

What It Feels Like To DieSeptember 13, 2016 |
Science is just beginning to understand the experience of life’s end
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What It Feels Like To DieSeptember 13, 2016 |
Science is just beginning to understand the experience of life’s end
Science is just beginning to understand the experience of life’s end
“Do you want to know what will happen as your body starts shutting down?”
My mother and I sat across from the hospice nurse in my parents’ Colorado home. It was 2005, and my mother had reached the end of treatments for metastatic breast cancer. A month or two earlier, she’d been able to take the dog for daily walks in the mountains and travel to Australia with my father. Now, she was weak, exhausted from the disease and chemotherapy and pain medication.
My mother had been the one to decide, with her doctor’s blessing, to stop pursuing the dwindling chemo options, and she had been the one to ask her doctor to call hospice. Still, we weren’t prepared for the nurse’s question. My mother and I exchanged glances, a little shocked. But what we felt most was a sense of relief.
During six-and-a-half years of treatment, although my mother saw two general practitioners, six oncologists, a cardiologist, several radiation technicians, nurses at two chemotherapy facilities, and surgeons at three different clinics—not once, to my knowledge, had anyone talked to her about what would happen as she died.
Image: By Billwhittaker at en.wikipedia, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=5067597
Reframing Shared Decision Making at the End of LifeAugust 29, 2016 |
Video: Our Marie Nolan delivers the National Institute of Nursing Research Director’s Lecture
Video: Our Marie Nolan delivers the National Institute of Nursing Research Director’s Lecture
William J. Hager, 86, said he had run out of options. His wife, Carolyn Hager, 78, had been ill for the last 15 of the more than 50 years they were married. The cost of her medications had become so burdensome that they could no longer afford it, he said
William J. Hager, 86, said he had run out of options. His wife, Carolyn Hager, 78, had been ill for the last 15 of the more than 50 years they were married. The cost of her medications had become so burdensome that they could no longer afford it, he said
So on Monday morning while she was sleeping, he shot her in the head, he told the deputy who came to their Florida home.
The killing in Port St. Lucie and Mr. Hager’s explanation were detailed in an arrest affidavit and by local news media. Mr. Hager was arrested and charged with first-degree premeditated murder. But the case appeared to also highlight the difficulties faced by older people who are retired or on fixed incomes and struggle to pay for their medicine when they are ill or in pain.
At the sheriff’s office, Mr. Hager told deputies that his wife had a “lot of illnesses and other ailments which required numerous medications,” which he “could no longer afford,” the affidavit said.
Aid-In-Dying: Not So EasyMay 5, 2016 |
Starting June 9, terminally ill Californians with six months or less to live can request a doctor’s prescription for medications intended to end their lives peacefully. If that sounds simple, it won’t be
Starting June 9, terminally ill Californians with six months or less to live can request a doctor’s prescription for medications intended to end their lives peacefully. If that sounds simple, it won’t be
California’s End of Life Option Act creates a long list of administrative hurdles that both patients and their doctors must clear.
For instance, you must make multiple requests for the drugs, orally and in writing, and provide a written attestation within 48 hours of taking the medication (you must be able to take the drugs yourself, without help, to qualify).
Two doctors must confirm your diagnosis, prognosis and ability to make medical decisions, and you must prove you’re a California resident.
And more.
Image: By Diane A. Reid (Photographer) – This image was released by the National Cancer Institute, an agency part of the National Institutes of Health, with the ID 3860 (image) (next).This tag does not indicate the copyright status of the attached work. A normal copyright tag is still required. See Commons:Licensing for more information.English | Français | +/−, Public Domain, https://commons.wikimedia.org/w/index.php?curid=24062766
Not long ago, a frail-looking elderly patient appeared at my cardiac health clinic with a file full of hospitalizations stemming from a heart attack years before… I saw that a previous doctor had written “DNR” — do not resuscitate — in his chart, so I asked him to confirm his wishes. No, he said, to my surprise. He actually wanted to be a “full code”
Not long ago, a frail-looking elderly patient appeared at my cardiac health clinic with a file full of hospitalizations stemming from a heart attack years before… I saw that a previous doctor had written “DNR” — do not resuscitate — in his chart, so I asked him to confirm his wishes. No, he said, to my surprise. He actually wanted to be a “full code”
No, he said, to my surprise. He actually wanted to be a “full code” — meaning that chest compressions, shocks and intubation were to be used if necessary to keep him alive.
I was taken aback. Someone had presumably told him that he would probably not survive a cardiac arrest even with cardiopulmonary resuscitation. (Only 1 out of 7 patients older than 80 do; this man was close to 90.)
