Tag Archives: terminal illness

Sa Gitna Ng Malalim Na Pag-iisip

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Disclaimer: Mahaba-haba itong post na ito at hindi ko alam kung kailan ulit ako makakapost. 🙂

Nabanggit ko sa nakaraang blog post na magso-social media hibernation ako as part of my personal prayer and fasting, but I thought mas maigi sigurong sumabay na lang ako sa mid-year prayer and fasting sa church, which will most likely fall in July siguro.

Because the pain I mentioned in that article is, I think, my cue already to schedule a doctor’s appointment asap. Though I have no other symptoms, it may have been just part of my PMS since I just had my period yesterday.

But just so I have peace of mind, I am planning on getting a medical checkup tomorrow. Kaya nitong nakaraang linggo, panay research na ako ng anything related to breast cancer from PhilHealth’s Z Benefit package, the YAKAP program, palliative care, at marami pang iba.

As someone with OC tendencies, I have a knack for organizing stuff. I love details, and details love me back. Unlike Math. It just doesn’t love me back. Hays.

Sa sobrang dami nga lang nitong mga nahanap ko, hindi ko na tuloy alam kung ano ang uunahin kong gawin. lol Seriously though, ito na ‘yung sinasabi ng mga breast cancer patients and all patients in general na sobrang exhausting and draining, physically, emotionally, mentally, and spiritually ang magkasakit. Andami mong aasikasuhin at iisipin. Siyempre, magastos din at goal ko na huwag magagalaw ang savings at huwag manghingi o manghiram ng pera.

So now, I am putting ChatGPT to the test again, kung kaya niyang i-synthesize lahat ng info na makukuha niya sa mga screenshots na ito na plan kong i-upload lahat sa isang prompt lang. Para mas comprehensive ang guide pero simplified and coherent version. Magagawa kaya ito ni ChatGPT? 😀

Acceptance As A Pathway To Peace

By the way, kasama na sa ginawa ko ang last love letter to my family na isi-send ko sa husband ko and sa family ko. It included steps on what to do kapag terminal stage na or palliative care here at home pati ‘yung sa insurances, medical and burial assistance, cremation, etc.

I also added a DNR (do not resuscitate) request if ever i-rush pa nila ako sa hospital, and that I prefer a 1-day wake and prayer vigil only. Yep, I am a nonconformist – I don’t follow cultural norms and traditions all the time. I also and always question the status quo, but I am very compliant naman with God’s laws. 😀

Ganyan ako mag-ayos ng mga bagay-bagay because I just love to plan. Pero syempre ni-remind na naman ako ni Lord na many are the plans of man, but it is God’s purpose that will prevail. I already planned everything kasi ayoko maging burden sa lahat ng aspeto sa loved ones ko when I get sick. Sobrang stressful on their end kapag wala kang habilin, and itong ginawa ko will make decision-making easier for them. Actually, for execution na lang talaga sya.

Right now I am doing a lot of mind conditioning for myself and si husband ay inuunti-unti ko na din. Kasama na din sa ni-research ko kung paano kapag hindi tanggap ng loved one mo ang terminal diagnosis mo, kasi siyempre dadaan din sila sa stages of grief at bawat tao may kanya-kanyang way and timeline to cope with a terminal diagnosis and eventually loss of a loved one.

ChatGPT Does It Like No Other

Now, let’s move to the fun part ng article kasi ayoko ito maging super heavy. Speaking of ChatGPT, ‘di ba nga ni-try ko ipa-edit ang 2×2 ID photo ko na gawin niyang bald dito sa article na ito kasi gusto ko lang makita how I’d look without any hair on and nag-malfunction siya. So, ni-try ko ulit kasi syempre favorite natin ang persuasion. Bumigay din si ChatGPT, and I was stunned by the result.

Kasi sabi ko lang sa prompt, eh breast cancer warrior ang babae, kaya dapat ang aura ay confident na sort of mala-women empowerment. Ayun, sinamahan na niya ng quotation sa gilid. O ‘di ba, winner talaga.

Parang gusto ko na magpagupit ng ganito next week. lol Ang galing na talaga ng AI mang-convince. 😀

Mission accomplished na sana, kaso napansin ko na sa unang photo na na-generate niya, ang laki ng ulo ko (mayabang daw ako sa tingin ni ChatGPT). Sabi ko kay ChatGPT, “Witchikels, sakit na breast cancer lang po ang meron itong babae, hindi po kasama ang hydrocephalus.” huhuhu

Naubos ang image creation limit ko (up to 5 only sa free version ng ChatGPT) dahil pinapabago ko ang poses pati ang details sa background at sa outfit. Para lang ma-achieve itong “Crazy Rich Asian” na datingan ng photo na ito. Pero kapag ako talaga ‘yan, “Crazy Asian” lang. lol

Sabi ko, i-adjust niya ang size ng ulo ng babae para mag-match sa body build niya. In fairness, nakuha naman ni ChatGPT ang tamang edits, and the photos above are the best results. At dahil natuwa ako sa resulta, na-curious ako kung ano kaya kung pagawin ko naman ang tousled crop look.

Hindi ko muna pinagamit ang 2×2 ID photo ko at baka magka-hydrocephalus naman tayo. Sinabi ko lang na Asian woman, and I included my basic facial features, i.e., heart-shaped face, chubby cheeks, dark brown hair, etc. At ang resulta ay maeenganyo ka talaga gayahin ang mga suggested looks ni ChatGPT. Galing, noh?

