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end of life options/Issues/ GriEving

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Overview
 
There are no perfect solutions inherent in bodily decline. Arriving at an acceptance of one’s mortality (Being Mortal) is a natural process. By most standards, a good death is one in which a person dies on his own terms with no protracted suffering, and in a supported and dignified setting. In truth, how one dies is shaped by the attitudes, physical conditions, medical treatments and mix of people involved.  Consequently, it's important to talk about your end-of-life wishes with loved ones, and it is equally important for caregivers to listen to a patient who wants to live despite life-limiting conditions. Last update: 2.11.21


End-of-Life Options

Hospice and Palliative Care
 
Hospice and Palliative care are very similar when it comes to the most important issue for dying people: care. Both Hospice and Palliative care protocols call for patients to receive a combined approach where medications, day-to-day care, equipment, bereavement counseling, and symptom treatment are administered through a single program in the home or an institution.

Where Palliative care programs and Hospice care programs differ is in the care location, timing, payment, and eligibility for services. For Hospice care, the patient must have a terminal prognosis, be medically certified at hospice onset, and have less than six months to live. There are no time restrictions for Palliative care, which can be received by patients at any time, at any stage of illness whether it be terminal or not. Learn more: Caregiverslibrary.org   Wikipedia

Spending Your Final Days At Home,
New England Journal of Medicine

Right to Die/Death with Dignity

The Right to Die is a moral principle based on the belief that a human being is entitled to commit suicide or to undergo voluntary euthanasia. It is often understood to mean that a person with a terminal illness should be allowed to commit suicide or assisted suicide, or to decline life-prolonging treatment for a disease that would otherwise prolong their suffering to an identical result. The question of who, if anyone, should be empowered to make these decisions is often a central issue.

Proponents typically associate the Right to Die with the idea that one's body and one's life are one's own to dispose of as one sees fit. Hinduism accepts the right to die for those who are tormented by terminal diseases or those who have no desire, ambition or no responsibilities remaining; and allows death through the non-violent practice of fasting to the point of starvation.

The Jewish, Christian, and Muslin faiths believe that God created human beings and only God can determine when it is time to die. Compassion and Choices
is a non-profit organization focused on improving care and expanding choice at the end-of-life.

Death with Dignity Legislation 
  • World
  • United States
  • End-Of-Life Option/Dementia​

Voluntary Euthanasia and Physician-Assisted Suicide

Voluntary Euthanasia/Physician-Assisted Suicide, also called Physician Aid-in-Dying/PAD, has been the focus of great controversy in recent years. Assisted suicide is a practice in which a person receives assistance in bringing about their death. The person typically suffers from a severe physical illness and has no more than six months to live.

Some forms of Voluntary Euthanasia or Assisted Suicide are legal in Belgium, Luxembourg, the Netherlands, Switzerland, Germany Albania, Colombia and Japan, and the U.S. states of Washington, Oregon, Vermont, New Mexico, Montana and California (June 2016). 
​
  • Rethinking Aid-in-Dying, MedCity
 
Voluntary Stopping Eating and Drinking (VSED)

VSED is the intentional decision to stop drinking liquids and eating food for the specific purpose of causing death. Death takes place within 5 to 21 days. The cause of death is dehydration. Legally, VSED falls under the doctrine of “informed consent” which recognizes the value society places on a person’s autonomy. Forcing someone to eat and drink is considered medical treatment, and under this doctrine, a competent individual can legally refuse any type of medical intervention to protect the integrity of his body.

However, advancing the dying process through VSED is easier said than done. You have to make sure that the patient is medically competent to make such a decision, and convince family members that it is the right thing to do. Further, you need the support of the patient’s personal physician, who is empowered to provide a hospice referral so the patient gets the proper care. You also have to overcome the fundamental focus of the medical profession to save lives and not end them.


