Death and Dying From a Doctor’s Perspective

Often we don’t think about the other side of the end of the community that is just as important in the death and dying process on the medical side. This is an excellent article. Although this article was written a couple of years ago, all of the information is current. We seem to be moving at a snail’s pace in terms of developing good communication tools between doctors and their patients. We’re all going to die. None of us know in advance how they will occur. We will all end our lives more peacefully and with greater dignity if we start having end of life conversations while we are still healthy.

What Doctor’s Don’t Learn About Death and Dying

The biggest legacy my husband left me, when he decided to voluntarily stop eating and drinking rather than live into the late stages of Alzheimer’s, was his courageous demonstration of how he faced his own death. It made me look at my own fear of death that I have carried around with me for most of my life. In my upcoming book, “Choosing To Die, I share my own journey about how my husband’s death affected me and freed me from my own fear of dying. The book will be available on Amazon about April 9, 2017.

 

End of Life Option Debating Begins in Massachusetts

He said he watched his father die painfully of prostate cancer. In his final month of life, he said, his father, as he withered away, was either sedated or awake in severe pain. He told his family, “It’s taking me too long to die.”

Ruby said his mother, now 93, told him, “Don’t let this happen to me.”

As states are beginning to pass end of life option acts, debates are beginning for how to fund end of life option programs.

In Massachusetts, as many states are beginning to pass end of life option acts, debates are beginning for funding end of life option programs with surveys from 25,000 physicians and medical students. It is notable that more and more people want end of life options. Positive physician-patient relationships regarding end of life are dependent on having your personal wishes written in an advance health directive. It is the only way to have a clear communication about your wishes at the end of life. Debates go both ways, but end of life options are important for everyone. There is no one choice.  For people suffering with terminal illnesses,  their last days can turn into months if doctors keep them alive with invasive procedures rather than focusing on the best quality of death. The end of life movement is creating compassionate conversation. No one wants to suffer at the end of their life. 

For full article see here.

Quality of end of life care in nursing homes

This study shows that having an advance directive is extremely important for those in nursing facilities. Especially for dialysis patients, an advance directive will enhance end of life care based on the patient’s preferences and values. Those with an advance directive explained when they wanted to stop dialysis or reject invasive surgeries. Without these instructions patients are routinely treated and go put through medical procedures without their say because it is not specified. Advance directives are the best way that your wishes can be explained in end of life care.

Many nursing home residents with renal disease lack advance directives to address end-of-life care

Changing The Way We Look At Death

In June 2016 California became the 5th state to allow assisted dying. Ray Perman was diagnosed with cancer and instead of fearing his death he embraced it with living life to the fullest. Ray set goals about what he wanted to experience in the final days of his life. He decided to take advantage of the death with dignity law. He took advantage of this by taking medication and was surrounded by his loved ones at the time of his death.

“I will have my closest loved ones around me when I do that. I’ll have an open house in the morning for my friends to give me a hug goodbye and then we’ll probably do the deed in the afternoon. Then my family can have time with my body in the evening, as long as they’d like. And I have a complete description on where to dispose of my ashes. It’ll be in the departure path of a Boeing aircraft that took off with my father, on an outgoing tide.”

Bay Area Cancer Patient Confronts and Embraces His Right to Die

Zen Hospice

B.J. Miller, after a tragic accident,  began to positively think about how medicine and dying are connected. He has been an advocate for palliative care. A patient Sloan was nearing death as a 20-something year old. Eventually through medical advice from Miller, he entered Zen Hospice where he continued to receive good care and hospice became his family. Zen Hospice is a place not only to be comfortable but how to transcendent experience into death.  Zen Hospice’s mission is to change death from a medical point of view into a human experience.

B.J. Miller has taken it upon himself  to change the way we think about death and how it doesn’t have to be a feared experience. View his TEDTalk here.

Using empathy and a clear-eyed view of mortality, BJ Miller shines a light on healthcare’s most ignored facet: preparing for death

In preparation for his death, my husband did a lot of inter searching and was able to move past the fear of the unknown, and to think about how he wanted to die. He chose to pass away with his loved ones. I was there by his side when he passed.

This article in the New York times shows the amazing work that B.J. Miller is doing.

Spiritual Beliefs are Important when Preparing for your Death

Many religions accept death as a part of life or a state of transition. Discussing death as a part of life, being more accepting and educated about end of life care is something thinking about long before you die.  Write all your needs in your Advance health directive and talk to your health providers about it. We can all live our lives to the fullest and not fear death. Death occurs to everyone. It is simply a part of life.

 

If you are interested in different religious ideas around death, this is a great resource. By expanding our thinking cross-culturally we can understand death in more than our own way. Education is a key part of the dying process. By thinking about what occurs after death can make death more approachable. Even if you are not religious assessing your values and how you want to leave your body can affect your end of life decisions.

Reading about beliefs and aspects of other spiritual practices can help you identify how you see death and want to make your directive for end of life.

http://lmrpcc.org.au/admin/wp-content/uploads/2011/07/Customs-Beliefs-Death-Dying.pdf

Loddon Mallee: Regional Palliative Care Consortium

Honoring Dementia Patients In End Of Life

It is challenging to talk about end of life options with someone who already has dementia. If they are in the early to mid stages of dementia and are still mentally competent this article will help guide you to have better conversation with your loved one. Discuss how the person with dementia thinks about death. How do they see themselves passing? If a health directive has not been completed yet, it is essential to do so now. All wishes should be written down so that when the time comes, all of the loved ones and caregivers are on the same page.

Because my husband and I had so much conversation about his end of life choices, he had a peaceful passing.

Because my husband and I had so much conversation about his end of life choices, he had a peaceful passing. He had a thorough health directive at the time of his death. He had the Alzheimer’s Disease and Dementia Advance Directive  (End of Life WA state).  We were well informed. Different states have different requirements for end of life papers. There are many sites that will help you find the right directive for you in your state.

For more explanation and details about my husband’s personal passing the section Alan’s Transition on my website .

We’re Not Too Young

As newly weds it was important to have a discussion about what matters most at the end of life so we can make the right decisions for each other when the time comes

I hope that someday everyone fills out a health directive when they become an adult at 18. Our parents are legally responsible for us in the United States until then. At 18 ideally everyone should fill out a health directive. If you don’t do this and you are in an accident or get a terminal disease doctors and hospitals have a the legal right to make all decisions for you. Your health directive ensures that your loved ones will be able to represent you and your wishes. I filled out my first health directive when I was 40. I still didn’t believe I was going to die someday. I know It is challenging to think about a health directive when you think you are immortal. They vary from state to state, but what is important is what you write. Nevertheless, we are all going to die and we all want to have a good death. We are all familiar with death and through figuring out what what state we want to live into is something only you can decide. That is why preparing is important even when we are young and do not think about death.

A touching story of two Newlyweds 

How to Talk about End-of-Life Care When a Loved One Has Alzheimer’s Disease

When my husband was diagnosed with Alzheimer’s disease, instead of living into the late stages, he chose to vsed. I was his advocate. We discussed everything. He had excellent support. In order for my husband to have a good quality of death there was a lot to talk about. Being able to comfortably talk about end of life is essential in order to prepare for a good quality of death.. Informing ourselves and others without judgment is key to living a good life and having a good death. Cultivating support systems will help yourself and others.

This article reiterates the difficulty of discussing end of life with someone in every stage of Alzheimer’s disease and how you can try to communicate how they want to leave their body

The Conversation Project is a great resource for end of life preparation and support.

How to Talk about End-of-Life Care When a Loved One Has Alzheimer’s Disease