Kaya next prompt ko kay ChatGPT eh i-apply na niya sa picture ko ang hairstyle na ito. And voila, the AI-generated images look so posh, hindi na pinalaki ulo ko. Humble na daw kasi uli tayo. I styled this look and mga poses at nakuha naman ni ChatGPT ‘yung bet kong concept.

The top has to be pink, kasi ‘yun ang universal awareness color ng breast cancer. Although this will not be the first time kasi noong high school ako, I sported this short hairdo – part of my rebellious teen era, which I am not proud of, by the way.

Siyempre, dahil nag-e-enjoy tayo kay ChatGPT, umiral na naman ang creative side, kaya simula sa crew cut hairstyle na napunta sa tousled crop hanggang sa nilagyan ng headband, tapos ang ending ay fashion styling. At siyempre, background si Mt. Mayon. Slay ba, mga ‘teh? 😀

Bet na bet ko itong may headband na scarf. Although ‘di nga masyado nakuha ni ChatGPT eksakto ang sa prompt ko kasi ang instruction ko sa kanya na nasa left side ng leeg ang knot ng scarf para sa mas edgy look. But I still love this look.
❤ Chinitang Bicolanang Fashionista ❤

‘Yung ganitong aura-han actually keribels siya kapag nasa UP Diliman ka. I wouldn’t think twice about wearing this while inside the Diliman campus; normal lang doon makakita ng mga extreme—nakapambahay na getup like bagong gising at nakasuot lang ng shorts, t-shirt, and tsinelas kasi late na sa klase at meron ding may nakatakong ng almost 1 foot na. Seryosooooo?!?!

Siyempre joke lang ‘yung 1 foot, basta mga very unique choices. We celebrate freedom of expression and creativity sa unibersidad, basta siyempre hindi offensive sa ibang tao. Kumbaga may limit pa din naman.

I would love to wear this here in Bicol sana, but most likely, I’ll be getting a lot of stares. Baka matawag pa tayong Disney Princess na galing sa Maynila. Or worse, nepo baby. Nepopotamus po siguro, pwede naman. Pero maganda rin mag-social experiment. Malay natin the mindset has shifted already, given na madami na gumagamit ng internet and social media.

I’ve already been seeing a lot of photos of brave women who shared their post-chemo and surgery pictures nila, because of breast cancer. I joined breast cancer support groups, by the way, on Facebook in 2023 after Mom passed away because of breast cancer. And one of these beautiful breast cancer warriors is Ms. Cams.

Her photos are BEAUTIFUL. She has a very pretty face (Coleen Garcia look-alike), but there is something about her aura that exudes confidence and a quiet strength, which makes her even more beautiful. And if ever ganito rin ang pagdaanan ko, gusto ko rin ng ganitong photos. Though for me, dahil nurturer ako, and I am ready to go na talaga, parang gusto ko alagaan si cancer, and I will just let it grow. lol

Waiting On God’s Will And Instructions

Seriously, death is only terrifying when we are not yet ready to go. And we will only be ready to go when there is peace in our hearts because of the following truths:

  • we have been saved by the Cross
  • we know that this world is only temporary
  • we believe we will see and will be reunited with our loved ones again, together with God, in the new Heaven and new Earth
  • we have faith that life in eternity is waaaaaay better.

I have this quiet resolve that whatever the diagnosis, whether I have stage 1 or stage 4 cancer, whether I have months or years to live, my perspective about death will never change – it is nothing to be feared, and it is an answered prayer. Why answered prayer? Who wouldn’t want to be with God in a place where everything is perfect? 😀

But then again, this is my wish. But what if God has another plan? Kasi meron ding desire sa puso ko na, if ever I have cancer and God wants me to survive it, I really want to be a volunteer patient assistant/coordinator/navigator. Nga lang, volunteering will require a lot of resources, time, and manpower. Kaya ang prayer ko kay God na bigyan Nya sana ako ng different sources of income that will give me more autonomy when managing my time, so I can still volunteer on the side.

May isa kasing incident noong 2023 sa isang Facebook group ng mga breast cancer warriors na hanggang ngayon hinding-hindi ko nakakalimutan. I shared an infographic from the Philippine Society of Medical Oncology about how to get treated kapag na-diagnose ng breast cancer, at may isang matandang babae who PMed me kung pwede ko daw syang samahan kasi 68 years old na sya and walang available to assist her.

I really would love to say yes, kaso at that time, I am still grieving over my Mom, and from Batangas sya tapos nasa Pasig City ako. Tsaka marami pa akong hindi alam about navigating through a breast cancer treatment as a patient. Pero naawa talaga ako sa kanya, ang sakit sa puso na I had to decline her request.

Marami pa akong need matutunan, like, paano ba ang sistema gaya ng pagpila kung ia-avail niya ang mga free treatments na ino-offer sa ating mga pampublikong ospital. Kaya sa tingin ko, kung mag-positive ako sa breast cancer and kahit ayawan ko ang medical treatment dahil siyempre stubborn ako, pero doon at doon din ako nili-lead ni God, I have no other choice but to obey in the end.

Sabi ko sa asawa ko na dito ko preferred sa Bicol magpa-checkup o magpagamot if ever. Tingin ko, lalo akong mase-stress sa traffic sa Manila, plus the metropolitan pollution might aggravate my allergic rhinitis at bababa ang immune system ko lalo.

Mas madali rin sa akin mag-commute via public transportation dito sa Bicol since plano kong mag-isa ko lang lalakarin ang lahat kasi gusto ko talagang matutunan kung paano ang pasikot-sikot ng sistema. At para malaman kung ano pa ang puwedeng ma-improve sa sistema to make it easier and more convenient sa mga kapwa pasyente.

