Dying: Go gentle -- but not just to save money

  • Article by: BILL KELLER , New York Times
  • Updated: October 10, 2012 - 10:07 AM

Address end-of-life care for the simple reason of humanity.

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radagastOct. 9, 12 7:25 PM

People are so afraid of death, but death is nothing to fear, no matter your beliefs. If you believe death is the end, then death is literally nothing, which is nothing to fear. If you believe there is something more, then consciousness goes on, which is nothing to fear. I don't fear death, I fear the process of dying - which is made so much worse by futile, intensive procedures near one's end in a hospital. None of that for me. No tubes, wires, drugs (except morphine), surgeries, yada. The Brits have the right idea - just palliative care and the respect and consideration to be allowed to die quietly, with dignity.

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jpcooperOct. 9, 12 7:42 PM

Does the The Liverpool Care Pathway cuts costs? Not using is sure drives up the costs.

In looking at Healthcare for our terminally ill over the last 20-30 years it has changed dramatically. In the 1970's when my grandmother was diagnosed with terminal cancer she was sent home to OUR house for care. She had pain medicine and drugs to help her sleep. She passed away in her bed.

2 years ago my mother was terminal with cancer she was in and out of the hospital, 100's of tests, doctors appointments 2-3 times a week, blood transfusions, dialysis, radiation, all in a 4-5 month window. Medicare spent over $240K on a 83 year old terminal woman. I lived out of town it was hard to visit on the weekends and see toll this took on her. In the end, she said "no more" she wanted to be home, no more tests, no more blood drawn, just wanted her family near. She died in her bed

Now and in the coming years we as a society have to make a moral decision with our terminal loved ones. No one want to hear about it or talk about it but life saving measures at all costs are not the right thing to do in the case of a terminal elderly loved one

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reidOct. 9, 12 8:43 PM

For those of us who are brave enough to do so, tell loved ones exactly what you will and won't accept during such terminal times. Make a living will. If the hospital is owned by a Catholic hospital, make sure their leaders will honor a POLST or go find another one that will. Take control of your future and death. Many nasty family conflicts arise during death of an elder (usually the most strident to keep Pops alive is from the child who has not had a chance to make amends), and can lead to accusations of trying to kill a family member off, to save money, to get property, etc. All avoidable, but only if the dying person takes leadership of their death before it starts.

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FrankLOct. 9, 1210:29 PM

having just gone through this with a parent, the doctors are the worst problem. The options were constantly heroic operations or do nothing. How about some middle ground? We couldn't even get hospice until the last few days because the biopsies came back inconclusive, even though all the symptoms pointed to pancreatic cancer. They would have had to do major surgery to tell for sure which would have killed her. All she wanted to do is die in her own bed in some comfort. The worst was after one hospitalization she was sent to a nursing home that did not want to give her up despite a living will. One excuse after another, it took threatening to get a lawyer involved before she was released.

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erikj3Oct. 10, 1212:22 AM

No one wants to die, but obviously it's inevitable. Not preparing for end of life makes as much sense as not doing your taxes!

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crystalbayOct. 10, 12 2:14 AM

Two years ago, I was diagnosed with Stage 3 esophageal cancer. My odds of survival were set at less than 10%, but with many weeks of chemo and radiation followed by a 9-hour surgery at Mayo, I've now made it to 50% odds. I sailed through the treatments, but the massive surgery nearly killed me and I spent close to four months in hospitals on a feeding tube. The last six weeks of these months were in a nursing home since I wasn't well enough to be at home alone, and no longer ill enough to be in the hospital. It was a nightmare to be a vital, lucid mid-60s woman in this setting. The dangerously negligent medical care almost cost me my life and I lost weeks of progress in this setting, ultimately being rushed to ICU due to overwhelming dehydration. This experience taught me that, no matter what, I will never consider entering such a setting again. I would literally rather die. I've watched my parents and a few other very old people consuming untold amounts of medical resources when there really was no hope for surviving much less thriving. I've thought about how such intense resources would be better spent on those for whom recovery is likely. In all but one case, it was the doctors and families pushing for more medical treatments beyond the point of reason, not the elderly ill person. If my cancer recurs, I'm likely to refuse further treatment.

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joespookOct. 10, 12 6:40 AM

The hardest part, The people left behind suffer the most emotional pain ever. If true love was there. Stop everything, spend every minute you have with them, soon you will know why. Alot of tears come from good memories, not bad ones. A river flows from my eyes. LOVE YOU FOREVER.

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owatonnabillOct. 10, 12 8:15 AM

This article, while containing good points, is misleading in the reference to Palin and Bachmann. What these two were referring to were decision-makers on behalf of the insurance companies and/or government (pretty much one and the same under Obamacare), rather than the patients. The point of this article is that the program being referred to is VOLUNTARY, with the dying person and/or the immediate family making the calls instead of a separate group of people looking at charts and tables. A world of difference and some shoddy partisan journalism on the part of the Strib.

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northhillOct. 10, 12 8:32 AM

Medicine has made great progress over the years in prolonging life; but in the end we are all mortal.We need to have this conversation and not in the arena of politics.Is it ethical to spend $50,000 dollars to prolong life for a couple of months more? This conversation needs to be made with your family and with your doctor.There is also the issue of following doctor's instructions.What do we do with the heart patient who still smokes and eats a high fat diet after a heart attack? America is a nation that expects happy outcomes.However,end of life issues will still be there.Our mortality will not allow us to ignore them.

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cstoney48Oct. 10, 12 9:47 AM

owatonnabill said: "What these two were referring to were decision-makers on behalf of the insurance companies and/or government.." Same old tired lines. People like Bachmann and Palin are the problem in the discussion. Funny, how the people who claim to be the most religious do the most to avoid the discussion.

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