What kind of care can I expect at the end of life?
Many kinds of treatment are available to manage symptoms and keep you comfortable at the end of life. These types of treatment are known as palliative care. Palliative care can also help people manage symptoms associated with other kinds of chronic conditions, such as heart disease or rheumatoid arthritis. The goal of palliative care is to help people maintain comfort and quality of life, regardless of whether their disease is curable.
At the end of life, care may be given at home or in a hospital or nursing home. You may also choose to receive care through a hospice, either at home or at a hospice facility, which provides palliative care and emotional and spiritual support for people who are in the late stages of a terminal illness. Your doctor can continue to direct your care and guide you to other resources as needed. Family, friends, and health professionals may help care for you as well.
What issues do I need to consider at the end of life?
Ideally, you will consider many end-of-life issues while you are active and able to communicate your wishes. By making arrangements in advance, valuable time can be used for other important matters, such as spending time with loved ones or tending to and nurturing relationships.
Important issues to consider:
- The type of medical treatments and procedures you want or don't want.
- The benefits of creating an advance directive that ideally includes a living will and a medical power of attorney. A living will is a legal document that expresses your wishes for medical care if you become unable to speak or make decisions for yourself. It allows you to provide guidance, in advance, about your wishes and preferences regarding your medical treatment at the end of life in the event you are incapacitated. A medical power of attorney (or durable power of attorney for health care) allows you to legally appoint a health care agent (also called a health care proxy) to make medical treatment decisions for you, not only at the end of your life but any time you are unable to speak for yourself.
- Whether you are interested in donating your organs. If so, you can complete an organ donor card, a witnessed document that states your desire to donate specific organs when you die. Many states allow you to designate your wishes on your driver's license.
It is important to communicate your feelings openly and clearly to those you love and to your health professionals. Making end-of-life care plans while you are still able may ease your mind and make your final days more meaningful.
Will I ever have to choose between palliative care and curative treatment?
In many cases, you can pursue curative treatment as you receive palliative care to help keep you comfortable. However, at some point you may want or need to choose which type of treatment takes priority. This is commonly the case if a patient decides to enter hospice care.
Stopping curative treatment is an option when it is very clear that your illness cannot be cured, if it becomes clear that further treatments will not be helpful, or if you and your doctor feel that the difficulties of treatment would outweigh its potential benefits. It is also an option if you simply decide, for whatever reason, that you no longer wish to receive treatment for your disease. However, focusing on pain relief and symptom management does not mean that you will not have access to your doctor or to excellent care. Furthermore, if your condition or desires change, you can talk with your doctor about shifting back to curative types of treatments.
How does culture affect the approach to care at the end of life?
Society's attitudes about the dying process help shape people's feelings about death and the kinds of treatments they wish to pursue near the end of life. In developed countries, death has evolved from an event that is accepted as a natural part of the cycle of life to something that many people try to avoid or escape.
In the past, death was visible and dealt with openly. A dying person was almost always cared for at home. Advances in medical technology have made death more removed from everyday life. People near the end of life are now cared for most often in hospitals or nursing homes. As a result, many people are less familiar and less comfortable with the dying process.
Aggressive medical interventions have prolonged life, even in the face of long-term, chronic illness. As a result, some people view illness as conquerable and death as something that can and should be avoided as long as possible, at any cost, and sometimes even without regard to quality of life.
Consider your cultural background and feelings about death as you review your treatment options at the end of life. If you can discuss these issues openly with your loved ones, it will help them to understand and be familiar with your treatment preferences, and to be emotionally prepared for your death and best able to support you as the process unfolds.
Important Decisions
Many important decisions can be made about the care you want to receive at the end of life while you are active and able to communicate your wishes. By making arrangements in advance, you can spare your loved ones from having to make agonizing decisions on your behalf, without your input.
Communicating Your Health Care Decisions
By completing an advance directive, which documents your health care preferences, you can help ensure that your wishes will be respected if you become unable to communicate for yourself.
An advance directive can always be changed as your personal needs and goals change. Advance directives include:
- A living will, which is a legal document that expresses your wishes for medical care if you become unable to speak or make decisions for yourself. It allows you to provide guidance, in advance, about your wishes and preferences regarding your medical treatment at the end of life. Check the laws governing living wills in your state. When considering some of the more difficult end-of-life decisions, it may help to think about what kinds of medical procedures you would or would not want. Be sure to discuss these with your physician.