Sa kaka-research ko, ang dami kong nahalungkat, pati ‘yung uso daw na mga kabitan sa medical field. Anyare algorithm at nasama ito sa research ko. Paki-explain please. Or else, off with your head, too. lol

Caring For The Community

Hindi ako most likely makakapasa as indigent, pero ang gusto kong tulungan kasi ay galing sa group nila. Hindi sa akin prob ang pumila nang mahaba kasi siyempre graduate ako ng University of Pila. Like ‘yung dito sa SMMG Medical Plaza sa Bulan na pipila sana ako ng mga 3am para kumuha ng slot para sa ultrasound ni Dad at every Saturday lang schedule nila.

Kaso, pag-research ko sa Fb, gabi pa lang na mga 10pm, pumipila na sila, tapos 35 lang daw ang slots, tapos 4am pa lang, puno na. I was shookt mga ‘teh. As in shakening shakening like that.

And yet, I am very GRATEFUL. Why?

May 35 na mga taga-Bulan ang nabibigyan ng serbisyong medikal gaya ng ultrasound bawat linggo. 35 na pasyente na ang nakatipid sa pamasahe para pumunta sa karatig na bayan at doon magpa-ultrasound. 35 na pasyente ang hindi bumyahe nang malayo o gumastos para sa pagkain nila.

Samantalang 10 years ago, marami ang deprived ng mga serbisyong pangkalusugang ito na, sadly, nakakadagdag sa mortality rate sa town. Kaya hindi na kami pumila, para ibigay na lang ang slot para sa mas nangangailangan na taga-Bulan. Dad can still travel pa naman at may sasakyan para comfortable ang byahe nya.

And another reason to be grateful is that may cardiologist na din sa Bulan, si Dr. Clarisse (Hi, Dra.!), Dad’s new cardio. She’s the first cardiologist, if I am not mistaken, in Bulan. We don’t have to go to Sorsogon City para sa follow-up checkup ni Dad every 3 months since kailangan ng close monitoring ang heart condition ni Daddy dahil 86 years old na sya and may Stage 5 CKD din.

Kaya hanga talaga ako sa mga doctors to the barrios and other health practitioners na mas pinili na manilbihan sa mga komunidad na malalayo sa kabihasnan. Hindi biro ang calling na ito, and it requires a lot of sacrifices. Sila na ang lumalapit sa mga komunidad para hindi na bumyahe nang malayo ang mga pasyente.

Parang ito ang counterpart ng Gurong Pahinungod, ang volunteer teaching program ng UP (w/ monthly stipend naman) na gusto ko rin sanang salihan, but I am only one, ang dami kong gustong gawin, and yet I cannot do everything. 😀

An Advocacy In The Making

Going back to BC cancer support groups, naghanap din ako kung merong breast cancer support groups sa Bicol sa Facebook. So far, Albay lang ang meron. Gusto ko gumawa din for Bulan or sa Sorsogon Province. Para mas madali ang breast cancer education para ma-raise ang awareness and ma-break ‘yung social stigma nila about having the illness or the medical treatments, in particular ‘yung chemotherapy kasi takot malagasan ng buhok or ‘yung mastectomy.

Isa sa nakikita ko na challenge ng mga galing dito sa Sorsogon ay ang transportation. Puwede magamit ang old Innova namin panghatid-sundo sana para sa lahat ng mga breast cancer patients sa Sorsogon if sa Sorsogon, Legazpi, or Naga pupunta. Need ko lang ng volunteer driver, kasi ayoko mag-drive when there are so many things running in my head tas sa pang-gas hanap pako ng magdo-donate, although may nakikita na akong prospect. 😀

Kausapin lang namin ang doktor namin kung puwede pare-pareho ang schedule ng appointments namin. Puwede kaya ‘yun? Sabihin ko, maggi-girl bonding kami sa ospital. Siyempre, maganda rin sana may free food and accommodation, especially if ang iba mag-u-undergo na ng treatments and traveling long distances nang tuloy-tuloy, e hindi advisable.

At kung indigents ang tutulungan, kahit basic needs salat sila, kaya hindi talaga nila priority ang pagpapagamot. Actually, if ma-diagnose ako with breast cancer, mag-a-agree lang ako to get medical treatments para ang libreng gamot na makuha ko, ibibigay ko sa breast cancer warrior who has young kids and ayaw na ayaw pa niyang mamaalam sa mundo because nafi-feel niya na madami pang pinapagawa sa kanya si Lord.

Altho sa accommodation, meron na akong nakikita din na host na possible can help us out. Kung nasa Manila ako, mabilis sana mag-organize ng ganito kasi ang mga friends ko doon, lalo na noong mga young professionals pa kami and single, ‘yung tipong kahit last-minute na invite para sa isang volunteering event, e go kaagad ang mga ‘yan.

‘Yung mga biglaang PM na “Hey girl, you free this weekend? Tara, volunteer tayo. No worries sa transpo and supplies, konting add na lang sa ganito ganyan.” 😀

Nga lang, feeling ko kami ‘yung mga grupo ng mga pasyente na maiingay kapag nasa ospital na. Kapag nakarinig kayo ng malalakas tumawa, alam na this. Siyempre, good vibes dapat, lalo na kung ang ibang pasyente e sobrang bigat talaga ng pinagdadaanan.

‘Yung tipong gusto ko silang biruin ng “Manay, huwag kang matatakot. Gusto mo sabayan kita papunta sa kabila. Pero syempre hatid lang kita. Kontratahin ko muna si Lord na bigyan ako ng return ticket. Kasi madami pa akong ia-assist sa Earth kaya need kong bumalik.”

