifies that a patient has six months or less to live if an illness runs its normal course. A person’s decision to go on hospice care is not irreversible. It’s a care choice, and you can always change your mind and return to curative medical care.
The number of people choosing hospice is growing every year, and Seth is now ramping up Ecumen’s hospice services in the Twin Cities metro area, expanding referral networks and recruiting staff. (Go to this link for a list of Ecumen Hospice job openings.)
“Most people working in hospice will tell you it’s not just a job — it’s a calling,” Seth says. “People who work in hospice are extremely compassionate and caring.”
November is National Hospice and Palliative Care Month. This month, the National Hospice and Palliative Care Organization, and other organizations are teaming up to encourage increased understanding and awareness of end-of-life care.
This month, the Ecumen Changing Aging Blog is featuring posts about hospice care.
Here are some of our favorite posts on hospice: