Why Should We Talk About Death?

Modern society has turned death into a taboo subject that we prefer not to think about, much less make it part of our lives.

Unlike other cultures, Westerners see death as something that must be fought and overcome. Before, people would pass away at home, surrounded by family, friends, and even children, all of which were participants in the progress. Now, it is something that happens mostly in hospitals, outside of the household.

However, no matter how much we want to ignore the matter, eventually, it will need to be addressed when we care for an older adult.

Death as a Natural Process

“Life is a process of transformation, but in our context, we do not see death as part of life,” highlights Delza Canto, a thanatologist, social worker, and university professor. She states that part of this attitude of denial is due to our fear of the unknown and the suffering that represents letting go of our loved ones’ physical presence.

However, this act of denying death and not preparing for it robs our own lives and those of our family and friends of meaning. “Being aware of your own end makes you value your life even more, helps you strengthen bonds, and decide how you want to live your life to the fullest,” says Canto.

Among the recommendations offered by this professional to start the discussion with yourself and those close to you are as follows:

• Educate yourself on the topic.
• Familiarize yourself with the emotions and feelings that can trigger you and learn to work with them.
• Call it by its name and introduce the topic to our families.
• Celebrate life and, precisely because it is finite, appreciate its value and its meaning.

When the End is Near

“When the doctor told us there was no longer anything they could do for dad, and he recommended that we considered hospice, it has a hard blow,” recalls P. Fernández, who, along with her family, decided in 2014 to transfer their father to hospice care.

She tells us that her father was 90 years old when he was diagnosed with cancer. “We weren’t really expecting him to recover, but it felt as if we were letting him die. Today I can say that placing him in hospice was the best decision for him and us. He passed away at home, calmly, and with his family.” She explains that her father received the necessary care to be as comfortable as possible during his time in hospice.

“The care that is offered in palliative care and hospice programs has been available for many years. However, there is still much unawareness about what they are and how they work. Not only is it unawareness on the part of patients and their families but also, as physicians, we are learning to see these options as a continuous part of medical treatment,” explains Dr. Jadeyra Rivas, medical service provision director[MB1]  at Triple-S Medicare Advantage.

She also points out that due to cultural beliefs and the taboo that talking about death represents, many patients and caregivers do not consider the hospice option and opt to continue with medical treatment even though there is no real chance of cure.

For patients and caretakers, these options offer “the relief of having a multidisciplinary team to help them manage a complex disease or the final stage of a terminal condition,” she explained.

For her part, Canto recommends that those facing a death process—be it their own or of a loved one—speak honestly and address medical care from a realistic perspective. If there is no cure, what are the alternatives? “It is important to educate on the topic to bring it out of obscurity and put it from the perspective of the process of life.”

Palliative Care and Hospice: What They Are and Their Differences

“While palliative care and hospice care share common elements, they are not the same. The first is focused on providing relief from physical suffering for those patients who have a chronic condition, but not necessarily a terminal illness. Palliative care considers the patient’s physical, mental, social, and spiritual aspects and uses medication and treatments to improve their quality of life. The main objective is to accompany the patients in all phases of their disease until they heal or transition to another stage of care.”

Doctor Rivas mentions that those who can benefit from this type of care deal with serious illnesses such as heart failure, chronic obstructive pulmonary disease (COPD), cancer, diabetes, and liver and kidney disease, among others.

“As for hospice care, this is available for people who are terminally ill and there are no longer any real medical options for the patient to recover. The focus here is to offer the necessary care and services for that person to be comfortable and to begin preparing them, as well as the family, emotionally and spiritually for this final stage of their life,” explains Dr. Rivas. The main difference with palliative care, she highlights, is that in hospice care, treatments, or medications to extend life are no longer used. She also clarifies that to take part in a hospice program, there must be a medical recommendation by the doctor that understands that the patient has 6 months or less of life left.

Innovating Program for Vulnerable Patients

“I am proud that at Triple-S we can provide care for a person from the time they are an unborn baby until their last moments of life. As part of this philosophy, we have developed a special program that combines both palliative and hospice care for our most vulnerable patients,” expressed Dr. Rivas. She explained that the program has the initial participation of two expert organizations in palliative and hospice care: Grace Health and Brisas Health. She also added that Triple-S Advantage members and their caretakers could inquire about their options by contacting the Hospice and Palliative Care Program[MB2]  personnel, writing to tripleshospiceprogram@ssspr.com, or calling 787-749-4949 Ext. 8321806.

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 [MB1]Recomendamos verificación del puesto de la Dra. Rivas (si la traducción incluida es la apropiada).

 [MB2]No logramos confirmar el nombre oficial de este programa en inglés. Recomendamos su verificación y modificación de ser necesario.