The Other Side Of Medicine – Easing Death

Modern medicine is good at staving off death with aggressive interventions—and bad at knowing when to focus, instead, on improving the days that terminal patients have left.

From an article in The New Yorker.

The subject matter discussed in this article is dear to my heart. I have not had a chance to read the whole thing but what I have seen looks interesting.

Thanks once again to Julius in London who regularly turns up valuable web content.

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5 thoughts on “The Other Side Of Medicine – Easing Death”

  1. This is so near to my heart at the moment! My Dad and Mom decided on home hospice care as they realized my Mom was truly dying from her cancer. In fact, my Mom so deeply trusting my Dad asked if she was dying. He was so overwhelmed with sadness that he couldn’t answer, but that was just the right answer for my Mom. Hospice brought in a bed and my Mom was in the living room of my parents house. She was able to be right in the middle of everything, even when she slipped into a coma. My Dad woke up ever 2-3 hours in the night to give her drops so that her throat remained open to breathe and morphium drops for pain. She was surrounded by love and prayers and music the whole time. We all also slept in the living room and someone was always at my Mom’s side holding her hand. For me, it was a good opportunity to just be still next to my Mom. Present with her brightness and the Eternal Brightness. Our family washed and cared for her and the hospice nurses called or dropped in to see how things were going. Everything was done for comfort, but not to try to extend life. Life was simply ebbing and death was starting to wash through my Mom. That meant my Mom didn’t have anything to drink or eat when she slipped into the coma, but we kept her lips moist with a cream and her mouth moist with just a little water. Her breath became calmer and calmer and one morning when my sisters were washing her, she simply and quietly ceased to breathe. Hospice was then notified, a wonderful nurse came and asked us how long we’d like to have before the body was picked up and we said about three hours. Our family then bathed my Mom and we put her favorite lavendar lotion on her, dressed her in a bright gown, she loved bright colors! and were able to cry and tell wonderful stories and say goodbyes and be together. I really have to say it was a “good” death for everyone. Hospice has even kept contact with my Dad to see how he is doing each week. When I got back home here, someone at work was talking about their Mom who was dying at a hospital with cancer and how cold and sterile it was and distressing for him. SO, if you have the chance for hospice care at home for yourself or loved ones, I can only say it made a big difference for me and my family. Sorry that this is so long!

  2. I think Jack says it all very movingly, and I hesitate to add anything. I read the New Yorker article this morning, and can’t help but think it more reflects US practice. My mother-in-law died of Ovarian cancer: her doctors were honest and helped inform her decision to live out what time remained at home, with her family, and without chemotherapy or surgery. It was very much her decision. I was and remain moved by the strength she showed. She spent short times as a patient in a hospice then returned home. This was good time, and I strongly feel we should devote more resources to helping people die, of which the hospice movement is part. But, I do not believe her experience is unique. Doctors and nurses are humane and caring people. It may be worth noting that the UK was recorded to be the “best place to die” by the Economist Intelligence Unit:
    http://www.eiu.com/site_info.asp?info_name=qualityofdeath_lienfoundation&page=noads&rf=0
    (if the link fails, search on “Economist Quality of Death”.

    The Hippocratic saying sums it up:

    Ars longa,
    vita brevis,
    occasio praeceps,
    experimentum periculosum,
    iudicium difficile

    Usually translated as:

    [The] art is long,
    life is short,
    opportunity fleeting,
    experiment dangerous,
    judgment difficult.

    In gassho
    Walter

  3. That was lovely to read. My situation is somewhat different. My dad is 90 & the doctors have said possibly 9 months or so left although it looks like less to me. He would like to stay at home & so far we have done everything we can to do that. He is not an easy person to take care of. He wants to stay in control of everything but isn’t really up to it. Our family is not pulling together so there are silly games going on around my dad who really shouldn’t have to bother with stuff like that just now.
    I am sharing this partly just to share it, and partly so that other readers know the beautiful way is not always how it goes, lovely as it sounds it isn’t always possible. My dad has always been a very strong willed character & old age has brought this more to the fore. Our relationship has been difficult to say the least. I am currently taking time out from looking after him because I can’t cope with the unpleasantness. Hopefully I will recharge & be able to get back to it but it is by no means certain.

  4. Thank you, Jack and Angie, for sharing your experience and to Walter for your thoughts too. My family have also had very a positive experience with Hospice support in the UK.

    I have spent time as a volunteer visiting elderly people facing the end of life in hospital. I wish everyone had the opportunity to be cherished and cared for, as they should be, at this time in their lives.

    My thoughts are with you Angie.
    In gassho
    Julie

  5. Yesterday I took my frail old dad into a nursing home for a week’s respite care. Partly it’s respite intended for his main carers, myself & his partner, who doesn’t live with him but is close by. She is away on holiday so it fell to me to take him.I was hoping he might feel safer & cared for with people on hand 24 hours as he is normally on his own at home, particularly during the night time.

    Taking him was emotional to say the least. The best part is it drives a wedge between the behaviour of someone stuck in a rut at home, unable to go out, angry & frustrated, lashing out at those close to him. This is a new experiment & the nursing care so far does not seem what was promised. He doesn’t like it there & I have promised I will take him home early if he still feels the same way tomorrow.

    It would appear that we are getting his care right at home after all. I was worried we are amateurs & might be missing things but actually we pay attention to detail & do what we can for his best care. It’s exhausting for me.

    Our roles have reversed again so that I am the protector. He knows from past experience I won’t let him down. It feels better than directly bearing the brunt of his disappointments. And so we go on, along the roller coaster of an old man clinging to life but expressing the wish to die.

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