End-of-Life Choice, Palliative Care and Counseling

palliative care

On a Mission to Transform End-of-Life Care

by Michelle Brandt
Scope
November 27, 2012

No one likes talking about dying, but Stephanie Pincus, MD, MBA, believes we all need to do more of it. Pincus is one of the key people who participated in the work that resulted in  a new Institute of Medicine committee tasked with exploring and preparing a report on the current state of end-of-life care in the country. The committee’s ultimate goal is to ensure that people are able to die as they wish.

“People do not want to die alone, in a hospital bed, hooked up to 15 different machines, with buzzing in their ears. They want to be with their families in familiar surroundings, able to say their good-byes peacefully,” Pincus, who recently gave a talk at the medical school sponsored by the Stanford Palliative Care training program, told me.

“Until about 100 years ago death was part of life. In early times in the U.S. when someone died they were laid out on the kitchen table,” she continued. “But as we moved medical care to the hospital, death became isolated and isolating. We need to reclaim death from the hospital and reintegrate with the family.” More

Treating the Body, Mind and Soul

by Chris Conrad
Mail Tribune
October 21, 2012

Eighty-seven-year-old Dorella Johnson is tired.

She’s tired of suffering through multiple blood-draws every day to treat the chronic illnesses that have landed her in Providence Medford Medical Center. Her deep and fragile veins make it difficult to insert needles into her arms. Her arms are splotched with large purple and black bruises that stretch from her wrist all the way past her elbow.

She’s tired of spending her days in a hospital bed and not at the Medford home she and her late husband of 68 years, Roger Johnson, lived in for several years.

Her sister Ruth Wineteer came to Medford from her home in Eastern Oregon to be there when a decision was made on Johnson’s fate.

“She told me that she didn’t want any more shots, no more poking,” Wineteer said. “She just said, ‘No more. It hurts.’ ”

Johnson knows she has reached the end of her life and she wants to live out her final days in relative comfort, away from hospitals and doctors. More

When Prolonging Death Seems Worse Than Death

NPR
October 9, 2012

Many of us think of death as the worst possible outcome for a terminally ill patient, but Judith Schwarz disagrees.

Schwarz, a patient supporter at the nonprofit Compassion & Choices, says prolonging death can be a far worse fate. For many patients, good palliative or hospice care can alleviate suffering, yet “a small but significant proportion of dying patients suffer intolerably,” Schwarz says.

Based in the New York area, Compassion & Choices is an organization that helps terminally ill patients and their families make informed and thoughtful end-of-life decisions to hasten a patient’s death. These decisions are not made impulsively, Schwarz tells Fresh Air‘s Terry Gross. “Nobody makes this choice unless the burdens of living have so consistently, day after day, outweighed all benefit.” More

Bringing Palliative Care Into the Conversation

by Dana Sitar
Seven Ponds
October 4, 2012

California State University is tackling a shortage in palliative care workers by launching the first statewide educational and workforce development initiative dedicated specifically to palliative care. With an aging population and an increase in the number of people living with serious illness, health care systems are facing the challenge of providing the care our population needs, and the CSU Institute for Palliative Care will help overcome that challenge.

“Our aging society requires a qualified palliative care workforce that can support people’s desire for quality of life, independence, and choice and control in their health care decisions,” said Joseph Prevratil, CEO and President of Archstone Foundation, which provided initial grant funding for the Institute, along with California HealthCare Foundation.

The CSU Institute for Palliative Care at CSU-San Marcos will offer palliative care training for professionals, and it will educate the public about the value of palliative care and how to access it. This public awareness will be invaluable to those who would benefit from palliative care but know so little about it. More

Do Seniors Turn to the Right Places at End of Life?

by Andrew Seaman
Chicago Tribune
October 1, 2012

A new study says almost one third of Medicare’s beneficiaries use the program to pay for end-of-life care at nursing homes, which may not be equipped to treat or prevent pain and suffering.

Those palliative care services are usually associated with hospice care, while nursing homes are typically for rehabilitation and long-term care.

The study’s researchers, who published their findings in the Archives of Internal Medicine on Monday, say the findings suggest that palliative or hospice care should be incorporated into Medicare’s nursing home benefits.

“Often our focus on these patients is trying to keep them functional or independent for as long as we can. What we may be overlooking is that they are on an end-of-life trajectory,” said Dr. Katherine Aragon, the study’s lead author from Lawrence General Hospital in Massachusetts. More