- A medical power of attorney (or durable power of attorney for health care), which allows you to legally appoint a health care agent (also called a health care proxy) to make medical treatment decisions for you, not only at the end of your life but any time you are unable to speak for yourself. You can and should make decisions about your medical treatment for as long as you are able to make and communicate them. However, when this is not possible, your health care agent can use both the written information in your living will as well as what he or she knows about you personally to make decisions about your medical treatment.
- Make sure copies of these important documents are safeguarded by a trusted family member or friend, and are also in your medical files at your physician's office.
For more information on choosing a health care agent and writing an advance directive, see:
Organ Donation
Organ donation is another important decision to consider at the end of life. Many people need organ transplants because of medical conditions such as kidney failure, corneal disease, or heart failure. After your death, your organs may be useful to others depending on your condition. Talk to your doctor about whether your illness allows you to be an organ donor.
If you choose to donate, your organs may be distributed to one or more people, based on blood and tissue type, the severity of the recipient's medical condition, how long the recipient has been waiting, and geographical location.
If you are interested in donating, you can indicate this on an organ donor card, a witnessed document that states your desire to donate your organs. On this card, you can specify which organs you wish to donate, or you can choose to donate any organ that is needed at the time of your death. Many states allow people to designate their wishes regarding organ donation on their driver's license.
People under the age of 18 must have a parent's or guardian's consent to donate organs.
Even if you complete a donor card or indicate your wishes on your driver's license, it is important to discuss your decision with your family. After your death, your family may be asked to give consent prior to donating your organs. For this reason, it is important to make sure that your family knows and understands your desires.
Organ donation will not disfigure your body, nor will it interfere with your funeral, including plans for an open-casket funeral. You and your family will not be responsible for the costs associated with organ donation-those costs are paid by the person who receives the organ or their insurance company.
Estate Planning
As you make end-of-life decisions, an attorney can advise you on how best to organize your estate so your family can handle your affairs after your death. Also, a financial planner or social worker may be available in your community or through a local hospital or hospice program. If your finances are limited, some attorneys and accountants offer services at a reduced rate or at no cost (pro bono).
Estate planning may include:
- Writing a will. If you already have a will, it may need to be updated. If you do not make your wishes known in a will, your state law will dictate what happens to your property when you die. Generally, property is distributed to a spouse, to children, or if there are no spouse or children, to other relatives. If no relatives can be found, your property may be taken by the state. Consider appointing a person to oversee your property after your death. This person is called an executor. Once your will is written, keep it in a safe place, and let your executor and close family members know where it can be found.
- Appointing someone to make financial decisions for you in the event you are unable to do so, through a document called a "financial power of attorney."
- Choosing one or more people to care for your minor children (guardianship). A guardianship is a legal arrangement in which an adult has the court-ordered authority and responsibility to care for a child under the age of 18 or for an incapacitated adult.
- Ensuring your records are in a safe, accessible place. Documentation of a life insurance policy, pension, retirement account, or annuity should be stored in a safe place, along with bank account information, deeds to real estate, and investment information. Close family members, the executor of your estate, and your attorney should know where this information is kept.
Choosing the Care You Want
When you are diagnosed with a terminal illness, it can be difficult to know whether you should focus on treatment to cure your condition or prolong your life or, to focus instead on palliative care to relieve pain and maintain comfort. Several factors may affect your decision about the kind of care you want, including:
- Your illness: If you are diagnosed with a serious illness, curative treatment options may be available. Certain diseases, such as skin cancer, colon cancer, testicular cancer, and cervical cancer, are often cured with appropriate medical treatment. Other serious illnesses, such as diabetes and AIDS, cannot be cured but can be managed successfully for many years. Conversely, some illnesses are more aggressive and life-limiting.
- Your treatment options: Many medical treatment options offer the chance of curing a disease with little impact on the quality of your life. However, other treatments may prolong your life but may be associated with side effects that drastically decrease the quality of your life.
- Your age and other health conditions: Older people with multiple health problems may be more likely than relatively healthier younger people to choose care that focuses on keeping them comfortable rather than keeping them alive as long as possible.
To read some stories from patients who were considering the kind of care they wished to receive, click here.
Talking to Your Health Professional
When you are diagnosed with a terminal disease or condition, it is important to communicate your preferences and concerns clearly to your health professional. Likewise, you should expect your health professional to communicate openly and sensitively with you and your loved ones. Your health professional can provide information, answer questions, and advise you. So can family and friends. However, the decisions are yours.
