The Federal Government has plans to put into place, by the end of the year, a five-star ranking system for nursing homes. At first blush, this seems like a terrific idea. Families could easily find out the ranking of a home and then make a decision based on the number of stars. Five - g...
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A simplicistic rating system may not honor patient's goals
DrTerman
Thursday, July 24, 2008 at 10:07 AM
Refusal of food and fluid is the only way a patient with advanced dementia can cease to exist. It is better to dehydrate with comfort care to the mouth in two weeks than to starve slowly, for up to two years, as happened to the father of Bob Burke (his real name): from 180 to 70. The gradual weight loss would probably not give the nursing home a "ding," but it inspired this title of a story in my new book: "A Well-Intentioned Hell." (The Personal Challenge of Advanced Dementia: An ironclad strategy for 14 million baby boomers and others will be available later this year.) Forced feeding should be forbidden. Highly skilled encouragement of feeding should be based on the patient's goals.
Stanley A. Terman, PhD, MD
Board Certified in Psychiatry
Medical and Executive Director, Caring Advocates
www.CaringAdvocates.org
2730 Argonauta St.; Carlsbad, CA 92009
800 647 3223 or 760 431 2233
Author of The BEST WAY to Say Goodbye: A Legal Peaceful Choice at the End of Life and Lethal Choice, and co-developer of the Physician's Orders to Permit Natural Dying, a document containing both Physician's Orders and an Advance Directive
re: A simplicistic rating system may not honor patient's goals
Carol Bradley Bursack
Thursday, July 24, 2008 at 12:07 PM
Well put. You've been there, as have I.
Thanks so much for your comment.
Carol
Refusal of food and fluid is the only way a patient with advanced dementia can cease to exist. It is better to dehydrate with comfort care to the mouth in two weeks than to starve slowly, for up to two years, as happened to the father of Bob Burke (his real name): from 180 to 70. The gradual weight loss would probably not give the nursing home a "ding," but it inspired this title of a story in my new book: "A Well-Intentioned Hell." (The Personal Challenge of Advanced Dementia: An ironclad strategy for 14 million baby boomers and others will be available later this year.) Forced feeding should be forbidden. Highly skilled encouragement of feeding should be based on the patient's goals.
Stanley A. Terman, PhD, MD
Board Certified in Psychiatry
Medical and Executive Director, Caring Advocates
www.CaringAdvocates.org
2730 Argonauta St.; Carlsbad, CA 92009
800 647 3223 or 760 431 2233
Author of The BEST WAY to Say Goodbye: A Legal Peaceful Choice at the End of Life and Lethal Choice, and co-developer of the Physician's Orders to Permit Natural Dying, a document containing both Physician's Orders and an Advance Directive