It's not always easy to talk about end-of-life care – and that's partly because people tend to look back at them a little bit. We focus too much on the first word: End and not nearly enough on the most important word: Life. This shift in perspective may seem small, but it can make all the difference when it comes to a productive and proactive discussion about end-of-life care.
In part due to a lack of ease-accessible resources for patients and their families, there are a variety of misunderstandings regarding hospice and care at the end of life. The tendency to fix on the word end in elderly care is one of them, which in and of itself can have disastrous consequences. Viewed through the narrow lens of the end, one can assume that end-of-life care is a point where nothing meaningful can be done for the patient ̵
No one wants their relatives to spend their last moments in distress and discomfort – and hospice and palliative care can actually help alleviate unnecessary suffering for patients and their families. In addition, it has been shown that the early utilization of hospice and palliative care services produces a notable difference in patient outcomes, particularly in terms of quality of life. And that is the true heart of the problem.
In my view, patients do not go to the hospice to die – but to live and enjoy their remaining lives while the hospice team looks after them for medical problems. And although the individual care plan is tailored to each hospice patient, the overriding goal of this care is always the same: to improve the quality of life of the patient and his family.
Focusing on quality of life makes it easier for you to consider all your options, open a discussion, and make proactive decisions about end-of-life care. Still, it can still be uncomfortable when the time comes to sit down and have a conversation. To help get you started with this discussion, I've reviewed some tips from my own work as Head of Palliative & End of Life Care from Michigan Health Professionals and Head of Inpatient Clinical Operations at Karmanos-McLaren Oakland Cancer Center:  Choose a Quiet, Comfortable Environment: This is not a conversation you should make immediately. Plan on meeting your loved one at a time when you know none of you will be distracted – in a quiet and comfortable place where privacy is assured.
Author: DR. Adil Akhtar is associate professor at the Department of Medical Oncology and Hematology at Oakland University at the William Beaumont School of Medicine. Director of Inpatient Clinical Operations at Karmanos-McLaren Oakland Cancer Center, Michigan; and Head of Palliative & End of Life Care for health professionals in Michigan.