Partnership with Your Local Hospice

One of the problems faced by students who are interested in the issues of death and dying, are that we are unsure of where the resources are in our communities: Where we should go for assistance, where to find voices that have more experience. A helpful resource to you is your local hospice/ palliative care center. What is hospice? Hospice is a team of professionals and specially trained volunteers who work to address the medical, social, psychological and spiritual needs of the patient and their families. Hospice assists terminal patients with home-health care, with certain hospices having inpatient units for special needs. However, most hospices operate with the goal of the patients being cared for in the home setting, where it is most comfortable for the patient. Wherever the hospice care is presented, the main focus of hospice care is upon palliation of pain and other symptoms with the goal of improving quality of life rather than length of life. This emphasis on comfort care is the hallmark of hospice.

How does one access the resources of a local hospice?

1. Introduce yourself. The logical first step in approaching your local hospice is to make them aware you exist! As a medical student, you wield the tools necessary to approach anyone in the health professions: tact, courtesy, enthusiasm, and a learning mind. Write or call the medical director of your local hospice. Find out where your local hospice is from your medical school (try the dean of student affairs, your school's ethics department, or if all else fails, trustworthy physicians in your hematology/oncology department.) Explain to them that you are a medical student at such and such medical school, and say that you would like to learn more about hospice care, and care of the dying, and could you please meet with them (the hospice director) to discuss this. Few hospice directors will look upon your unfavorably. They realize that you are the future doctors who will be taking care of dying patients, and are eager for you to learn quality care for the dying.
   
   
2. Meet with the hospice. Don't skip the step of meeting with the hospice director: a face-to-face meeting will accomplish more than an arsenal of phone calls. This establishes you as the medical student who wants to learn about hospice. Often you will get a tour of the premises (if they have an inpatient unit), or your meeting will lead to an arrangement where you might "follow" one of the doctors or nurses on a home visit, so you can see what hospice is really like. Talk honestly and openly about your goals: what do you want to do in partnership with the hospice? What do you want to learn? How can they help you learn about good care of the dying patient? And lastly, what can you do for them as a student to further their goals?
   
   
3. Involve others. Don't keep all the riches to yourself! If your meeting with the hospice director goes favorably, ask the director if you may direct other medical students to them if they are interested in care of the dying. For a small hospice, they may not be able to accommodate more than one or two students: ask if there are other resources in the area that medical students may tap. Then ask your classmates and fellow medical students if they are interested in learning about care of the dying and hospice care.
   
   
4. Follow up. Don't sully the grand start you have made by "blowing off" any appointments or arrangements you have made with your local hospice. If you are the first medical student to ever approach them, remember you represent all the future medical students who may ever approach them. Treat this as you would any serious commitment. Keep the communication lines open. If you have to change plans, do so in a timely manner.
   
   
5. Caveat: Check with your school. As always, you are a medical student at your respective school, and as such, whatever you do reflects upon the school. Although you'd find it difficult to believe that doctors would not support hospice care, there may be some political/economic ramifications that you are not aware of. For example, medical school X does not associate with hospice Y because hospice Y has an association with medical school Z. Stranger things have happened, and you do not want to be caught in the middle. When you meet with the hospice director, ask if there are any issues between the hospice and the medical school/hospital you are from. Ask your dean of student affairs if they see any conflicts of interest.