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Taking Death and Dying Out of the Closet: An Op-Ed From A Hospice Manager

Robert Abel of Hallmark Health Visiting Nurse Association and Hospice lets us in on the importance of end-of-life conversations.

Written by Robert Abel, RN, CHPN, CCM, CMC, and Hospice Clinical Manager:

The National Hospice Foundation found that Americans are more likely to talk to their children about safe sex and drugs than to talk to their terminally ill parents about end-of-life preferences and options. 

With more than 2.4 million Americans dying each year---and the number growing---it is vital that thoughtful, serious, person-to-person conversations take place about the kinds of experiences Americans would want for themselves or their loved ones as the inevitable end-of-life draws near. 

Often such conversations are avoided out of an understandable desire to spare each other’s feelings. It’s startling how few Americans have advance directives, an umbrella term including living wills that state your wishes and health care proxies that designate someone to carry them out if you cannot.

That can put both physicians and families in an awful bind. If a terminally ill parent is hospitalized and one daughter tells the staff no feeding tube, will the patient's other daughter accuse the sister of killing their mother? If the respirator is turned on, will the son argue that the mother declared that she never wanted to be kept alive by machines.

The time to discuss your views about end-of-life care and to learn about end-of-life care options is before a life-threatening illness occurs or a crisis hits.  This greatly reduces the stress of making these end-of-life decisions under duress.  By preparing in advance, you can avoid the uncertainty and anxiety associated with not knowing what your loved ones want. Instead, you can make an educated decision that includes the advice and input of loved ones.                

There exists an end-of-life option that provides dying patients and their families with comfort, compassion, and dignity ay the end of life. This option is "hospice care." Hospice is truly a model for quality, compassionate care at the end of life. It utilizes a team approach of expert medical care, pain management, and emotional and spiritual support expressly tailored to the patient’s wishes. Hospice focuses on the final season of life and helps the dying “live” out their final months and days with dignity; peacefully, and comfortably. By doing so, hospice demonstrates the reverence for human life in all its stages.              

Unfortunately, too many patients reach hospice in their final days or even hours of life, leaving their families wishing they had known about hospice care sooner.  Many patients die without ever being offered this tangible end-of-life support that hospice provides, instead struggling with untreated pain and with the side effects of by-now-futile, curative medical treatments.  All this in addition to watching their families struggle to cope with the escalating demands of their care.                           

The next time your family is together, possibly over the upcoming holidays, take time to have a discussion about this important life event.  Let your loved ones know now—when you are still able to effectively communicate---what your preferences for treatment would be if you were confronting a terminal illness.  Living wills and other advance directives are very important in communicating your preferences, but only if they are a first step for generating personal conversations on your specific end-of-life preferences.                                       

For further information on hospice care services, call Hallmark Health Visiting Nurse Association and Hospice at (718) 338-7903.

Zach White November 17, 2011 at 09:52 PM
I talk to an older adult group about death and dying, there perspective my be helpful www.ZachsGroup.com
Kasey Hariman November 18, 2011 at 02:33 PM
Cool! Is this a local Malden group? If so, send them to this article! We'd love to see their comments.
Alexandra November 25, 2011 at 02:38 PM
An incredibly worthwhile, and timely effort! There is a movement called Engage With Grace that is all about this very thing....and we hold a blog rally every Thanksgiving for the very reasons you cite (family together, perfect time to share). Check out http://www.engagewithgrace.org/rally/ or search engagewithgrace or #EWG on Twitter - lots of great activity going on right now ... please join in! Best alex
Kasey Hariman November 25, 2011 at 04:50 PM
Cool! Thanks for this information. If there are any Maldonian bloggers (you? someone you know?) who'd be interested in having their blog cross-posted on Patch, or Malden folks you know who might want to start a blog on Malden Patch, shoot me an email at kasey.hariman@patch.com. We'd love to help you get your voice heard!

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