I know that we all have a lot to focus on as we go through menopause, but I’d like to take a few moments to bring us to the moments before you die. Please join me in thinking about the end-of-life care that you want.
I can hear it now. “Gee, Dorian, you are such a downer!” Well, perhaps I am, but I would guess that many readers are dealing with their parents’ health failing health or their death. I know that I watched my vibrant mother’s health start to fail over the course of a decade as she developed chronic obstructive pulmonary disease and then Alzheimer’s disease. And I’m back in the middle of thinking about this topic as my father, who is nearly 90, faces major health issues.
So now I hear you say, “Well, Dorian, you’re talking about your parents. They’ve lived a long and good life and they’ve reached their 80s. I’m only in middle age, so I need to focus my energies on figuring out what to do about these darn hot flashes and not on death.” And I’d agree with you except for my friend, Molly. She was about the age that we are now when she was in a car accident while taking her son, a high school senior, to look at colleges. Her son was killed instantly but Molly was rescued from the car and taken to the hospital where she lingered for almost a week on life support.
So frankly, it is a good time to think about our own deaths, even though it may not be the most comfortable reflection you’ll have. Need another reason? Just check out the new report from the Institute of Medicine that stated that Americans actually suffer needless discomfort and have a lot of unwanted and costly procedures as they are dying. That’s completely opposite to what most people voice as how they want to die – at home without pain.
The report offered several important points:
- Most Americans do not have knowledge about end-of-life care choices. Furthermore, health care providers and policy leaders have not done a good job making that knowledge available, meaningful and relevant.
- We need to start having conversations about death and dying. The report points to social trends that indicate that the time is right to begin talking about this. These include Americans’ motivation to have high-quality care for themselves and loved ones, a willingness to share stories about end-of-life experiences, the emergence of leaders at the local level who are talking about end-of-life care and the creation of some national coalitions and collaborations that are focused on end-of-life care.
The report also offered three important recommendations that have implications for us all:
- All individuals, including children who have the capacity to do so, should actively participate in all of their health decisions throughout their life and as they approach death. They should then receive medical and related social services that are consistent with the individual’s values, goals, and informed preferences.
- Clinicians should initiate high-quality conversations about advance care planning and then use the feedback as part of ongoing care plans for the individual. This information also should be communicated to other doctors who the individual may see.
- Doctors also should continue to talk about advanced care planning with their patients because the individual’s preferences and circumstances can change over time.
If you want to think more deeply about death, I’d encourage you to learn more about Death Cafes. These are discussion groups that allow participants to talk and learn about death. These groups have no agenda, objectives or themes; it is not a grief support or counselling session. They also offer a how-to guide to host one of these conversations. The website also offers a place to reflect and learn about death.
Taking the time now to think about your death will help you and your family make better decisions when the time comes. That way, you can end your good life with a good death.
Primary Sources for This Sharepost:
Death Café. (2014). What is Death Café.
Institute of Medicine. (2014). Dying in America: Improving quality and honoring individual preferences near the end of life.
Sedensky, M. (2014). Study: Americans endure unwanted care near death. The Columbian.
Published On: September 18, 2014