Several concepts are particularly worth considering:
• End of life discussions are difficult, but according to a 2008 coping with cancer study, the terminally ill patients “who had substantive discussions with their doctor about their end-of-life preferences were far more likely to die in peace and in control of their situation and to spare their family anguish.”
• Hospice can prolong life with less suffering and works better when started earlier. In a 2010 Massachusetts General Hospital study, “those who saw a palliative care specialist stopped chemotherapy earlier, entered hospice far earlier, experienced less suffering at the end of their lives and they lived 25% longer.”
• Doctors die differently, often refusing gung-ho treatments with little, if any, chance of success. My husband lectured extensively on this topic.
• “25% of all Medicare spending is for the 50% of patients who are in the final year of life.”
Take control. Think about your wishes. Have a discussion with your loved ones about your preferences (
advance directives) before something happens. Consult your attorney about including a durable power of attorney for healthcare in your estate documents.
Gwande suggests thinking about advance directives for healthcare along these lines:
• Who do you want to make decisions on your behalf if you can’t?
• If time becomes short, what is most important to you?
• What are your concerns about what lies ahead? Hopes? Fears?
• How do you want to spend your time if your health worsens?
• How much are you willing to go through to have a shot at being alive?
• What level of being alive is intolerable to you?
We hope these ideas will prompt you to take action.
In loving memory of Dr. Edward H. Gaston
The views and opinions expressed in the posts on this page are those of the author and do not necessarily reflect the position or views of Ingalls & Snyder, LLC. Certain content on this page were originally posted in a personal blog maintained and operated independently by the author prior to joining Ingalls & Snyder, LLC.
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