THIS is what we should be discussing with our patients

[GetMeOuttaThisMess]

http://www.dallasnews.com/business/health-care/20151108-all-out-care-at-end-of-life-takes-toll-in-agony-expense--and-its-worse-in-dallas.ece

 

Not only do the numbers provided make me squirm but also the comments from readers regarding how we are killing patients to get them out of the way.  We've lost the ability to comprehend that end-of-life IS part of life and it should be discussed just like where everyone is getting together at for the the holidays, which by the way is a great time to discuss the matters.

[Guest Paula]

The key phrase is "having thoughtful and ethical discussion  around end-of-life care".  I agree that we need to bring this up with patients and families, especially when a loved one is getting admitted to a nursing home or dementia unit, and even the assisted living facilities. 

 

I am so fortunate to have had discussions with my father over the past many years about what he would like for end of life care.  He did not want extreme measures, understood what he did and did not want, no feeding tubes, no respirators, no CPR and was DNR.  He did not have dementia.  He lived his last 6 months comfortably in a nursing home with good care.  He told one of my sisters that he "was done making decisions" and handed it over to us for his POA, Power for Healthcare, etc.  When he finally told the nursing home that he was not going to eat anymore, and they offered him a feeding tube, he said no.  We started Hospice and he died peacefully 2 days after his decision to stop eating.  We supported  his decision and it was ok.

 

It really helps to have the conversation with families ahead of time to prevent  indecision and guilt families feel and lack of knowledge.  We must start talking about  death as a part of life. 

[Guest Paula]

I will have to say I was furious when I found out my fathers Dr. ordered a lyme test, lipid panel and metabolic panel 1 week before he died.  WHY???  We all knew Dad would not benefit from any interventions, even if he had lyme disease.  He had polio and hadn't been able to walk for about a year, and was very thin, hadn't been outdoors hunting for 15 years or more.  

 

I saw it as money grubbing the system.  I believe one of my sisters sent a note to the hospital/clinic administrator to do a quality assurance check on why the physician made the orders.  We never heard back.  

[GetMeOuttaThisMess]

Perfect example Paula. My mom is ready and wants NOTHING done for any life-threatening condition. Got a call earlier this year about sudden back pain at her ECF. Abdominal bruit w/o mass but made it clear no hospital transfer. If a AAA, so be it. I fully respected her decision and knew her wishes beforehand but wanted to make sure she understood. She did agree to have an U/S the next day which was negative. Don't know cause but it was still a good "drill". She is bed/ WC confined so as not to be a fall risk. She would die today I think if given an option. Again, quality, not quantity.