When Grandma was diagnosed with terminal lung cancer 2 months ago, I urged Mom to learn about hospice. Everything I’d read was positive, and having been through a lot of scary drama during the last few days of my grandfather’s life, I strongly felt that this time we needed to be smart, be prepared, and take steps early on to ensure that the final days pass as smoothly and peacefully as possible.

Unfortunately, denial is pretty powerful — as are misinformation and fear. And so when Mom asked Grandma’s primary care doctor about hospice, she came away from the conversation frightened, with a skewed view of the facts and a very negative impression of what hospice does. She agreed to use home health services instead, despite the fact that they cared for my grandfather and were unable to make him comfortable in his final days.

Thankfully, my aunt (Mom’s sister-in-law) took over last week and did some research herself, calling the nearest hospice agency and discussing the situation with them. Based on that conversation, she scheduled a meeting for us to learn more about what hospice has to offer.

We spoke with the hospice rep for nearly 2 hours on Wednesday. It was emotionally grueling; Mom is extremely invested in Grandma’s care (she’s moved in with her and cared for her almost constantly the past 3 weeks) and isn’t ready to admit that Grandma’s condition is only going to deteriorate more as the days pass. The rest of us — me, Dad, Mom’s brother and his wife — all came away from the meeting in favor of switching to hospice now, before Grandma gets any worse; hospice personnel are cancer experts, and they’re most capable of guiding us through the minefield we have to navigate. But Mom has the final say, and even after 2 hours of discussion, Mom wasn’t ready to say yes.

Mom and I talked more yesterday and again today, going over the same details. No, they won’t give her morphine until she needs it. Yes, Grandma can still get treatment for anything other than the cancer. Yes, they’ll give her antibiotics if she needs them. Yes, you can call 911 if she has a heart attack while she’s still at home. No, they won’t take her to the hospice facility until it’s necessary. Yes, they’ll move her to the facility if she can’t get out of bed anymore. And on and on.

Mom said she needed to talk with a priest. I explained to her that she didn’t need permission from the church, that we aren’t required to keep someone alive with a machine (in this case, a ventilator) when there’s no chance of recovery.

She wanted to hear that from someone in authority.

But this afternoon, after meeting with a priest, Mom gave the order to Grandma’s doctor: we want to switch her to hospice care.

It was pretty tumultuous getting to this point, although I can understand Mom’s point of view: once she signs the papers, it’s real. No more false hope. No happy ending. But delaying just means a greater chance of the worst possible ending, of Grandma’s lung collapsing while she’s still in her home. And none of us want that.

A peaceful ending is the best any of us can expect. Sometimes, we just have to broaden our definition of peaceful.

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