Making the decision to change treatment goals from curing or containing a health condition to comfort care is totally personal -- and can be difficult to make.

If you are considering hospice care, we recommend the following six steps:

• Step One: Take some time to assess what is important to you now.
• Step Two: If you're leaning toward hospice care, where would you prefer to do it?
• Step Three: Discuss your health status and treatment/care options with your doctor.
• Step Four: Discuss the hospice option with your family and loved ones.
• Step Five: Speak with a mental health professional and/or your religious or spiritual advisor if you have one.
• Step Six: Think about how you will pay for hospice care or get it for free.

If you locate a hospice which is willing to also permit you to fight your health condition, an entry into hospice may not be as big a step as it would be otherwise.

An alternative to consider is to look for a palliative care program in a hospital. Palliative care programs focus on treating pain and extending comfort. Patients usually do not have to be certified as terminally ill and can continue with treatment concerning the health condition.

If you would like to speak with an independent counselor about these subjects, counselors are available free of charge at National Hospice and Palliative Care Organization, tel.: 703.837.1500 (www.nhpco.org )

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