Gather as much information about your disease as possible. If you do not understand what is being said, ask questions until you do. It may be helpful to write down your questions before your appointment. Important questions to ask your health professional include:
- What is my diagnosis?
- What are my treatment options? What are the side effects of these treatments?
- What do you think will happen if I choose not to treat my illness?
- How long do you think I have to live?
- How soon do I need to make a decision about which treatment to use (or to not use)?
- How will my illness and care affect my loved ones?
Explore all of the possibilities with your health professional and loved ones.
There may be times when you have difficulty understanding your health professional. Sometimes good communication is difficult, especially when end-of-life issues are the focus. You may be frustrated if you feel your health professional is not communicating openly with you or is avoiding your questions. Understanding why these problems sometimes occur may decrease your frustration and help you to think of ways to improve communication.
- Communicating difficult news to a person is not easy. Your health professional may have provided care to you for a long time; perhaps he or she feels close to you. Remember that your health professional is human, and although you want to know as much as possible about your illness, your doctor cannot predict exactly what will happen, especially how and when your life will end. A recent study showed that the better a doctor knows a patient, the more likely the doctor is to overestimate the patient's life expectancy and to delay end-of-life care.2 Health professionals may overestimate survival time because they do not want to believe that a patient they feel close to is not doing well. It may be helpful to see another doctor who can give you a second medical opinion.
- Some doctors have a difficult time talking to their patients about issues at the end of life because they view death as their own failure. Doctors have been trained to cure illnesses and save lives, so some may feel they have failed their patients. Until recently, medical schools in the United States did not teach about care at the end of life. As a result, many doctors may have little training or experience talking to dying people. As more medical schools address end-of-life care in their curricula, more doctors will learn to communicate more skillfully with their dying patients. Seeking help from others (such as a support group for people with life-limiting illnesses) may help you through this difficult emotional time.
- Some doctors feel they are not providing the best possible care unless they offer the most technologically advanced treatment, such as mechanical ventilation. Some doctors fear they may be sued for malpractice if high-tech treatments are not offered, even in situations in which death is certain. The best way to avoid unwanted medical treatments at the end of your life is to think about what treatments you do and don't want, communicate your thoughts clearly and directly, and record your wishes in writing through an advance directive.
- Your illness may prevent you from feeling well enough to communicate effectively with your health professional. You may be too tired, discouraged, or preoccupied to remember all your questions. Also, your health professional may explain the situation in terms that are difficult for you to understand. You may find it helpful to take along a family member or a friend to your medical appointments. Another person can help you listen as your disease and treatment options are explained to you. Don't hesitate to take notes, if this is helpful for you. Some patients even find it helpful to tape record their visits. And it's also OK to ask your health professional to slow down, if needed.
- Don't be afraid to raise spiritual issues with your doctor, especially if you have religious beliefs that affect your treatment choices. Although you cannot expect your doctor to understand or resolve your spiritual issues, discussing them may help your doctor better understand your emotional needs.
- Limited time with a health professional has always been a concern of patients (and health professionals). Prepare for your appointments by writing down your questions and concerns and take this paper to your appointment. This will help you remember to address the important issues. If a family member or friend is going with you to your medical appointment, rehearse with that person what you want to cover during your appointment.
- As your illness progresses, you may become too ill to continue seeing your health professional at a clinic or to talk on the telephone. If you wish to be at home as you die, it is helpful to designate only one family member or friend to communicate with your health professional. Choosing one reliable person to relay messages will help avoid the confusion caused by several people trying to communicate with your health professional.
Aggressive Life-Sustaining Medical Treatment
It is important and wise to discuss with your loved ones and health professional how you feel about life-sustaining treatment.
There are many things to consider in the event that you suddenly become critically ill and unable to make choices and decisions on your own behalf. For example, a primary question involves whether you would like to receive cardiopulmonary resuscitation (CPR) if your breathing or heart stops. There are different degrees of CPR that can be performed that involve additional, and sometimes very aggressive, maneuvers such as chest compressions, electrical stimulation of your heart, and administration of various intravenous medications. If you stop breathing and CPR is performed, a ventilator or respirator may also be used to mechanically breathe for you. Although mechanical ventilation can prolong your life, your remaining days may be spent in the intensive care unit of a hospital connected to life-support equipment. You may not be fully alert and may not be able to speak.