Tapos bigla akong sinakal ni ate, noh, sabay sabing ayaw pa niyang mamaalam. Kaya ‘wag din basta-basta magbiro. Piliin ang tamang oras at tamang salita.

When God Plants A Dream

Pero honestly, ito talaga ang rason kaya nagkaroon ako ng hospice dream. I want patients to die with dignity because not all of us are privileged enough to die comfortably and surrounded by loved ones. Kahit man lang sa huling sandali, we give them the peace and comfort that they need lalo na kung hindi naman kayang mapunuan ang need na iyon sa bahay nila.

Right now, priority ko muna ang makapagpa-checkup, and I will let God lead me from there. Kaya ngayon, siyempre “ging-ot is life” muna ang motto natin. Panay gulay-gulay ang kinakain ko, kasama na ang 1 glass a day ng ni-blender na fresh malunggay leaves na may halong kalamansi, carrots, and cucumber. Being healthy means eating as much fiber and getting as many nutrients as you can.

Gaya nitong pinya sa aming bakuran. Benta ko sa inyo ng 300 pesos. Syempre, infleshun is realz. So yaaas, buy na plith. May kasama namang flying kick, este flying kiss ‘yarn. Joke lang, pang-garden-to-table lang po itong mga pinya namin.

Na hindi ko pa alam ang tawag. Sabi ko sa ate ko, ‘“Di ba Mariposa ito?” Sagot nya, “Ha? Butterfly kaya ‘yang mariposa.” Sagot ko, “Ay lam ko na, Hermosa tawag dito.” ‘Di na nya napigilan tumawa kasi apelyido daw ‘yun. Kaya to the rescue na si Daddy, Formosa pala tawag dito sa pinya namin sa bakuran. Maliliit pero super tamis.

Maganda din itong gawing smoothie. Parang kasing smoothie-fied ng mukha ko. Itong Oppo Kopong Kopong ko kasi pinagmumukha akong 20 years old sa filter nya. Buti pa si ChatGPT e pinagmumukha talaga akong 40 years old.

I-normalize natin ang bacon neckline of pambahay clothes because why not.

Wala po akong makeup dyan or anything. Kasi noong pumunta ako sa Watsons, nagpa-assist ako sa sales lady. Sabi ko, “Miss, anong compact powder kaya bagay sa akin kasi ang dami kong tan lines. Iba kulay ng mukha ko, iba din sa leeg, iba din sa braso, iba din sa kamay, tas iba sa binti, at iba din sa paa. Alin susundin natin?”

Tumawa na lang si Ate pero feeling ko gusto niya akong sagutin ng “Ma’am, bumili ka na lang po ng Johnson’s Baby Powder.”

Ayun, Johnson’s Baby Powder na nga lang talaga binili ko kasi naawa naman ako kay Ate sales lady. Hirap na hirap kasi siya pabalik-balik kakahanap ng magma-match sa zebra stripes ko. Mamaya hindi ko rin magamit kasi ayoko magmukhang nag-chinchansu.

Ayun lang po. End of the story na tayo kasi ang haba na nito. 99.9% na-convinced pala ako ni ChatGPT doon sa tousled crop look, kaya i-te-test ko one of these days ang predictive ability ni AI, na even without any 3D facial recognition involved, ang resulta ng tunay kong haircut ay tulad ng suggestion niya.

Kung hindi tugma ang resulta sa expectation, eh talagang hihingi na ako kay Lord ng sign kung will ba talaga Niya that I survive or exit na sa Earth.

Sabi ko kay Lord dapat ‘yung sign na ipapadala Niya ay kapag ang UP Diliman ay naging UP Liwanagan. ‘Yun, sure talaga ako na sign ‘yun na gusto pa Niya akong maghasik ng katatawanan sa mundong ito.

Siyempre joke lang ulit. Iba ang calling sa akin ni Lord na ihasik at ito ‘yun:

“The Spirit of the Lord is upon me, for He has anointed me to bring Good News to the poor. He has sent me to proclaim that captives will be released, that the blind will see, that the oppressed will be set free, and that the time of the Lord’s favor has come.” – Luke 4: 18-19

I ordered this last week and got it yesterday.
The random Bible verse listed under the container was God’s clearest sign.

Please pray for me and all those who are sick, and for God’s will to be done always. ❤ And don’t forget to smile and laugh always. 😀

P.S. May nahanap pala akong bagong playlist ng mga worship songs na papakinggan at Filipino Christian artists sila. Please do subscribe to their channel to show your support. Ang gogondo ng mga kanta nila. ❤

https://www.youtube.com/@TindigWorship

P.P.S.

I also found these scholarly journals and research on the role of spirituality in the healing and recovery of patients with breast cancer. I am praying that more research will be conducted on this topic here in the Philippines, including Filipina breast cancer survivors as respondents. I volunteer as a respondent, if ever, and pwede rin akong mag-research assistant. Basta, wala lang computation. lol

“What Does It Mean To Die With Dignity”

“A Systematic Review of Spiritually Based Interventions and Psychoneuroimmunological Outcomes in Breast Cancer Survivorship”

“Spirituality’s Impact on Cancer Treatment Outcomes”

“Exploring The Role of Faith in Survival of Breast Cancer”

“Effectiveness of Spiritual-Based Interventions in Enhancing Quality of Life Among Breast Cancer Patients: A Systematic Review”

“Integrating Prayer and Faith in Complementary Alternative Medicine Into Treating Breast Cancer: Lived Experiences”

“Effect of Cognitive-Behavioral Therapy and Spiritual-Religious Intervention on Improving Coping Responses and Quality of Life Among Women Surviving from Breast Cancer”

