Hospice (cont.)

Medical Author:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Medical Editor:

Jerry R. Balentine, DO, FACEP

Jerry R. Balentine, DO, FACEP

Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

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A nurse will assess the ill person's condition and keep in close touch with the doctor. Other key staff members include the following:

• The nurse also will keep in touch with the treating physician and the hospice medical director about any symptoms of pain, nausea, constipation, depression, or other medical conditions that need treatment. Often the ill person's symptoms can be improved significantly even though the basic illness cannot be cured.
• A social worker will assess any issues affecting the ability of the ill person's family to deal with the illness or with any other social problems arising during the illness.
• Clergy will help the family deal with spiritual issues around death and dying.
• If necessary, a nutritionist will help the family deal with the fact that the person's appetite gets worse at the end of life. At times, the patient no longer likes the taste of foods that he or she previously loved. The nutritionist may help the family find other foods or recipes that the patient can enjoy.
• A grief counselor will evaluate the family for any abnormal problems with the grieving process. Grieving often starts before the patient actually dies. The counselor will monitor the grief process for about 13 months after the person dies.
• Some hospices also can provide art or music therapy.
• Here is one example of hospice at its best:

At my hospice, above an old man's bed, where other residents might have placed a crucifix or a favorite family photo, hung a simple frame with a yellowed piece of paper. On the paper, still legible, was a poem. The poem had been written, the old man said, during the long days aboard his troop ship headed for the Pacific islands during WWII. He'd always wanted to put it to music, but allowed as how he "just never got around to it."

Now, he knew, he was dying.

Both the old man and the poem deserved music. But the hospice served a small rural county; no music therapist here. I copied the poem and published it on the Internet to a music discussion chatroom. "Could someone put it to music?" I asked.

Someone could. An email brought me the composed tune. I printed the music out and gave it to a singer in our local community college theater group. She and one of the pianists in the group recorded the song.

The old man died. But not before he could hear the music he had started.

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