Everyone in your family kind of knows that Grandma is dying. No-one talks about it though. And absolutely no-one is going to try talking about it any time with Grandma. Secretly, they’re all afraid it would kill Grandma to think she’s dying.

This kind of family cowardice is a tragedy. It leaves Grandma without skilled comfort she needs. She’s going to be needlessly in pain. Really, it takes hospice to make sure people get skilled pain control. Non-hospice doctors are much more worried about creating dependency. As if 87-year-old dying Grandma was going down the corner to start dealing.

Hospice care is a medical specialization known as palliative care, which mean comfort care for the dying and support of their families. That’s when this person can at last be free of pain. Not tormented by treatment that is really only to make the family feel better, not for the dying person.

Too few doctors actually take the palliative care training – which must be because people don’t die any more, right? But hospice people have all done special training. They know how to have the conversations you guys are too scared to start.

Very few dying people don’t know that they’re dying. So, if none of you talk about it, you are leaving them to a very lonely death. Usually, everyone experiences a great relief when death can be acknowledged.

It doesn’t mean there’s no sadness or impending sense of loss. It just means that everyone is walking with the dying person to the gates of death. Doing what family does.

A good way to start is by asking Grandma’s doctor to make a referral for the family to have a hospice assessment. This lets the experts figure out what’s going on. Those experts are also expert in bringing up the subject of dying and enabling everyone to be able to talk about it.

They don’t ram it down people’s throats, but they also don’t avoid the necessary communication. Once a person has been accepted for hospice, then it becomes all about the comfort of the dying person. Plus supporting the family. For a family too terrified to think about death, this is the most transforming experience.

Hospice doesn’t make people die. Being terminally ill is what makes people die. Hospice doesn’t really have time limits. There are regulations for allowable 90-day and 60-day schedules, but those are to do with billing, not to do with you, Grandma and the family.

Hospice never turns anyone dying away and they never turn anyone away for monetary reasons. Medicare pays, insurance pays, Medicaid pays and, if there’s no-one to pay, you still get hospice. So there’s no reason to have financial fears.

All too often, people turn to hospice far too late. I’ve known several families sign on with hospice, only to have their family member die only days later. This means they could have been having hospice support for the previous six months – but they weren’t. Now THAT is a tragedy.

Hospice has home health aides, housekeepers, nurses, respite services, medication services, supplies such as adult protective underwear, spiritual advisers and volunteers. Imagine walking with all those people to help you, instead of struggling by yourselves to do jobs you don’t know how to do.

You probably don’t even know how to get the right medication to stop Grandma’s pain. Hospice does.

So, don’t be babies now — call your local hospice organization. Then you won’t be alone any more.