“The role of spirituality in improving psychosocial well-being in women with breast cancer: a qualitative study”

“The Role of Spirituality and Religion in Improving Quality of Life and Coping Mechanisms in Cancer Patients”

More Music Videos For The Souls In Battle:

Just Sharing – My Unusual Energy Of Other-Worldliness:

I slowly integrated Torti, our twenty-something-year-old male turtle, into our garden. It looks like he is nestled in quite comfortably.
This is one of the baby fruit bats that have been falling off the house’s roof vent as the heat index here in our town reaches 48 degrees Celsius. The effects of (super) El Niño on our wildlife will be critical. I pray for these creatures that they will survive.
This dragonfly has entered my bedroom, probably to cool itself down from the scorching heat outside. It breaks my heart that these little creatures will be the first to go when the effects of climate change worsen in the coming years. 😦
Tarantula in the house – only in the prabens. 😀

What To Expect When A Loved One Enters Hospice (from The Gospel Coalition)

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God sure knows when to reinforce my calling (a long-term goal and possibly a retirement project) lest I get distracted and focus on other things. I stumbled upon this article from The Gospel Coalition a couple of days ago, and this is exactly what I needed for the hospice project I am planning to propose to my siblings. I thought I’d share it here as well to help those who are going through a similar situation. 🙏

Original Article Link: https://www.thegospelcoalition.org/article/expect-loved-one-hospice/

“What To Expect When A Loved One Enters Hospice”

By Kathryn Butler

I recently lost a dear friend to cancer. She’d struggled with treatments and recurrence for years, and when her doctor finally said the heavy word “hospice,” she and her family were neither surprised nor despairing. As Christians, they drew comfort from the assurance she’d be with the Lord after she took her last breath (Rom. 14:8; 2 Cor. 4:17–18).

And yet, although my friend embarked on her hospice journey with full acceptance, none of her family was prepared for the tumult of emotions her final days incited. They trembled and choked back tears when she bolted upright in agitation. When she no longer responded to their voices, they nursed the ache of loss. Throughout, they struggled to reconcile the grim realities of death with the mother, sister, and wife they so cherished.

Families with loved ones in hospice all too frequently weather such storms. As the wages of our sin (Rom. 6:23), death is by nature harrowing, even when anticipated. We weren’t meant for death, and those of us who encounter it often struggle with lingering grief, confusion, and regret afterward, especially when it steals away someone we dearly love.

With a million and a half people in the U.S. receiving hospice care annually, many families will walk this troubling road, suffering doubts and heartache along the way. How do we shepherd caregivers and families as they aim to love the dying? How do we walk with them through the valley of the shadow of death, reminding them all the while of the Good Shepherd whose love covers them when the light dwindles (Ps. 23:4)?

𝗪𝗵𝗮𝘁 𝗛𝗼𝘀𝗽𝗶𝗰𝗲 𝗜𝘀

Misunderstandings about hospice abound and contribute to the pain families bear. Many people equate hospice with “giving up” on a loved one. Others confuse it with physician-assisted suicide and euthanasia. Still more have an accurate idea of hospice but can’t bring themselves to say goodbye to someone they can’t fathom living without.

To clarify, hospice care seeks to minimize pain and suffering at the end of life among those with terminal illnesses. A multidisciplinary team, usually comprised of physicians, nurses, social workers, chaplains, and health aides, provides medical care as well as spiritual and social support with a focus on symptom control and quality of life, rather than on cure. Although we often associate hospice with cancer, the most common qualifying diagnoses are severe dementia, emphysema, and heart failure.

For people with a life expectancy of months, hospice services often begin as regular home visits from nurses, social workers, and home health aides to ensure patients are stable and comfortable. As the illness advances, support increases, and eventually the dying require continuous care at the bedside and frequent doses of medications to ameliorate pain, anxiety, and air hunger. In the home, this care often falls to loved ones, which can be emotionally traumatic. In such circumstances, a hospice house, where staff nurses monitor patients 24/7, may be a better alternative.

People can only receive hospice services if they have a life expectancy of six months or less. Such patients, after consultations with doctors they trust, accept that further interventions for a cure would be futile (e.g., a cancer has metastasized to other organs and treatment options have run out). In hospice, medical care continues, but that care shifts to focus on lessening symptoms rather than eradicating the disease.

Studies suggest that rather than indicating caregivers have “given up” on patients, this shift in care can actually increase the life expectancy of terminally ill patients for up to three months. In our highly technological medical system, accepting the inevitability of death has a clear, measurable benefit.

It also has a biblical precedent. Although Scripture directs us to honor life (Ex. 20:13), it also reminds us our times are in God’s hand (Ps. 31:15). Like the grass of the field, we wither and fade (Isa. 40:7–8); until Christ returns all of us will succumb to death (Rom. 5:12). When we deny our mortality and chase after treatments that don’t promise cure, we dismiss God’s grace in Christ and the power of his resurrection. Christ has transformed death, swallowing it up in victory (1 Cor. 15:54) such that, as the Heidelberg Catechism aptly states, it’s no longer “a payment for our sins, but only a dying to sins and an entering into eternal life.”

𝗪𝗵𝗮𝘁 𝗛𝗼𝘀𝗽𝗶𝗰𝗲 𝗜𝘀𝗻’𝘁

While hospice reflects biblical teaching, the same can’t be said for euthanasia or physician-assisted suicide (PAS). Families facing hospice for a loved one may confuse these practices, especially given the terminology of “Medical Aid in Dying,” or MAiD, now adopted in Canada and used in the U.S. with increasing frequency. While in hospice, death occurs secondary to an underlying illness, in MAiD, terminally ill patients seek medical means to deliberately end their lives.

