Category Archives: End-of-life issues

“When death is imminent, end-of-life care decisions sometimes go out the window” – STATnews

Woman supporting mother with cancer

by Jay Baruch

Two medics roll Mrs. M into the emergency department. Sweat drips from her forehead. Her chest heaves in and out as she tries to suck every last oxygen molecule from inside the oxygen mask. I introduce myself and she opens her eyes but her glassy stare lands beyond me. “She has metastatic breast cancer,” says one of the medics. ‘She’s in hospice. But her son wants everything done.’

“‘Doing everything isn’t a plan that’s compatible with hospice,’ I mutter.

“‘We didn’t know what to do,’ says the medic, shaking his head. ‘She wasn’t this bad when we arrived at her home. She was working to breathe, but not like this.’”

Read this STAT article in its entirety, click here.

“End-of-Life Care Legislation Clears Key Committee Vote | POLST Legislation Would Provide Consistency and Clarity for End-of-Life Care”

Harrisburg, Pa. (December 12)—The Pennsylvania hospital community is praising the State Senate Health and Human Services Committee for its unanimous passage of legislation to help patients and their families communicate their end-of-life care wishes. Senate Bill 623, legislation sponsored by State Senator Gene Yaw (R–Lycoming), would establish the Pennsylvania Orders for Life-Sustaining Treatment (POLST) program.

POLST is a voluntary program designed to work in tandem with advanced directives, helping patients and their families plan and communicate their wishes, so that they can receive the right care for them, in the right place, and at the right time.

The Hospital and Healthsystem Association of Pennsylvania (HAP) and its member hospitals and health systems, along with the Pennsylvania Medical Society, and other health care advocates, have been vocal supporters of POLST legislation.

“End-of-life health care is one of the most difficult topics to discuss with family and friends, but it is necessary in order to carry out the wishes of loved ones. I know from my own personal experience just how important a program like POLST can be in helping patients and families make sure that their medical wishes are honored,” said Andy Carter, HAP president and CEO.

Senate Bill 623 would codify POLST, providing a consistent and clear form that puts patients and families in charge of their end-of-life care. POLST provides an opportunity for patients and families to provide directions for the use of medical interventions, feeding methods, transportation, administration of medication, and resuscitation. The bill would ensure that the decision to complete a POLST form is voluntary and done at the discretion of each patient and his or her family. These orders would apply across all health care settings.

“Pennsylvania hospitals are proud to have closely worked with a diverse group of physicians, nurses, patient advocates, home health professionals, nursing homes, and faith-based community members to assist with developing this common-sense legislation,” Carter continued. “We applaud the committee’s vote on this bill and urge the Senate and House to follow suit, and Governor Wolf to sign it.”

Companion legislation, House Bill 1196, sponsored by Representative Bryan Cutler (R–Lancaster), awaits consideration by the House Health Committee.

SOURCE: news release

ABOUT HAP:  HAP is a statewide membership services organization that advocates for nearly 240 Pennsylvania acute and specialty care, primary care, subacute care, long-term care, home health, and hospice providers, as well as the patients and communities they serve. Additional information about HAP is available online at www.haponline.org.

This recent HAP Blog article provides additional information about POLST.

“Facing Down the Biggest Fear of All | 5 ways to conquer your fear of death and age courageously” – next avenue

facing downCredit: Adobe Stock

(Editor’s note: This essay is part of a series from author and speaker Ken Druck, based on work in his book Courageous Aging, which is about how all people can make peace with, and find joy in, every stage of life.)

“Our fear of death begins when we’re kids. Perhaps we had to face the mystifying idea of impermanence when a beloved pet, parent or grandparent died. The stark reality that this loved one was really gone — and gone forever, was both devastating and terrifying. From early childhood, when we’re introduced to the concept of “futureless-ness” — that is, old age and eventually death, there are few things as difficult for us to deal with. Facing down the fear of dying requires great strength, humility and spiritual fortitude. But, as you will see, it’s worth the effort.

“Summoning the courage to quell our fears and come to terms with our mortality may be one of the most challenging things we ever do — but it may be one of the best things we can do. Freeing up the space in our minds and hearts where fear has resided and replacing it with newfound peace, courage and understanding is one of the greatest gifts we can give ourselves.

“5 Ways to Overcome Your Fear of Death”

To see the five ways and read this article in its entirety, click here.

 

“How To Plan A Relaxed Family Conversation About Death” – The Wisdom Daily

Last night there was a Death Cafe at Tellus 360; topics like this came up, because what’s written in this article is a kind of “family death cafe.”

“As the youngest in my family, it’s a reasonable assumption that I’ll be the last one to go. The final go. Yes, I’m talking about death.

“It’s not something anyone in my family ever really discussed. We talk about issues: faith, relationships, dreams and goals, worries and fears. But the biggest fear of all — our own mortality — never seemed to come up.

Talk by breakfast

“That started changing when my parents turned 60. They suddenly began dropping ‘when we’re gone’ into conversations. They asked my sister and I about items we’d like bequeathed to us. It felt weird. I wanted to say, ‘I don’t care about your stuff, Mom; I care about you.’ But I shied away from delving into an unwieldy, uncomfortable topic.

“At first. As I thought about it more, I realized this is a big deal. Our existence is because there is a period at the end of it. Those two bookends of birth and death define our life on earth. We hate talking about death, but it matters — a lot.