It is essential to discuss all of these options and choices directly with your health professional, before a life-threatening emergency arises. Make sure all of your questions about your illness, specific treatment options, and chances for recovery are answered. Your family is an integral part of this process; discuss your options with them and clearly state your wishes. Some people who are facing death have strong and definite feelings about CPR, and the decision for or against life support may be easy. For other people, this decision is difficult. There is no right or wrong about this. What is most important is that you come to a decision that you feel is the right one for you, and for your unique circumstances.
To read some stories from patients who were considering this decision, click here.
Artificial Hydration and Nutrition
Another important treatment issue to consider is whether you would like intravenous lines (called "IVs") or "feeding tubes" to be used if you are no longer able to take food or fluids by mouth. Receiving fluids and/or food in this way is known as artificial hydration and nutrition. An IV is a needle placed into a vein through which fluids, liquid nutritional supplements, or medications can be given. A plastic or rubber feeding tube can be inserted into the stomach through the nose (called a nasogastric [NG] tube) or surgically inserted into the stomach through the abdomen (called a gastrostomy tube, a PEG tube, or a G-tube). As with an IV line, liquid nutritional supplements, fluids, or medications can be given through a feeding tube. A third form of artificial hydration, called hypodermoclysis, involves the infusion of fluids directly into the tissue beneath the skin.
Most patients who are unable to take in adequate food or fluid during an illness will be offered artificial hydration and nutrition, unless they explicitly document-in advance-that they do not wish to receive this treatment. As with other forms of life-sustaining treatment, it is important to speak with your doctor about your questions and preferences. Establishing a plan for IV fluids and feeding tubes early in the course of your illness will be very helpful if you are faced later on with the decision to pursue or forgo these treatments, especially if you are unable to speak on your own behalf. Remember to take the time necessary to communicate your wishes clearly with your family and doctor.
To read some stories from patients who were considering artificial hydration and nutrition, click here.
Where to Receive Care at the End of Life
Deciding where you will receive care as your illness progresses can be challenging, but discussing and planning for this in advance can decrease anxiety later on. Talk to your loved ones about the type of care you would like to receive at the end of your life. Discuss their expectations as well as your wishes, care needs, finances, and the needs of your family. Remember that your can always re-evaluate your options, and your choices may change as your illness changes.
Several care options are available, including hospice, home care, nursing home placement, and care at an assisted-living facility.
Hospice Care
As death nears, you may choose to receive help and support from a hospice. Hospice care focuses on using palliative therapies to manage pain and other symptoms when you and your physician have decided to forgo further life-sustaining treatment for your disease, and typically if death is anticipated within 6 months. Part of the care you receive in a hospice is focused on keeping you as alert and comfortable as possible in a familiar environment surrounded by your family and friends.
Hospice care is provided by a team of professionally trained health workers, including nurses, social workers, volunteers, counselors, and personal care assistants. Your doctor can continue to direct your care and work closely with you and the hospice team.
Hospice care most often occurs at your home, although it can be given in a nursing home, a hospital, or a residential hospice center. If you remain at home, the hospice team provides additional support to your family members, and gives them assistance and support in their care giving for you. And "family" is not limited to your spouse (or partner) or blood relatives; friends from your workplace, church, community, or neighborhood may be considered part of your family and participate in your care as well. If you are being treated in a residential hospice facility, your family and friends can visit you there, and also provide assistance with some aspects of your care. While visitors are generally welcome at nursing homes, most aspects of your daily care will be handled directly by nurses and other trained staff.
In addition to relieving physical symptoms, hospice care seeks to address your emotional, social, and spiritual needs, as well as those of your loved ones. Hospice offers a chance to address difficult but normal concerns that you and those you love may have about death and dying, such as pain, unresolved personal or interpersonal issues, and caregiving needs. If you choose, the counseling and support services that hospice provides will offer opportunities to work on mending important relationships and to explore spiritual issues.
The hospice team is available to help with advance directive forms and with legal and financial affairs. Also, hospice staff can answer questions about treatment and what to expect during the dying process. Assistance is also available to help with daily care needs, such as bathing, changing bandages and dressings, and organizing medications.
Hospice services are a benefit of many private health insurance policies; check your health plan for specific information about hospice coverage. Also, if you qualify for Medicare benefits, hospice services are covered through the Medicare hospice benefit.
For more information on choosing hospice, see Hospice Care.
