The Four Stages of Hope
According to hospice expert Cathleen Fanslow-Brunjes, hope in serious illness typically has four main stages:
- Hope for a cure. "I'm not going to let this stop me."
- Hope for treatment. "I think the radiation is really working!"
- Hope for prolongation of life. "I want to go to the family reunion."
- Hope for a peaceful death. "I'm hoping for no pain in my final days."
The four stages often align with disease progression. But it's not uncommon for a person to move back and forth among them.
Knowing the four stages, you can better support your family member in sustaining his or her hope. Listen carefully for comments that indicate hope. You might also want to read our article about hope and serious illness.Many families are concerned about "realistic hope." Find out what your loved one is hoping for and ask the doctor if it is feasible. If so, then all of you can work toward this shared goal.
If the hope is not realistic, it may signal the need for a change in care goals. But it does not mean your loved one must be without hope! Instead, it means you need to talk together with the doctor and come up with a more achievable project or purpose.
Dr. David Casarett, a hospice physician, wrote an insightful book about this topic called "Last Acts." It specifically looks at the many ways his patients chose to find meaning in their last few months, weeks, and days.
Hope is always available. We just need help knowing how to look for it.To read the entire newsletter and for more information on caring for the seriously ill, visit http://www.seriousillness.org/
