Tim Bowers got to decide for himself whether he wanted to live or die. When the avid outdoorsman was badly hurt Saturday in a hunting accident, doctors said he would be paralyzed and could be on a ventilator for life. His family had a unique request: Could he be brought out of sedation to hear his prognosis and decide what he wanted to do? Doctors said yes, and Bowers chose to take no extra measures to stay alive. He died Sunday, hours after his breathing tube was removed. "We just asked him, 'Do you want this?' And he shook his…
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The chilling dilemma of “the unbefriended elderly,” who don’t have family or close friends to make medical decisions on their behalf if they can’t speak for themselves, generated a bunch of ideas the last time we discussed it. One reader, Elizabeth from Los Angeles, commented that as an only child who had no children, she wished she could hire someone to take on this daunting but crucial responsibility. “I would much rather pay a professional, whom I get to know and who knows me, to make the decisions,” she wrote. “That way it is an objective decision-maker based on the…
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We turn to doctors to save our lives – to heal us, repair us, and keep us healthy. But when it comes to the critical question of what to do when death is at hand, there seems to be a gap between what we want doctors to do for us, and what doctors want done for themselves. In this Radiolab podcast, Producer Sean Cole introduces us to Joseph Gallo, a doctor and professor at Johns Hopkins University who discovered something striking about what doctors were not willing to do to save their own lives. As part of the decades-long Johns…
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It's one of the toughest questions patients and their loved ones can discuss with physicians: When is further medical treatment futile? The conversation can become even more difficult if patients or their families disagree with health care providers' recommendations on end-of-life care. Early, clear communication between patients and their care teams, choosing health care agent (Surrogate) to represent patients, by signing a Medical Power of Attorney and Living Will, can help avoid conflicts. "Health care professionals in the United States have struggled with the importance of maintaining patient autonomy while attempting to practice under the guidance of treatments based on…
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Living wills and other advance directives describe your preferences regarding end-of-life care. Because unexpected situations can happen at any age, all adults need advance directives. Living wills and other advance directives describe your preferences regarding treatment if you're faced with a serious accident or illness, states the Mayo Clinic. These legal documents speak for you when you're not able to speak for yourself — for instance, if you're in a coma. Living wills and other advance directives aren't just for older adults. Unexpected end-of-life situations can happen at any age, so it's important for all adults to have advance directives….
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A study published in the Journal of the American Medical Association, found that in regions of the U.S. that tend to spend the most on end-of-life care, patients who have "advance directives" cost Medicare about $5,600 less per person. (Advance directives allow patients to communicate their end-of-life wishes if they are unable to do so themselves.) These patients' quality of life also appeared to be better; they were more likely to receive hospice care and to be at home when they died. But the differences in spending and care did not hold up in regions of the country with low-…
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A Wall Street Journal Online article discussing end-of-life planning through advanced directives and an increasingly powerful tool of “Physician Orders for Life-Sustaining Treatment” or POLST, that are meant to compliment advanced directives. The orders have been adopted in 14 states and similar programs are developing in another 16, and allow for greater control over decisions.
To be eligible for hospice a physician must certify the patient to be terminally ill with a life expectancy of six months or less and treatment for a cure is no longer provided. The focus for the patient has changed to supportive care and quality of remaining life. Hospice is paid for by private insurance, Medicare or Medicaid Hospice Benefit or personal funds. Here are the conditions that apply for Medicare Hospice Benefits: You are eligible for Medicare Part A (Hospital Insurance) Your doctor and the hospice medical director certify that you’re terminally ill and have 6 months or less…
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Hospice uses pain management techniques to compassionately care for the dying, states The Hospice Foundation of America. The first hospice in the United States was established in New Haven, Connecticut in 1974.Today there are more than 4,700 hospice programs in the United States. Hospice programs cared for 965,000 people enrolled in Medicare in 2006, and nearly 1.4 million people in the United States in 2007. Hospice is not a place but a concept of care. Eighty percent of hospice care is provided in the patient's home, family member's home and in nursing homes. Inpatient hospice facilities are sometimes available to…
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Most people cannot afford to keep a loved one in a nursing home, without the help of government assistance, Medicaid.
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