Home Care
You may choose to remain at home as your illness progresses, especially if you have a large support network of family and friends who can help with your care. A variety of medical supplies and equipment can be brought to your home to facilitate your comfort and wellbeing, such as an adjustable hospital bed, oxygen tanks and tubing, and even intravenous (IV) infusions pumps if necessary. Another factor in making the choice to stay at home during this phase of your illness may include whether you have the financial resources to hire trained caregivers to assist your family with your care. For many people, remaining at home in a familiar environment, surrounded by loved ones, is indeed the best care option.
Many communities have a variety of services available to help your family provide care for you at home. Talk to your doctor about receiving help from a hospice or a nursing agency. Develop a list of people who can help your family with your care, including people from work, church, or community groups. In larger communities, private case management practices are often available to help find and coordinate the services you may need to be safely and properly cared for at home.
Nursing Home Care
You may consider receiving care in a nursing home if you are unable to remain at home during your illness. A nursing home also may be the best option if you need more skilled care than can be provided at home or if family members are unable to care for you for any reason.
Assisted-Living Facilities
Assisted-living facilities are a popular alternative to nursing homes for people who can provide the majority of their own care. Assisted-living facilities generally offer individual rooms with limited cooking facilities in each unit. Residents usually meet in a dining room for meals. Housekeeping and laundry services, social activities, and access to a nurse are generally provided as well.
Some assisted-living facilities are connected to a nursing home. In these facilities, you can transfer easily from the assisted-care facility to the nursing home when you are no longer able to provide your own care. Make sure that you receive clear information from the assisted-living facility about what is expected if your condition worsens and you are no longer able to care for yourself. Many assisted-living facilities require that the resident move to a nursing home or hire a personal caregiver if skilled care is needed.
Regulations for assisted-living facilities vary from state to state, as do the quality of services offered from one facility to another. If you are considering moving to an assisted-living facility, take the time to visit a few different options, and get advice and support form trusted family members and friends.
The Dying Process
If you are dying, or are caring for a dying loved one, you may have questions and concerns about what will happen physically, emotionally, or even spiritually as death approaches. The following information may help answer some of these questions.
Signs of Approaching Death
The dying process is as variable as the birthing process, and will have elements that are completely unique for each individual. The exact time of death cannot be predicted, nor can the exact manner in which an individual person will die. However, people in advanced stages of a terminal illness may experience many similar symptoms as they approach the end of life, regardless of their illness.
A number of physical and emotional changes generally occur as death approaches, including:
- Increasing weakness, fatigue, and sleepiness as periods of wakefulness become shorter and overall energy declines.
- Breathing changes, such as periods of rapid breathing alternating with short episodes when breathing stops.
- Visual and hearing changes, including possible episodes of seeing or hearing people or scenes that others do not (called hallucinations).
- Decreased appetite, as metabolism slows and appetite and interest in food diminishes.
- Urinary and bowel changes, such as dark or red urine and hard stools that can be difficult to pass (constipation).
- Temperature changes, such as running a high temperature one moment, then feeling cold the next.
- Emotional changes, such as feeling less interested in the outside world and being less socially involved with others.
Dying people may also experience symptoms specific to their illness. Talk to your doctor about what to expect. Also, if you have chosen to receive hospice care, the hospice team is available to answer any questions you or your loved ones may have about all aspects of the dying process. The more you and your loved ones know, the better able you will be to navigate through whatever is happening calmly, comfortably, and peacefully.
Pain
Palliative care can help you to feel relief from many physical symptoms related to your illness, such as nausea or difficulty breathing. Pain and symptom control are an important part of managing your illness and improving your quality of life.
Whether a person suffers from physical pain in the days before death depends on a variety of factors. Some terminal illnesses, such as bone or pancreatic cancer, are more commonly accompanied by physical pain than others. However, there are many kinds of treatments that can effectively relieve pain in the vast majority of illnesses.
Pain and other symptoms can be so feared that a person may consider physician-assisted suicide. While understandable, it is important to know that pain associated with the dying process can almost always be managed in a safe and meaningful way. Any pain should be reported to your family and your health professional. Many different medications, and many complementary therapies as well (such as acupuncture and massage), are available to treat the pain associated with dying. Do not hesitate to ask for help. Have a loved one report your pain if your illness prevents you from communicating with your doctor.
Many patients want to protect their family members from their suffering. While laudable, this impulse can often make the situation worse. It is important to tell your loved ones if your pain level is not tolerable so they can promptly inform your doctor and help you receive the care and assistance you need and deserve.
