How Do I Turn This Thing Off?!!!
When you’re a heartbeat from dying, the high-tech gizmo that keeps you alive may do so against your wishes.
The “Shell Game” is Deadly Serious, and Fraught With Room for Mistakes
When dementia looms, how do you define ‘guideposts’ to signal: Enough is enough?
Avoid becoming a victim of the U.S. end-of-life care system: Choose wisely
American healthcare is supposed to help. At end of life, too often it victimizes us.
What Ways Can You Die When You’ve Had Enough of Life?
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.
There Is No Autopilot for Navigating Advance Directives
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.
Pets vs. Humans: A Difference In Compassion, And In Knowing What The Patient Desires
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.
Surrogate Challenges Can Overwhelm Even An Experienced Hospice RN
“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?
Improving End-of-Life Family Meetings Part 3
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.
Improving End-of-Life Family Meetings Part 2
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.
Improving Family End-of-Life Discussions Part 1
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.