Continue reading this article in its entirety at The Wisdom Daily Website.

“What is palliative care? A patient’s journey through the system” – The Conversation

This is the first article in our series on demystifying palliative care, where experts explain the process of end-of-life care in Australia.” [NOTE: While the article is about end-of-life care in Australia, it is relevant here, too.]

palliative

“A diagnosis of a serious illness has a multitude of consequences. There may be significant symptoms related to the disease such as pain, breathing difficulties, nausea, fatigue and weakness.

“Such illnesses often limit a person’s ability to do the shopping and chores, attend the many medical appointments required, and can potentially lead to social isolation.

“What is palliative care?

“Rebecca lived with her husband, Rob, and six-year-old son, Jack. She was 34 when she met the palliative care doctor, after being diagnosed with a particularly aggressive lung cancer. She had undergone extensive surgery and was due to have radiotherapy and chemotherapy. She was struggling with some ongoing pain after her operation.

“Her cancer doctor suggested she see the palliative care team to help manage her pain so she could cope better with the next steps of her cancer treatment.”

Read this article at The Conversation in its entirety, click here.

 

“Cashing in on the donated dead | The Body Trade” – Reuters

“In the U.S. market for human bodies, almost anyone can dissect and sell the dead”

Part 1: When Americans leave their bodies to science, they are also donating to commerce: Cadavers and body parts, especially those of the poor, are sold in a thriving and largely unregulated market. Grisly abuses abound.

“LAS VEGAS – The company stacked brochures in funeral parlors around Sin City. On the cover: a couple clasping hands. Above the image, a promise: “Providing Options in Your Time of Need.”

“The company, Southern Nevada Donor Services, offered grieving families a way to eliminate expensive funeral costs: free cremation in exchange for donating a loved one’s body to “advance medical studies.”

“Outside Southern Nevada’s suburban warehouse, the circumstances were far from comforting. In the fall of 2015, neighboring tenants began complaining about a mysterious stench and bloody boxes in a Dumpster. That December, local health records show, someone contacted authorities to report odd activity in the courtyard.

“Health inspectors found a man in medical scrubs holding a garden hose. He was thawing a frozen human torso in the midday sun.”

Read this Reuters article in its entirety, click here.

“Adapting to the Changes of Old Age” – Time Goes By | What it’s really like to get old

Here’s another column from one of our favorite sources.

plato on age“Being about midway into old age now, it seems to me that changes great and small come barreling down the pike lickety-split – that there are many more arriving at a much faster rate than at previous ages of life.

“I can’t prove that with facts and figures and numbers and charts but it feels about right and I’ve come to believe it is an important job of elderhood to learn to adapt as we are buffeted front and back, up and down, left and right and around again with each new, often unexpected development.

“It’s not easy. As you know, my life was upended three months ago with a cancer diagnosis. I’m still trying to find a way to make the large number of restrictions that control my days now as commonplace as, for example, brushing my teeth has always been.

“It’s frustrating that I’m not there yet. I have other things I’d rather do than try to remember if I took those pills after breakfast or treated my hands with that special lotion.”

Read Ronnie’s column in its entirety here.

plato on aging

“Are doctors recommending hospice too late?” – Futurity.com

pre-hospice

“Despite experiencing symptoms for months before the end of their lives, older adults are spending shorter periods of time in hospice.

“The finding suggests there may be a need for more attention to symptoms and disability for these elderly people—and perhaps earlier hospice admission.

“Researchers looked at information from a study of 562 people, aged 70 and older, who were not disabled when the study began but died over the following 16 years.

“Of these individuals, 244 (43.4 percent) were admitted to hospice during the last year of life. They were slightly older and more likely to have cognitive impairments (problems thinking and making decisions) than older adults who weren’t admitted to hospice.”

Read this article at Futurity.com in its entirety, click here.

“Shedding New Light On Hospice Care: No Need To Wait For The ‘Brink Of Death’” – CaliforniaHealtline

Living With Parkinson's Disease

“A few weeks ago, Kathy Brandt’s 86-year-old mother was hospitalized in Florida after a fall. After rushing to her side, Brandt asked for a consult with a palliative care nurse.

“‘I wanted someone to make sure my mother was on the right medications,’ Brandt said.

“For all her expertise — Brandt advises end-of-life organizations across the country — she was taken aback when the nurse suggested hospice care for her mother, who has advanced chronic obstructive pulmonary disease, kidney disease and a rapid, irregular heartbeat.

“‘I was like — really?’ Brandt remembered saying, struggling with shock.

“It’s a common reaction.”

Read this article at CaliforniaHealthline in its entirety here.

“Dying At Home In An Opioid Crisis: Hospices Grapple With Stolen Meds” – California Healthline

handpillbottle

“Nothing seemed to help the patient — and hospice staff didn’t know why.

“They sent home more painkillers for weeks. But the elderly woman, who had severe dementia and incurable breast cancer, kept calling out in pain.

“The answer came when the woman’s daughter, who was taking care of her at home, showed up in the emergency room with a life-threatening overdose of morphine and oxycodone. It turned out she was high on her mother’s medications, stolen from the hospice-issued stash.

“Dr. Leslie Blackhall handled that case and two others at the University of Virginia’s palliative care clinic, and uncovered a wider problem: As more people die at home on hospice, some of the powerful, addictive drugs they are prescribed are ending up in the wrong hands.”

Continue reading this article in its entirety at California Healthline.