By Erin Rose
The Windham Public Library will be hosting a discussion of end-of-life options for residents from 6 p.m. - 8 p.m. on Friday, November 14.
Allison Osgood, Hospice Liaison with Beacon Hospice, will provide more details about hospice care and how it can help patients live out their lives comfortably, and Bob McCown, a volunteer with Maine Death with Dignity, will present information about Maine’s Death with Dignity law and how terminally ill Mainers can choose to end their lives through aid in dying medicine.
The hospice program overall is misunderstood, Osgood said, adding that many patients don’t take advantage until their illnesses are advanced, to where they’re no longer able to enjoy the time they have left with their families and loved ones.
“I want to change the stigma around hospice care,” she noted, saying that many people do not think to take advantage of the six months of benefits that are available to patients. “We can keep you home where you can do what really matters to you.”
A patient is eligible for hospice care once they receive an order from their doctor that states if their disease follows the normal course, the person will likely pass away in 6 months or less. Once the hospice provider completes an evaluation to ensure the patient meets the Medicare guidelines, a team of people are engaged to provide care for the patient and their families. A nurse and aide will each separately visit the home several times a week to check on the patient’s wellbeing, ensuring their comfort.
“One patient just wanted to play cribbage with their aide, so they set a date every week,” Osgood said. “It made his day. He looked forward to it every single week.”
Hospice also helps beyond just patient care, as being a caregiver and managing a patient’s medical care can be difficult and overwhelming. The team from hospice can help alleviate those worries and concerns to allow families and friends to enjoy whatever time they have left with their loved ones.
“We’re there to walk you through the process so we can tell you what is happening and what to expect and be that communication liaison between the families and doctors, so everyone is on the same page” Osgood said. “Sometimes we get these families on, and you can just see the wave of pure calm come over them. We’re taking those little things away so that they can be family members instead of just caregivers.”
Hospice does not preclude a patient from seeking aid in dying medicine. Frequently, patients are on hospice at the time they choose to take the medication, and the hospice care team can be present to help at the end, as they would for an unexpected death. While the hospice personnel cannot be present in the home when the patient is taking the medication, after it’s taken, they will provide the patient with any care they need in their final moments.
“As soon as meds are taken, they can go in and provide support, including to the family sitting vigil and make sure that the patient is comfortable while waiting for the medication to take effect,” Osgood explained. “It’s incredible. I think it gives a sense of control back to these people.”
“When you’re losing your independence, going through serious illness, you lose a part of yourself, so having that option of Death with Dignity gives them a measure of control,” she added.
Aid in dying medicine is “an emerging field of palliative medicine,” noted Reverend Valerie Lovelace, Executive Director of Maine Death with Dignity, a nonprofit organization that provides services, education and advocacy for patients. “It’s just one more tool in the end-of-life toolbox for patients and physicians, if those patients are seeking that kind of support.”
Lovelace explained that in Oregon, one of the states with the oldest aid in dying laws, 90% of patients were on hospice at the time they chose to take the medications. Patients find comfort in having the medication and having a sense of control when their disease has dramatically reduced the control patients have over their lives.
“Not everyone dies well. There’s this idea out there that end-of-life care is sufficient and that it meets everyone’s needs. And the truth is, it doesn’t,” she said. “You only have to work in hospice for a short time to see the other side of things. And so, this meets the needs of people who want to have some control, some say in how long it takes for them to die. There are some patients who say it is palliative just having it. Even if they don’t use it, it’s plan B.”
She added that “a number of patients here in Maine have felt so relieved once they are through the qualification process and they know they can use the medication if they need it. It brings so much relief.”
Maine’s Death with Dignity Act was adopted into law in 2019. It allows terminally ill patients, in conjunction with their physician and a consulting physician, to request medication that would end their life. There are considerations and requirements in the Act, ensuring that patients are appropriately screened so that the decision is being made while the patient is of sound mind and capable of considering the grave consequences.
To qualify for the medication, terminally ill patients whose condition will likely be fatal within six months must make two oral requests to their physician for the life-ending medication, separated by a 15-day waiting period, during which the patient must also submit a separate written request, appropriately witnessed by two others. Some patients may be required to undergo psychological examination as well, to ensure their competence and ability to make a rational decision.
The Maine Death with Dignity Act Statistical Report, an annual report required by the law, reported that while 66 state residents applied to the program in 2024, 48 of those residents died by “patient choice”. Thirteen of the applicants passed away due to their illness before receiving the medications. Applicants represented all 14 Maine counties and were aged from 53 years old to 101 years old. Most of the applications were from patients diagnosed with cancer, while others suffered from ALS (Lou Gehrig’s disease), heart disease, and COPD.
For more information about Maine’s Death with Dignity Act, visit www.mainedeathwithdignity.org
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