Over the past week, we have heard a lot about former First Lady Barbara Bush making the decision to pass away on her own terms. She wanted to be surrounded by her loved ones and as she did in life, ended her days in a peaceful, love-filled environment.
You may recall, just days before her death, at the age of 92, Mrs. Bush made the decision with her doctors to no longer seek life-saving medical treatment, and instead preferred to receive “comfort care.”
While there are many viewpoints on what it means to stop fighting or continue to treat terminal illness, the conversation has sparked interest in the concept of comfort care.
Commonly thought of in cases where people are suffering through long battles with cancer and other diseases, comfort care usually refers to Palliative Care. This is a medical specialty that focuses on managing a patients’ symptoms vs. managing the disease or illness; and keeping the patient comfortable in their last stages of life.
According to reports, Mrs. Bush was hospitalized multiple times in the past year, battling chronic obstructive pulmonary disease (COPD) and congestive heart failure.
Comfort care is not just for those who have been diagnosed with a terminal illness. According to Palliative Care Specialist at Adena Regional Medical Center, Dr. Richard Greeno, “Providers engage in comfort care with all patients from the moment they see them – as the ultimate goal in treatment is to make patients more comfortable.”
In a situation like Mrs. Bush experienced, comfort care is when a patient decides it is time to stop treating the disease, and time to start focusing on treating the symptoms and being more comfortable.
When treatments are no longer working, and the patient is ready, physicians often suggest comfort care. If the patient and their family is ready, the provider will focus on keeping them comfortable on the final leg of life’s journey.
“We work with the patient and their family to determine what option is right for them before making any decisions,” added Dr. Greeno.
It is common that patients will choose this option when they are experiencing side effects that cause them more issues and discomfort than the disease itself.
“I would rather have two weeks of being myself, reminiscing on the good times with family and friends, than six months of vomiting in the bathroom and sleeping away my final days,” explained Dr. Greeno. “At this point in life, there are medicines that can do things to you, but not necessarily for you. That is when comfort care can become the best option.”
Mrs. Bush’s death has inspired a national discussion among families and health care providers to discuss, define and document end of life wishes, and to consider and honor all alternatives.
The Palliative Care team at Adena recognizes this can be a challenging decision for patients and families.
“The first thing I do as a physician is sit down with the patient and family members to explain from a medical stand point, that we cannot stop death,” said Dr. Greeno. “Patients who choose comfort care, like Mrs. Bush, are not giving up. However, modern medicine is not always going to win the fight over certain diseases, especially when the human body is too tired.”
Sometimes, continuing to fight can cause more damage to the human body then helping it. “I explain to families that we are most definitely not giving up. We are just redirecting the fight to the symptoms, and not the disease,” he said.
A spokeswoman said former President George H.W. Bush held his wife’s hand all day, and was by her side when she passed.
“This is an example of how death should be,” said Dr. Greeno. “No one should ever die in pain or in fear. If I can help eliminate pain and fear in my patients, I consider that a victory.”
Even though we all ultimately face death, this topic is one that many people avoid talking about.
What if you were involved in an accident, or had a serious health condition where you could no longer speak for yourself? Who would make your health care choices? Would they even know what you would want?
To get these often difficult conversations started, and to help families plan for those end-of-life decisions, Adena’s Palliative Care Team and Chaplain Rev. Paul Ray will host “The Talk,” a free program to help families initiate end-of-life health care decisions. The Talk will be held on from 9 a.m. to Noon on Saturday, April 28 at Walnut St. United Methodist Church, located at 16 S. Walnut Street in Chillicothe.