The Decision for Hospice Care: How Can a Psychologist Help? by Dr. Rudy Nydegger
When someone has battled a serious illness and is given the information that there is nothing that can be done other than trying to make the patient comfortable and let the disease run its course, the patient and family are faced with an incredibly difficult and frightening situation with no clear path to follow. Fortunately, today there are some options that can make this impossibly challenging state of affairs somewhat more manageable. For example, in most communities there are hospice programs that are specifically designed to care for patients and families under these circumstances.
Hospice is a program of care for terminally ill patients and their families. Each patient/family has a multi-disciplinary team assigned to them that provides a number of different kinds of care: medical and nursing, psychosocial, spiritual if needed or desired, trained volunteers, and others if needed. The assumption is that each patient and family will have unique needs, and the treatment team is comprised of professionals and volunteers best suited to meet these needs.
The decision to enter hospice care is never an easy one, and often people do not know what hospice is or whether it is a reasonable option for them. Many feel that electing hospice care means that all hope is gone and they are just “giving up.” Actually, hospice care is not as much about death as it is about life and living it fully and comfortably even during the last stage.
When making a decision of this magnitude it is often helpful to have someone outside of the family who can assist the patient and family in understanding the ramifications of the decision, and to clarify issues that will help the patient and family decide what is best for them. Given the complexity and seriousness of this decision, a professional who is aware of the issues, familiar with the patient and family, and knowledgeable of the relevant options can be a significant help.
One professional who is well equipped to help families under these circumstances is a psychologist. Psychologists are trained to take very complex and difficult circumstances and formulate meaningful and responsive recommendations that can be very helpful. They are also able to look at the “big picture” and consider how various options will impact the patient and the whole family. Where the psychologist can be particularly helpful is to help the patient and family understand, evaluate, and consider the options that best meet their needs.
Finding a psychologist who might be of assistance in this type of situation is not as difficult as one might think. In most areas there are places where a person can find a psychologist and even determine what their area of expertise is. For example, one might determine if there is a local, regional, or state Psychological Association with a referral list, or the National Register of Health Service Providers in Psychology which has a listing of psychologists by location and has information about their training and areas of expertise.
For a decision of this magnitude, get the best source of help available—ask a psychologist; the helping professional who is trained to make a difference.
Rudy Nydegger, PhD
Chief of the Division of Psychology at Ellis Hospital
Clinical and Consulting Psychologist in practice over 30 years
Former President of the New York Psychological Association, and current Chair of the Legal and Legislative Committee.