Sometimes I wonder how we define comfort care. I am sure dying is not pleasant and I cannot imagine that dying is "comfortable". However, I am sure there is relative comfort in terms of medical or nursing services.
Having tubes is not comfortable for sure. Being bedridden or chair-ridden is not comfortable. It is not a good thing to die with dementia in late stage. Even for cancer in hospice, it is still lots of suffering although one may die painless in hospice.
Being fed by a caregiver who is feeding 2 or 3 people at the same time is not pleasant either. Sometimes the person with severe dementia has no idea what is going on but he is only confused if something is bugging him.
How do we know for sure what is comfort for the dying person or long-term demented patient? To die in sleep may be a good thing but the person may also die from heart attack and suffers from pain for a short time without CPR.
We say comfort care so easily but it is not really comfortable in reality. Guess we can only do our best to make sure that the patient has comfort care relatively or hospice, but either way, it is suffering or dying. Dying is a sad thing. It is esp. hard for families who are dealing with this. It is no comfort for families, I suppose. But I am sure the less stressful for the family, the better. Comfort care probably offers everyone a sad but peaceful choice.
Comfort care is just what it says..... as opposed to aggressive medical care. Comfort care is medical care that is focused on relieving symptoms and optimizing patient comfort. Comfort care does not seek to cure or aggressively treat illness or disease.
Dying may or may not be an easy process but that is related to the complications and symptoms present in the dying process. Dad slipped away over a period of a few days with very little discomfort. Yes, you can determine discomfort, even in the non verbal patient, by using the non verbal signs of pain and distress. Dad had a very peaceful facial expression with no agitation. Pain will cause grimaces and fidgeting. For those trained to observe it is relatively easy to know the comfort level. If there is discomfort it can be alleviated with medication.
As for family and friends, death is experienced in different ways as well. I found a peace in Dad's passing. Others find grief and suffering. The support and counseling of Hospice can help bring on comfort.
Yes it is easy to say comfort care. It is an approach of treating symptoms rather than aggressively treating the illness, and supporting the family with comfort counseling and support. It is giving both the best in an end of life situation... for the comfort of both!
When our loved ones come to a point that they are in the last stages of life I think that the last gift we can give them is to have peace. I know that is different in each person but the ultimate goal is to have our loved one be free od anguish and pain so what ever it takes to accomplish this is the route that one should take and not dwell to much on anything else. We all strive to do the best we can with the information at hand at that particular moment. Ther is no wrong choice if your loved one is peaceful. I know that is all I asked for with my mom and when it was finally achieved then there was a wonderful quit presence and I just knew that it was right..
Hugs Judy..
__________________ Forever in my heart
The following user gives a hug of support to jagsmu: Gabriel (05-28-2012)
Nina - As difficult as it was to know my stepdad was in the last few days of his life, it helped to remind myself that by his being on hospice and therefore on "comfort care" we were not putting him through: a traumatic hospital stay - intervening methods that would make him very uncomfortable and really not prolong his life - at least not his quality of life It of course also helped very much to know that he had a living will, he and my mom had talked things over years before he was ill, etc.
I think I know what you're expressing - that the word "comfort care" when the person is in the process of dying seems, well, ironic. It helped me alot that the caregivers were very in tune with my stepdad, knew the signs of discomfort (and there weren't many with my stepdad), and did all they could to keep him, well, comfortable. It was a much more peaceful ending than the whole medical intervention - ER - hospital route. I am grateful that he was able to stay in the adult family home until the very end.
I am sorry for what you're going through. It's really tough to watch someone shutting down and to know there's only so much you can do.
The Following User Says Thank You to TC08 For This Useful Post: ninamarc (05-29-2012)
"Comfort care" is sort of a euphemism for "no treatment"; nothing curative will be offered or attempted... Another term is "palliative care," meaning symptoms will be alleviated...
Comfort care to me means, to the best of our ability, to keep our loved ones from sufffering needlessly. We can't possibly know to what extent our loved ones are comfortable, but strive to the best of our knowledge, to keep our loved ones as free of pain and discomfort as possible.
Hugs to all
Aras
Forever in my heart 
It of course also helped very much to know that he had a living will, he and my mom had talked things over years before he was ill, etc.
