Palliative Medical Teams Encouraged By Institute Of Medicine’s “Dying In America” Report

Palliative Medical Teams Encouraged By Institute Of Medicine’s “Dying In America” Report

Posted on Friday, October 31st, 2014 at 7:07 am by lifemediamatters

Courtesy the John D. & Catherine T. MacArthur Foundation.

Courtesy the John D. & Catherine T. MacArthur Foundation.

Palliative medicine for the seriously ill should be covered by all payers and provided by all health organizations, said Dr. Diane Meier, director of the Center to Advance Palliative Care, during a presentation exploring new findings about dying in America.

Meier addressed a widely circulated report from the Institute of Medicine (IOM) calling for new public engagement strategies to foster informed decision-making. According to Dying in America, not only do most Americans lack basic understanding about end of life care choices, but community leaders “have not fully utilized strategies to make that knowledge available, meaningful and relevant across diverse population groups.”

Meier, a member of the IOM, helped develop the institute’s five key reccomendations: more person-centered, family-oriented palliative care; better doctor-patient communication and advance care planning; professional education and development; better policies and payment systems; and more public education and engagement.

The report cited the present as the best time to help normalize conversations about death and dying, partly because millions of aging baby boomers will require such conversations in the near-future. It also pointed to the social trends of health consumers’ willingness to pursue high-quality care, a growing urge to share stories about end of life care experience that resonate across diverse populations and engaged leadership within local communities.

“When the IOM says that something should be done, there is enormous imprimatur, legitimacy and influence on the zeitgeist about what’s acceptable to talk about,” Meier said. The IOM acts under the National Academy of Sciences through its congressional charter as advisor to the federal government. It is nonpartisan and funded by a network of donors, endowments and contracts.

Meier acknowledged the difficult nature of changing federal policies and payment systems involving end of life care, partly because of political polarization surrounding the Affordable Care Act– the health reform law signed by President Obama in 2010 and recently upheld by the Supreme Court.

Thirty percent of likely voters when polled said the law allows government “death panels” to make decisions about patients’ end of life care, a theory discredited by most medical professionals.

American Cancer Society Adverrtismemnt

American Cancer Society Advertisement

“We have a real challenge to improving accurate information and understanding on the part of the public about what palliative care is about and what it’s not,” she added. Palliative medicine is usually provided only to the terminally ill to help treat symptoms and side-effects of disease and aggressive treatments. The goal is not cure.

Meier mentioned a handful of national campaigns helping familiarize Americans with the benefits of comfort care and advance care planning, including a major effort from the American Cancer Society’s Cancer Action Network.

“We are working with disease-specific organizations. When a patient googles lung cancer, two things come up: the Wikipedia page and the American Cancer Society or other disease-specific organization,” Meier offered. “Through our partnership, we have developed a series of ads talking about palliative care that sees the patient beyond cancer treatments.”

Part of the cancer network’s “Quality of Life” campaign includes advertisements in magazines. One depicts a female cancer patient looking upward with the word “chemotherapy” written below. The “che” and “apy” are crossed out in purple, highlighting the word “mother.”


Brittany Maynard, Terminally Ill Woman Choosing To Die Nov 1 Tells CNN: Now ‘Doesn’t Seem Like The Right Time’

Posted on Thursday, October 30th, 2014 at 12:40 pm by lifemediamatters

Brittany Maynard says she hasn’t decided yet when she’ll end her life, but it’s a decision she’s still determined to make.

“I still feel good enough and I still have enough joy and I still laugh and smile with my family and friends enough that it doesn’t seem like the right time right now,” Maynard says in a video released to CNN on Wednesday. “But it will come, because I feel myself getting sicker. It’s happening each week” (WGN-TV).


Burial and Death: Author Caitlin Doughty, Smoke Gets In Your Eyes

Posted on Wednesday, October 29th, 2014 at 7:33 am by lifemediamatters

Author Caitlin Doughty. Image via Twitter

Author Caitlin Doughty. Image via Twitter

Caitlin Doughty, acclaimed author of Smoke Gets In Your Eyes: and Other Lessons from the Crematory, wants to encourage more open discussion on a taboo subject: death and decay. In 2011, Doughty founded The Order of the Good Death, a group of funeral industry professionals, academics and artists exploring ways to better familiarize America’s “death phobic” society with mortality and its meaning.

Doughty, a trained mortician, spoke with Life Matters Media about her memoir, burial wishes and experiences working in a crematory.

What inspired you to write Smoke Gets In Your Eyes?

I worked in a crematory, and it was so fascinating, the things that I saw and the things that other people didn’t see, because of the way that death works right now in America. It’s a hidden culture and a culture of silence– how we deal with death. My policy is always that we’re better when we know what’s going on, when we know the facts.

What goes on behind the scenes in a crematory?

A lot of crematories now are somewhat industrial environments, because things get centralized. There’s a single point that all the bodies will go to, whether it’s a centralized embalming facility or centralized cremation facility.

It’s completely fascinating. It’s one of the most fascinating places that you can go to, especially in a world where we don’t see a lot of death. It’s new everyday. Each body is different, each case is different, each family is different.