“I don’t want anyone giving up on me,” he said. No matter how much I explained that CPR would probably only cause him to suffer longer without adding to his life, he remained adamant. He left my office visit with a yellow “full code” indicator in his chart instead of the red “DNR” one.
Image: By Rama – Own work, CC BY-SA 2.0 fr, https://commons.wikimedia.org/w/index.php?curid=3632271
As the End Nears, ‘Death Doulas’ Ease the WayApril 8, 2016 |
Among midwives and doulas, there’s a belief that no one should feel alone during life’s mystifying, sometimes terrifying, start. A growing number of people believe death should be no different.
Among midwives and doulas, there’s a belief that no one should feel alone during life’s mystifying, sometimes terrifying, start. A growing number of people believe death should be no different.
It’s why Dr. Jackie Yaeger, a hospice medical director in Wisconsin, began training to become what is known as a “death doula” last year.
“I’m not sure I’m comfortable with that term yet,” Yaeger said by phone recently from her home in La Crosse. “It’s really about offering wise guidance or transitional guidance, like a midwife. Maybe ‘death midwife’ is better.”
The concept of death doulas is relatively new. There are perhaps hundreds of them today — no one has a firm count — but their ranks are growing.
By Aali Oubadi – Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=40254344
“It’s Not Worth Me Having a Long-Life Lightbulb”April 6, 2016 |
Death is a part of life for people over 95 years old, who mainly live day-to-day, concludes a rare study of attitudes to death and dying amongst the very old. The research, from the University of Cambridge and published today in the journal PLOS ONE, finds that this group is willing to discuss dying and their end-of-life care, but is seldom asked
Death is a part of life for people over 95 years old, who mainly live day-to-day, concludes a rare study of attitudes to death and dying amongst the very old. The research, from the University of Cambridge and published today in the journal PLOS ONE, finds that this group is willing to discuss dying and their end-of-life care, but is seldom asked
Improvements in our environment and lifestyles, as well as significant medical and healthcare advances, mean that more and more people are living to a very old age. According to a report published last year by the Office of National Statistics, the number of people aged 90 or more at the time of their death has tripled in the past three decades in the UK.
“Despite the dramatic rise in the number of people living into very old age, there is far too little discussion about what the ‘oldest old’ feel about the end of their lives,” says Dr Jane Fleming from the Department of Public Health and Primary Care at the University of Cambridge, who led the study. “We know very little, too, about the difficult decisions concerning their end of life care.”
In a study part-funded by the National Institute for Health Research, researchers interviewed 33 people over 95 years old from the Cambridge City over-75s Cohort and for 30 of these and for 9 people too frail to be interviewed in person, a ‘proxy’ – a relative or member of care-home staff, for example – about attitudes towards death, dying and end-of-life care. The responses are at times poignant and occasionally humorous, but provide a fascinating perspective on the views of an often overlooked minority.
Image: Chalmers Butterfield CC BY 2.5
A Letter To… The Hospice Doctor Who Helped Us to Say GoodbyeMarch 28, 2016 |
…”For the first time in the entire period of my father’s cancer, my mother cries. Woman to woman, you look at her and she feels your genuine solidarity. It is a turning point, and from then on my mother prepares to cut free from her husband of more than 55 years”
…”For the first time in the entire period of my father’s cancer, my mother cries. Woman to woman, you look at her and she feels your genuine solidarity. It is a turning point, and from then on my mother prepares to cut free from her husband of more than 55 years”
When my father arrives in the hospice, there is a flurry of activity. Drug charts are checked, vital signs are tested. We all know he has come here to die, but still the idea is that something might be fixed, at least temporarily, and the young doctor and nurses on duty that evening have an air of “sorting things out”. It is a relief to get here; they know what to do. The flat has become a claustrophobic, smelly and unmanageable place for my mother to care for Dad.
The next day, you slide into the room like an elegant cat – without an entourage of junior doctors, a computer on wheels or a stethoscope slung around your neck. You lean over my sleeping father and take him in without saying anything, and then turn to my mother with a smile that is at once kind and serious.
You take us to a side room and tell us that he is nearly finished with his body now, that it is normal and natural and that there is nothing to be done except to keep him comfortable. You say it clearly and calmly, making eye contact with my mother. It is a beautiful day, and you suggest we take a walk and look at the sky, the daffodils, the trees beginning to bud. “He will be with you in these things,” you say, entirely without sentimentality. “It is time to let him go.”
Image: zen via flickr – CC BY-NC-SA 2.0