by Lindsay Abrams
January 7, 2013
You know how if someone e-mails you over and over, and doesn’t stop until you finally respond or just go ahead and do what they’ve been asking you to, it’s really annoying, but also a pretty good strategy on their part because they ended up getting what they wanted?
The same thing, it turns out, works with doctors. Only in this case what they’re being nagged about is having an important conversation with terminally ill patients that, let’s be honest, they shouldn’t have been avoiding or forgetting in the first place.
The number of patients with incurable cancer whose charts indicate whether or not they want to be resuscitated can be doubled, a new study in the Journal of Clinical Oncology found, provided doctors are sent e-mails reminding them to ask.
Per national guidelines, this conversation is supposed to occur when a patient’s prognosis is less than a year. More
by David Wahlberg
Wisconsin State Journal
December 10, 2012
When patients near the end of life, many doctors say there’s nothing more they can do.
But “there is so much we can do for people at the end of life,” said Dr. Jim Cleary, UW Health’s director of palliative care.
Doctors can provide pain relief, comfort care and guidance to families, Cleary said.
“For a physician to say, ‘There is nothing else I can do,’ is really, I think, a neglect of their physician duties.”
Cleary’s comments are from “Consider the Conversation: A Documentary on a Taboo Subject.” The 2011 film by two Wisconsin men has sparked an initiative to expand advance care planning around the state.
In the first phase of the effort, nurses, social workers and clergy at Madison’s health systems will begin offering discussions about end-of-life decisions to select groups of patients in March. Broader outreach is planned in 2014.
Instead of merely asking patients if they have living wills or health care power of attorney documents, hospitals and clinics will offer discussions about a variety of questions — from whether to resuscitate and ventilate to what kind of people, music and lighting patients want to be surrounded by when they approach death. More
by Laurel Lewis
December 5, 2012
These tips come from my experience of being with hundreds of people as they have died and with the thousands of family members who have witnessed this event. Consider using these tips for dying well … and for living well!
10. Talk about what you do and don’t want.
Tell your family, friends and doctors how you want to be treated and what kind of treatments you want or don’t want! Consider a living will or other advance directives so that your wishes will be known prior to end of life choices. Consider your needs: physical, emotional and spiritual because they all impact your final days.
9. Have a life review. Recall significant and meaningful events .
Share your stories either verbally or written with your loved ones, in a journal or on tape. As you do this forgive yourself and others for everything! Let go of judgments. Judging people and events take up precious energy that could be spent loving instead. Release the judgments and allow yourself to be fully present to what is in your life right now.
8. Express gratitude daily – for something, anything!
This will help move you from the context of small self who is dying to connect with the bigger part of Life that is surrounding us always. Expressing gratitude creates a positive shift in our mental state, which in turn has positive physical benefits. More
by Patricia Patton
November 17, 2012
It is the end of life.
My sister lies in her hospital bed, and I am being challenged to set her free. But what I really feel like doing is SCREAMING at the top of my lungs. The doctors have finally stated, “We can make her comfortable.” That means the family must now shift gears and face our reality.
I had been managing my sister’s emotional care from across the country. In truth, her husband had been her primary caregiver and I was his wing wo/man. I had been criss-crossing the country, trying to help her experience some joy by staying close to her and by helping her heal old wounds with her adult children. The downward spiral had begun in earnest at least 18 months before. However, consistent with our black southern tradition, my family had not taken even one of the AARP recommendations for those preparing for death. Why? Because of religious beliefs and my sister’s children and her husband were in denial. Also they really didn’t know what to do.
AARP research has found that 46 percent of family caregivers perform medical/nursing tasks for their patients who are suffering with multiple chronic physical conditions. My sister had been suffering from kidney failure and breast cancer among other things. So her husband was indeed a part of this 46 percent statistic. He was also one of the three out of four (78 percent) caregivers who managed medication, including administering intravenous fluids and injections. He performed these tasks to avoid institutionalizing her because their financial resources would not have allowed for assisted care or live-in help.
So, as I was saying, there we are in the hospital and clearly we are approaching the end of her life. The sister I know is gone, even though her body is lying in the hospital bed. Technically she is still here, thanks to a ventilator — but I don’t think this could be called living. More
November 15, 2012
Consider this situation: you are driving home in a rain storm; you lose control of your car and hit a tree. You are taken to the hospital and need emergency medical attention. After the surgery, they determine that there is no hope of recovery, and you can only be kept alive by machines. What happens to you now? Would you choose to be kept alive artificially, or would you prefer to die with dignity? Unless you make your wishes known beforehand, you will not have a say. Your family will decide your fate without knowing what you wanted done.
Unfortunately in our society today, very little planning is done for the certainty of death. In the absence of documents stating someone’s preference regarding end-of-life issues, the person is vulnerable to the will of the physician, family, friends or other acquaintances. Alarmingly, only 11 percent of African Americans express their wishes regarding end-of-life care, compared to 38 percent of whites. More