When you’re a heartbeat from dying, the high-tech gizmo that keeps you alive may do so against your wishes.
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When dementia looms, how do you define ‘guideposts’ to signal: Enough is enough?
American healthcare is supposed to help. At end of life, too often it victimizes us.
When you believe it’s time to go, what options do you really have? There are more than you you think, without having to resort to a violent ending.
Having a firm Advance Directive is one of the most important things you can do to ensure your end-of-life wishes are honored. But it can be tricky to obtain the right document(s) you need.
It’s a pillar of the RTD movement, that we treat our suffering pets more humanely than suffering friends and family members. “Let me die like a dog” has long been a call to compassion. The author went through the agonizing decision to “put down” a beloved canine companion, and he regrets not knowing what “Woody” would have wanted.
“Sleep deprivation amplified every emotion and wore me down quickly,” she said. She was exhausted, angry, and felt guilty. She was “flying blind” to be the surrogate as Betty neared death – and she was a trained, experienced hospice RN. What does that say about your chance of being an effective surrogate?
As discussed in Part 2, the SPIKES framework is useful to explore the family’s understanding of their loved one’s illness and to share information about medical condition and prognosis. When the purpose of a family meeting is to discuss goals of care, it may be useful to “unpack” care goals using the REMAP framework.
Just as for any medical procedure, conducting a meeting with families of seriously ill patients requires training and practice. Practitioners must develop skills in structuring serious-illness conversations and responding with empathy in emotionally fraught situations.
Timely, well-conducted conversations about goals of care in serious illness are associated with improved outcomes, including care aligned with the ill person’s values, less unwanted (and often expensive) care, improved satisfaction with care, and fewer mental health consequences for patients and families.
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