Spirituality
Spirituality is a unique and highly individual aspect of life for many people. It may or may not be related to a one's particular religious beliefs, and often relates to a one's sense of meaning and purpose in life. It can also be connected with a person's relationship to a source of higher power or inspiration that gives their life meaning. For some people, spirituality is a very private, personal matter; others like to share and celebrate their spirituality with family, friends, and groups.
Some people do not think of spiritual matters often; for others, spirituality is a part of daily life. Facing the end of your life may cause you to confront your own spiritual questions and issues. Organized religion provides comfort to many people as they face death. Others may find solace in exploring nature, through community involvement, by strengthening existing relationships, or by developing new relationships. Think about what provides comfort and support to you. What questions and concerns do you have? Don't hesitate to ask for support from friends, family, hospice workers, or spiritual advisers.
Caring for a Dying Loved One
The dying process can be a time for growth. It offers the dying person and his or her family and friends a time to mend relationships, share memories, and say their good-byes. If you are a caregiver, it is important to communicate openly with your dying loved one. Also, seek support from others and take care of yourself so you don't become physically and mentally exhausted.
Grieving the Death of a Loved One
It is normal to experience grief following a loved one's death and is part of being human. Grieving is also a gradual process that helps people accept their loss and to adjust to life without their loved one. It often takes 2 years or more to go through the most intense emotions of the grieving process. Although the pain of grief eventually fades, the sense of loss after a loved one's death may linger for a long time. Ideally, the sense of loss is gradually replaced by a deep sense of love and appreciation for all you shared with your loved one, and how blessed you feel by their presence in your life. It is common to feel and believe that this may never happen, especially when you are new to the grieving process. But trust and know that it can. Finding love, support, and connection with others can greatly facilitate the process.
Individuals experience grief physically and emotionally in their own unique ways. Shock, denial, anger, and guilt are all common reactions after the death of someone close. For example, a person may feel anger toward other family members, a higher being, or even at the person who died. Or survivors may feel guilty because their loved one had a long illness and they are relieved that the death finally occurred. These all are normal reactions to loss.
Survivors should strive to be kind and patient with themselves, and seek help and support if they are having a difficult time. Grief counseling can help many people who are having difficulty with the grieving process. Ask your own doctor, or your loved one's doctor, hospice care workers, or other health providers for advice and recommendations if you feel you need or would like some help in this or any other area.
Other Places to Get Help
Online Resources
Dying Well
The Dying Well website has resources for people facing life-limiting illness, their families, and their professional caregivers.
United States Government Site for Medicare Information
This website is the official United States government site for Medicare information. Basic Medicare information is available, including coverage, eligibility, and enrollment. Information on the Medicare hospice benefit and how to choose a nursing home is included.
Weill Medical College of Cornell University Division of Medical Ethics
The Division of Medical Ethics at Weill Medical College of Cornell University focuses on bioethical health issues such as cloning, physician-assisted suicide, managed care, and genetic engineering. A consumer workbook and video discuss end-of-life decisions, including how to assign a medical proxy, or health care agent. Help is available for patients, families, and medical professionals working through difficult ethical decisions that arise in health care.
Organizations
Caring Connections
1700 Diagonal Road
Suite 625
Alexandria, VA 22314
Phone: (800) 658-8898, (703) 837-1500
Fax: (703) 837-1233
E-mail: caringinfo@nhpco.org
Caring Connections, a program of the National Hospice and Palliative Care Organization (NHPCO), seeks to improve care at the end of life. Caring Connections provides free resources, including educational brochures, advance directives and hospice information, and a toll-free helpline to people looking for quality end-of-life information.
Compassionate Friends National Headquarters
P.O. Box 3696
Oak Brook, IL 60522-3696
Phone: (312) 990-0010
Fax: (630) 990-0246
Compassionate Friends is an organization that helps family members through the grieving process when they have lost a child.
Growth House, Inc.
Phone: (415) 255-9045
E-mail: info@growthhouse.org
Provides resources for life-threatening illness and end-of-life care.
National Hospice and Palliative Care Organization
1700 Diagonal Road
Suite 625
Alexandria, VA 22314
Phone: (800) 658-8898, (703) 837-1500
Fax: (703) 837-1233
The National Hospice and Palliative Care Organization (NHPCO) offers information on local hospice and palliative care programs across America. NHPCO is committed to improving end-of-life care and expanding access to hospice care with the goal of improving quality of life for dying people and their loved ones.
Related Information
· Choosing a Health Care Agent
· Grief and Grieving
· Hospice Care
· Writing an Advance Directive