In euthanasia, for example, a healthcare provider administers a lethal dose of medication––often an injection––on a patient’s request. Similarly, in PAS, doctors prescribe a dose of pills for a patient to take on his or her own. In both cases, the “aid in dying” isn’t symptom support but rather a lethal dose of medication.

As the legalization of PAS has steadily increased in the U.S. over the past 20 years, it’s crucial to understand its distinction from hospice. In hospice, the aim is to alleviate suffering from futile or excessively burdensome measures. People can “graduate” from hospice; if a patient unexpectedly improves and is no longer deemed terminal, clinicians rejoice and hospice services are discontinued. PAS, by contrast, involves the active taking of another life with the explicit goal to end it, and it violates God’s Word (Ex. 20:13).

𝗪𝗵𝗮𝘁 𝘁𝗼 𝗘𝘅𝗽𝗲𝗰𝘁

The knowledge that hospice care aligns with biblical teachings can provide solace to families. Yet even with this consolation, watching a loved one die can be crushing. Many families embark on this journey with confidence, only to find the unsettling details of dying overwhelm them.

The following common changes may occur when death is near, which may trouble those at the bedside:

As a dying person’s organs shut down, 𝗯𝗿𝗲𝗮𝘁𝗵𝗶𝗻𝗴 𝗿𝗲𝗳𝗹𝗲𝘅𝗶𝘃𝗲𝗹𝘆 𝗯𝗲𝗰𝗼𝗺𝗲𝘀 𝗿𝗮𝗽𝗶𝗱 to remove excess acid from the bloodstream. As such breathlessness worsens anxiety and fatigue, nurses will administer a narcotic (usually morphine) or a sedative to help slow the breathing.
Intestines shut down as death nears. 𝗣𝗲𝗼𝗽𝗹𝗲 𝘄𝗶𝗹𝗹 𝗵𝗮𝘃𝗲 𝗻𝗼 𝗮𝗽𝗽𝗲𝘁𝗶𝘁𝗲, and although loved ones may worry about starvation, forcing them to eat or drink leads to vomiting or abdominal cramping.
In the setting of dehydration close to death, 𝘁𝗵𝗲 𝗺𝗼𝘂𝘁𝗵 𝗮𝗻𝗱 𝗹𝗶𝗽𝘀 𝗱𝗿𝘆 𝗮𝗻𝗱 𝗰𝗿𝗮𝗰𝗸. Hospice care workers provide moist mouth swabs to counteract the discomfort.
𝗔𝗴𝗶𝘁𝗮𝘁𝗶𝗼𝗻, 𝗱𝗲𝗹𝗶𝗿𝗶𝘂𝗺, 𝗮𝗻𝗱 𝗵𝗮𝗹𝗹𝘂𝗰𝗶𝗻𝗮𝘁𝗶𝗼𝗻𝘀 are common near death and can be especially upsetting to witness. In the mildest cases, patients will see people from their past, which may alarm onlookers. In the most distressing, the dying will suddenly panic or lash out at others with cruel insults. Clinicians give medications to calm patients and avoid such outbursts, but when they do occur, delirious patients’ words can deeply hurt those they love. In such moments, we can reassure families that death affects the mind as well as the body and that their loved ones are unaware of their actions. Agitation near death reflects the disease, not the patient’s true thoughts and feelings.
People 𝗴𝗿𝗮𝗱𝘂𝗮𝗹𝗹𝘆 𝗹𝗼𝘀𝗲 𝗰𝗼𝗻𝘀𝗰𝗶𝗼𝘂𝘀𝗻𝗲𝘀𝘀 as death nears. However, in the days to hours before death, some suddenly awaken and carry on clear, coherent conversations. Called “𝘁𝗲𝗿𝗺𝗶𝗻𝗮𝗹 𝗹𝘂𝗰𝗶𝗱𝗶𝘁𝘆,” this phenomenon is poorly understood but well documented and can confuse loved ones who mistake the sudden clarity for clinical improvement. A good approach is to treat these moments as gifts from the Lord, offering loved ones a final glimpse of the person they’ve treasured.
Even when the dying are unresponsive, evidence suggests 𝘁𝗵𝗲𝘆 𝗰𝗮𝗻 𝘀𝘁𝗶𝗹𝗹 𝗵𝗲𝗮𝗿, with their brains responding to sounds as distinctly as do awake, healthy individuals. This can provide families with enormous comfort, as it means their loved one may still hear and understand their words. Encourage families to speak to their loved one, to read Scripture, to pray aloud, and to sing hymns and favorite songs. Such connection can provide much-needed closure and solace to the living, and minister lovingly to the dying.
In the last 24 hours, 𝘁𝗵𝗲 𝘀𝗸𝗶𝗻 𝘁𝘂𝗿𝗻𝘀 𝗺𝗼𝘁𝘁𝗹𝗲𝗱 𝗮𝗻𝗱 𝗯𝗹𝘂𝗶𝘀𝗵, especially in the hands and feet. This is normal and signals the circulatory system shutting down.
The last few hours of life are often marked by 𝗱𝘆𝘀𝗿𝗲𝗴𝘂𝗹𝗮𝘁𝗲𝗱 𝗯𝗿𝗲𝗮𝘁𝗵𝗶𝗻𝗴. People will breathe deeply and rapidly for several breaths, then not breathe at all for up to two minutes. Secretions pooling in the airways also create an unsettling rattling sound with each breath. Additionally, relaxation of the vocal cords can produce a sound similar to moaning, even in the absence of discomfort. While these changes are upsetting to witness, at this point patients are unaware of their surroundings and unlikely to experience suffering.
𝗛𝗼𝗽𝗲 𝗘𝗻𝗱𝘂𝗿𝗲𝘀

In addition to the troubling realities outlined above, families of hospice patients may wrestle with questions about the faith and salvation of their loved one. If a loved one isn’t a believer, relatives may urge nurses to withhold sedatives, clinging to hope for a deathbed conversion. If a loved one has proclaimed faith, moments of agitation may raise doubts about the sincerity of that profession.