There’s a lot of care for the body where I worked, and I certainly tried to do that. But that doesn’t mean that there’s not a high volume. If you are concerned about it, ask to see the facility, ask for a witness cremation.


Are cremations considered completely natural and green’?

No. The only really natural way to care for a body is just to put it straight into the ground. Dig a whole with a shovel and put the body right on in with a shroud. But cremation does use a lot of natural gas and releases mercury into the environment. The mercury comes from dental fillings.

Are ‘green’ burials becoming more common?

They absolutely are. I think it’s both environmental and a sense of “why am I cutting myself off from the earth? Why am I putting myself in a casket and then in a steel vault?” It’s also a cost issue.

How do you wish to be buried?

I would like to be naturally buried. Eventually, I would love to be left out for animals, but that’s not legal right now. I already have my cemetery picked out in Marin in California. Straight in the ground, please.

SGIYE

Why do you wish to be eaten by wild animals?

I think that metaphorically, it works very well for me. The idea of going back into the life cycle in a very basic way. Have it be fair play. I eat animals now, and I think that they should get to eat me, because I am an animal, too.

Why do you believe end of life discussions are taboo?

At a certain point in the early 20th century, both dying, the process of dying, and death itself, the dead body, got taken out of the home and given to professionals. Since that time, the cultural inheritance that we have is “don’t talk about death. It’s for the professionals, not for you.

Are you surprised by the positive reactions to your book?

The book has done pretty well, which shows that there is a market for it. People want to know about their death, they want to know the facts and be more comfortable with it.


LMM Founder Randi Belisomo Talks Senior Theatre With WGN Radio

Posted on Tuesday, October 28th, 2014 at 1:21 pm by lifemediamatters

Co-Founder Randi Belisomo spoke with reporter Andrea Darlas about “Bud’s Café Redux,” an original production from Chicago-based Time of Your Life Players.

Listen Here


One Chicago Catholic Parish Receives End Of Life Education

Posted on Monday, October 27th, 2014 at 7:12 am by lifemediamatters

SpiritualityAs Catholics worldwide mark October as a month to “Respect Life,” one Paulist priest told congregations at Chicago’s Old St. Mary’s Church that November could be an appropriate time to “Respect Death.”

Fr. Robert Cary addressed end of life care during homilies at all weekend masses at the South Loop Church; he also hosted a follow-up discussion in the parish hall that will be repeated later this week.

“If we are brought into life by love and sustained in life by love, then we should leave this life in love and care,” Cary said. Though he served Old. St Mary’s from 2007 through 2010, he is visiting Chicago from his current Austin, Texas parish to address questions of human life, medicine and advance care planning. Cary completed graduate work at Loyola University-Chicago in bioethics and health policy.

Our tradition affirms what we so often already know in our minds and feel in our hearts. If a proposed treatment will have little benefit, it is okay to stop.

His sermon on the topic, seldom directly discussed in the Church, began with remembrances of voice messages left by those killed in the September 11th attacks. “There was hardly anyone calling to express anger or hatred or resentment,” Cary said. “Those messages remain a powerful reminder that in the darkest moments, even facing death, the human urge is to love.”

Fr. Robert Cary

Fr. Robert Cary

That urge, he said, is a reflection of the commandment expressed in the day’s Gospel reading: the call of Christ to “love your neighbor as yourself.” Such love should be expressed to family members throughout their lives and serious illnesses, and Cary asked parishioners to consider how best to do so when situations are dire.

“Our tradition affirms what we so often already know in our minds and feel in our hearts,” he said. “If a proposed treatment will have little benefit, it is okay to stop.”

However, stopping treatment does not equate to a cessation of care. Cary suggested core tasks for both the dying person and for family members.

Core tasks of family

  1. Providing physical comfort and presence
  2. Allowing the dying person to go on with simple pleasures
  3. Fostering hope and faith
  4. Facing own fears and feelings of helplessness

Core tasks of dying person

  1. Asking questions about the meaning of life
  2. Reconciling with family and with God
  3. Accepting physical limitations
  4. Respecting death in faith

“We, too, need guidance in respecting death,” Cary said; such guidance was the purpose of a following presentation about the interaction of the Catholic faith and medical realities.

Cary’s discussion aligned bioethical principles of autonomy, non-maleficence, beneficence and justice with what he labeled “Catholic values” that must be considered when making any end of life care decision: the respect of life, the preservation of life, the diverse and changing essence of human life, and human life’s social nature.

He called on participants to differentiate ordinary and extraordinary medical care, acknowledging that the labeling of specific treatments is difficult and technical. Instead, Catholics could check instincts, recognizing that what care is required is care that is morally ordinary. Such care “gives reasonable benefit to a person without excessive burdens,” Cary explained.

Providing morally ordinary care requires an acknowledgment of the finite nature of humanity, he said, and Catholics should know that it is okay to let a loved one go. “Allowing someone to die is not the same as intending death.”

Fr. Bob Cary will repeat his presentation, “Care at the End of Life,” on Tuesday, Oct. 28th at 9:15 a.m.

Fr. Bob Cary suggests the following resources for Catholics considering end of life care: