What Matters Most? How to be There for Someone When They Really Need You
First, You Ask
I work with patients who have life-threatening illnesses, and many of them are facing death. Rather than talking specifically about spirituality, I ask them where they get their strength and what is important to them.
Read Full Article...
Palliative Care… What It Is and What It Isn’t
I work as a palliative care physician on a team with several nurses and several physicians. In the hospital, we do five things:
Read Full Article...
POLST: Physician Orders for Life-Sustaining Treatment
Does Your Parent or Loved One Have a Plan in Place? Advanced care planning involves filling out different types of legal forms that concern your parent’s preferences concerning end of life treatments. These documents are advance care directives, such as a living will, and a power of attorney for health care. They are usually filed away and referred to when patients have been admitted to the hospital and are unable to speak for themselves.
Read Full Article...
Advances in Medicine Require Advance Care Planning
Our attitudes about end of life issues have changed a lot over the years. In the early 1900s, people died one of three ways: childbirth, infection, or trauma. Half of the children did not live to celebrate their fifth birthday. People usually died very quickly. They could be well one day, perhaps have a horribly high fever for a couple of days, and then die within the week.
Read Full Article...
A Terrible Burden…Or a Sense of Pride?
Have the Conversation That Makes the Difference
Yes, it’s difficult to talk to your parent or loved one about end of life issues. But not nearly as difficult as the burden that could be left on your shoulders if you never have that talk. Choices about life-sustaining treatments can be agonizing for family members – even tearing some families apart – if the patient’s wishes have not been made known. It is quite a different story if you have sat down with your loved one and discussed treatment options. Your burden lightens considerably if you know those procedures they want and those they don’t want, and have turned their wishes into legal documents, including Physician Orders for Life-Sustaining Treatment (commonly referred to as POLST) if they are frail or have advanced chronic illness.
Read Full Article...
The Final Crossing: Learning to Die in Order to Live
All cultures, indigenous and modern, have their own stories about how a dying person progresses through different psychospiritual stages. In some ancient examples, such as the "Ars Moriendi" from medieval Europe or the "Tibetan Book of Dying" from Asia, these spiritual teachings about dying and death also inform people about how to live well.
One example of "the art of dying" that is not so well known comes from a Northern Cheyenne teaching that originated centuries ago in the ballcourt ceremonies of the ancient Mayans. In the Mayan version, the teaching was seen as a way of helping a ballplayer to prepare for a highly ritualized game that, on rare festival days, would culminate in a sacrificial death. It was later adapted to guide anyone who was approaching a more natural death: the old, the mortally wounded, or the seriously ill. This teaching about how to die eventually spread farther than the ballgame itself, including to the Midwestern Plains and the Northern Cheyenne people.
Read Full Article...
When the End is Near
Mark B. can barely take his eyes off his only grandchild, Sophia, who fills the house, and his life, with obvious joy. She is still too young to realize the hold she has over her granddad, who lost his beloved wife Dahlia to cancer on the same day Sophia was born, thousands of miles away.
Dahlia was diagnosed in 2005 with glioblastoma, an aggressive type of brain cancer. She underwent two surgeries and endured several rigorous treatments, and she was able to live a relatively full life for more than a year. Then an MRI in March 2007 revealed distressing news: the treatments were no longer working, and the cancer had spread.
Read Full Article...