While their heartache is understandable, to withhold medication and incur unnecessary suffering is neither loving nor compassionate. As solace, we can point families to the thief on the cross (Luke 23:39–43), whom Jesus invited into his kingdom as he was dying. We can reassure them that the Holy Spirit can work in someone’s heart regardless of their capacity for language or cognition, and the Lord can bring all he wills to himself (Eph. 1:3–7). The good news of the gospel declares that salvation depends not on us but on God’s grace––and he can turn every heart he wills from stone into flesh (Ezek. 36:26).

Above all, when families walk alongside a loved one in hospice, they show him or her, as well as surrounding caregivers, the character of Christ.

To abide with another through death is to love in the sacrificial, soul-weary way our pierced Savior loved us first (Matt. 26:38; John 13:34–35; 1 John 4:19). It’s to weep with those who weep (Rom. 12:15) and to bear another’s burdens (Gal. 6:2). It’s to offer a loved one a tangible reminder––perhaps with a hymn heard through the shadows, perhaps with a gentle touch––that God’s love endures forever (Ps. 107:1) and that, in Christ, nothing––not even death––can pry his beloved away from his grasp (Rom. 8:38–39).

Hospice Care 101 | Making Peace With Death

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I often wondered what is it with death that we are so afraid of. Maybe we’re not really afraid about dying per se, but more of how we are going to die. The topic of death has always been considered morbid and taboo. And yet all the more that we should talk about it because acceptance is always the pathway to peace.

When God placed a desire in my heart about hospices after my Mom passed away last year due to stage 4 breast cancer and the possibility of providing hospice care on our farm in the future, I asked Him to give me the means to make it happen. And it looks like I got my confirmation because He sent me a whole lot of resources and instructions to prepare for it. Or maybe this was the work of Facebook’s algorithm since I’ve been doing research on hospice care which is why I was getting similar recommendations on my newsfeed. 😀

By the way, I don’t have a personal Facebook account because I deactivated it. I have 1 dummy account though where I only have 1 friend and she’s my spiritual Mom/coach/mentor. I mainly use Facebook to stay updated with news and current events.

Here are some of the organizations I found if you need information on hospice care:

The Philippine Society of Hospice and Palliative Medicine – https://www.pshpm.org/

Asia Pacific Hospice Palliative Care Network – https://aphn.org/

The European Association for Palliative Care is also conducting a free webinar on February 21, 2024 at 5pm (Manila Time) entitled “Public Health Approaches to Bereavement Support.” Here’s the link to register: https://us02web.zoom.us/webinar/register/9717054994060/WN_A7NsLepPSIO2sn28NnZx9Q?fbclid=IwAR1KbkSVq0tRwg3MVTQXfmXUrVVvXab0TXiicyzBcL2F6NZzY8jvdd4qMyU#/registration.

I also chanced upon the website of the National Institute on Aging, which is one of the institutes of the National Institutes of Health in the U.S. It’s a privilege to be able to subscribe to their weekly newsletters and receive free caregiving tips and resources, which are all very informative.

I cannot tell though if the fulfillment of these plans will happen in my lifetime, but this might inspire others to follow suit if they also receive the same calling. But first, let’s define hospice care.

What Is Hospice Care?

Merriam-Webster Dictionary defined it as “a program designed to provide palliative care and emotional support to the terminally ill in a home or homelike setting so that quality of life is maintained and family members may be active participants in care. It is also a facility that provides such a program.”

The hospice project proposal and draft for another project are currently at 30% and 20% progress rates, respectively. I still have a lot of work to do. But, all in God’s perfect time. And I cannot work on a project without listening to worship songs. It’s a must. 😉

What To Do During The Terminal Stage Of An Illness?

It is part of my preparations to always assume the worst-case scenario. This helps me prepare holistically. However, I would suggest limiting these worst-case assumptions to a minimum because they can trigger anxiety, and we don’t want that. So let’s say I am diagnosed with a terminal illness, how am I going to take it?

1. Seek For Expert Opinion Re Treatments

I’ll ask my doctor how long I have like if I opt to go through all the treatments, will I have a couple of years and if I don’t, do I have a couple of months only to live? I will also ask what is my quality of life after receiving the treatments. Will I be able to live a normal life again?

If the answer will depend on how my body will respond to the treatments, then it’s a “go.” If my body won’t be able to survive the treatments, then I’m choosing palliative care and pain management instead.

2. Plan My Next Move

I did ask God what more can I do if I only had a couple of months or years to live. Because I felt like I could only do so much in just a short span of time. And yet God’s answer was that what we might consider as small efforts now may actually have a lasting and significant impact later on.

One example is meeting another patient who is already on the verge of ending his/her life, but by talking to him/her, hope in God is restored and this person is now helping others as a result. Or it could be a student who will be inspired by my testimony, and decades from now, that kid will become the President of this country who fears God and will genuinely serve his people. It’s like God was saying that there are plenty of opportunities to touch other people’s lives that don’t really require that much effort and too much time.

3. Prepare For The Actual Battle

We never go to a battle unprepared. And we don’t prepare ourselves only, but those around us, too. It is also important to be surrounded by people who can pray for you and encourage you to keep on fighting. The church is the right community for this.

Equipping warriors with the Armor of God in every battle (Ephesians 6:11-13). JEHOVAH NISSI. 🗡️🛡️

Breast cancer support groups, in a way, provide emotional and psychological help and other information based on every patient’s journey. But, we can’t totally rely on them because most of the people in these groups are going through treatments or have a family member who is ill. When one member dies, it can pull the morale of the rest of the members down.

Because when this happens, I know the next questions that will pop into their minds are these, “Lord, am I next? When will my time come?” Questions like these, if they are what occupy the patient’s mind often, will result in depression. And in the webinars I attended, when depression hits, it affects every treatment plan, especially if the patient doesn’t want to eat and take their medications or continue the treatments.

So I actually came up with this mantra to combat depression – we do not mourn the living, we mourn the dead. We can’t be sad all the time and cry over how difficult life is as a sick person. We don’t lose heart, but we keep moving forward. As long as we still breathe, we move forward. We call this in UP as “Padayon.” ✊

4. Pray And Let God Take Control

Once I start with my treatments, I will leave the results to God. Whether I get healed or my condition worsens, I will accept what God’s will is for me. If ever I decide to push through with palliative care, then I will let nature run its own course just like the stance of Ezekiel Emanuel, an oncologist, to refuse all treatments after the age of 75. You may read more about it in the following articles:

https://www.pbs.org/newshour/show/doctors-argument-living-longer

https://www.google.com/amp/s/www.dailymail.co.uk/health/article-11619519/amp/White-House-oncologist-Obamacare-architect-wants-die-75.html

Can We Ever Get Used To Seeing People Die?

I once asked my second sister who works as a nurse in a nursing home in Norway how she ever got used to seeing patients die. How do you care for someone without getting emotionally attached and not be sad when he/she passes away?

My sister answered that you will never get used to it. You somehow just learn to accept it. I guess we can learn from doctors, too, and how they approach every patient’s case objectively. However, this isn’t always the case like what our pastor shared in church about how one doctor cried because the patient, a member of the congregation, was all good to undergo surgery but suddenly died the next day. And they weren’t expecting it at all.

This is why I have so much respect for doctors. What they do is really not easy. Also, not all patients are the same. There are those who will use 15 minutes of the doctor’s time venting out his/her sob story but still fail to answer directly the doctor’s question of what their concern is. 😁✌️ Then there are those who are sometimes too stubborn to obey doctor’s orders (is that you, Christine? lol). And there are those who blame the doctors when results turn out differently than what they’re expecting (this is definitely not me). But, we all love and care for these patients just the same.

That is why I keep on praying to God that doctors will be given the best support system that they could ever have may it be in the form of trusted friends, a spiritual family, loving parents and siblings, a supportive partner, or awesome kids (even if they can get too rowdy sometimes). And this is also what I was hoping the hospice facility would be able to provide – whatever the dying patient wishes, it will be granted (as long as it is reasonable).

Look To Jesus For Salvation Amid Suffering

Each one of us will go through different ways of dying. Each of these deaths will have its own struggles and pain – except for those who died instantly. We will all go through these struggles before our last breath. And yet we should not be afraid.

Instead, we look up to Jesus and how He conquered death. And yet even His death did not happen in His own timeline. Only God knows when we leave this world. What really matters is what we do with this one life that we have here on Earth.

If we’ve been born again, then we only have one purpose and that is to use our lives for God’s plans and His glory. We are a living testimony of God’s grace through every pain, every sorrow, and every suffering that we encounter in this life. The book of Revelation already gave us a glimpse of what those who endured suffering will get in the end – the promise of eternal life. This is a wonderful place to look forward to because in it there will be no more pain, no more sickness, and no more death. ❤️

“My flesh and my heart may fail, but God is the strength of my heart and my portion forever.” – Psalm 73:26

“Therefore we do not lose heart. Though outwardly we are wasting away, yet inwardly we are being renewed day by day. For our light and momentary troubles are achieving for us an eternal glory that far outweighs them all. So we fix our eyes not on what is seen, but on what is unseen, since what is seen is temporary, but what is unseen is eternal.” – 2 Corinthians 4:16-18

Then I saw “a new heaven and a new earth,” for the first heaven and the first earth had passed away, and there was no longer any sea. I saw the Holy City, the new Jerusalem, coming down out of heaven from God, prepared as a bride beautifully dressed for her husband.

And I heard a loud voice from the throne saying, “Look! God’s dwelling place is now among the people, and He will dwell with them. They will be His people, and God Himself will be with them and be their God. He will wipe every tear from their eyes. There will be no more death or mourning or crying or pain, for the old order of things has passed away.” – Revelation 21:1-4

P.S. Here are some videos that I felt like God wanted me to watch as part of our preparation for the hospice project. Again, providing hospice care may or may not materialize in our lifetime, but maybe those who get to read this article might benefit from watching these videos. These videos can be emotionally heavy for some so I suggest being ready with your comfort food, favorite hobby, or a trip someplace else after watching these videos to release all the negative emotions. And don’t forget your rolls of tissue. *sniff*

“5 Things You Should Know When Someone Is Actively Dying”
“How Doctors Tell Patients They’re Dying | Being Mortal | Frontline”
“Before I Die: A Day With Terminally Ill Patients | Death Land #2”
“Inside The Children’s ICU | Episode 4: Facing Death”
“The Last Hours With Our Daughter”
“Brain Cancer: Dying To Live, Living To Die In 4:42 Minutes”