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One More Thing Barbara Bush Taught Us

Barbara Bush, wife and mother to presidents, has taught us another lesson this past week, and it is about how she chose to die.  She taught us that palliative care and hospice care are different concepts, but she also taught us about the importance of an end of life plan.  Let me start with the first.

Let me clarify that hospice care is reserved for patients who will face an end to treatment and wish to be comfortable.  Palliative care is simply the “comfort care” we saw requested for Ms. Bush, but it can be for any patient about to embark on a difficult or painful treatment regimen.  We deal with a lot of families of older loved ones who are faced with difficult diagnoses.  If the diagnosis has a treatment option that may prove difficult or painful, doctors may suggest palliative care.  And that is when some family members may freak out just a bit… not an exaggeration.  Yes, they may freak out because there is an association between palliative care and end of life, or hospice care.

So what we saw for the former first lady was a care plan that included anything she needed to simply die comfortably, hospice care, but they did refer to it as comfort care.  Ms. Bush was able to make her own decision at the point when a choice needed to be made, but so many people will not get that chance.  This is also why it is important for families to have a discussion about the “what if scenarios” that families may face.  What if there is no hope for recovery?  What if the patient will not regain consciousness to make a decision about how to cope with a potentially painful end of life?

As an Aging Life Care professional, we talk about the importance of a care plan.  A key element of a comprehensive care plan will be what to do if.   ….If mom cannot make the choice for ending treatment…If dad’s dementia precludes dad’s own decision for comfort care.

We were told in Ms. Bush’s eulogies that she ended life pretty much on her terms.  I would encourage us all in this country to make plans with family members that will assure the same level of comfort…that we should all end life on our own terms.  If you have not already, it may be time to speak with your older loved one about what “their terms” are.  You and they will be very gratified that you were sufficiently bold to start the conversation.

Charlotte Bishop is an Aging Life Care Advisor, Geriatric Care Manager and founder of Creative Care Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago.  She also is the co-author of How Do I Know You? A Caregiver’s Lifesaver for Dealing with Dementia.


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