Do Not Resuscitate Order (DNR)

The DNR is a medical order written by a doctor at a critical time during medical treatment. It instructs health care providers not to do cardiopulmonary resuscitation (CPR) if a patient's breathing stops or if the patient's heart stops beating. A DNR order allows you to choose whether or not you want CPR before an emergency occurs. It is specific about CPR and does not provide instructions for other treatments, such as pain medicine, other medicines, or nutrition. The doctor writes the order only after talking about it with the patient (if possible), the proxy, or the patient's family.

Physicians Orders For Life-Sustaining Treatment Paradigm (POLST)

The National POLST Paradigm improves the quality of care for patients who are seriously ill or frail by creating a voluntary system that elicits, documents and honors patient medical treatment wishes through portable medical orders. A Physician Orders for Life-Sustaining Treatment Paradigm Form is completed based on conversations between patients and health care professionals about goals of care, quality of life, diagnosis, prognosis and treatment options.

Click here to learn more about End-of-Life options.
End-of-Life Planning, Grieving and Related Thoughts

The Conversation Project is an organization dedicated to helping people talk about their wishes for end-of-life care. They offer advice and a Starter Kit to help you get your thoughts together and then have the conversation. Other websites to facilitate the planning process and help you create a living legacy after you are gone: Cake, Everest, SafeBeyond.
  • Medicare Benefit Pays for End-of-Life Planning, Kaiser

Four things every person needs to hear when facing death: "Please forgive me." "I forgive you." "Thank you." "I love you." The Four Things That Matter Most: A Book About Living, by Dr. Ira Byock

Five timeless truths from the Serenity Prayer, which has been closely associated with Alcoholics Anonymous' 12 Step program. The prayer is often recited by those experiencing turmoil, despair, or uncertainty, and is designed to help them overcome life's most difficult challenges.


Lonely Death. Kodokushi is the Japanese term for lonely death--the fear of dying alone and remaining undiscovered for a long period of time--which has become hauntingly common. NY Times article...The Lonely Death of George Bell.

Death Doulas/Death Midwives. Volunteers who visit a dying patient and offer companionship, or charge to do things like organizing paperwork, living with a patient or assisting with funeral arrangements. 
NY Times

Misc. Thoughts
  • A doctor's perspective on end of life care decisions: Harvard Medical School/Longwood Seminars
  • A Guide to Coping With Grief, HarvardMed
  • A Practical Guide for Life's End, NextAve
  • After Death Communication with a Deceased Person, Next Avenue
  • ​​Coping with Frozen Grief, Next Avenue
  • Coping With Sadness and Grief Before a Loved One Dies, Kaiser
  • Dying is Happier Than You Think, ScienceBlog
  • End of Life Stage, Next Avenue
  • Help for Pets of Dying Owners, Next Avenue​
  • How to Get Your Digital Affairs in Order, BosGlobe
  • Last Moments--End-of-life Rallies Before Dying, Next Avenue
  • Living Funerals Gaining in Popularity, Next Avenue
  • Obits That Keep You Laughing, AARP
  • On Death and Dying, STAT
  • The Anguish of Losing a Spouse, NY Times
  • The Art of Grieving: Differences between men and women
  • The End-of-Life Care People Want in 4 Countries, Next Avenue
  • The Funeral As We Know It Becoming a Relic, WashPost
  • ​​Therapy Dogs Provide Comfort at Funeral Homes, Animal Wellness
  • What Happens When You Die, CheatSheet
  • ​What to Say to Someone Who is Dying, Next Avenue
  • Where You Live May Determine How You Die, Kaiser​
  • You May Want to Marry My Husband, NY Times
  • 104-Year-Old Scientist's Birthday Wish is to Die, WashPost

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Funeral Costs & Customs; Estate Liquidation

The average cost for an American funeral is between $8,000 and $10,000. Learn more about:

  • Estate liquidation
  • Funeral Service trends
  • Green Funerals
  • Online/virtual memorials
  • Pricing options
  • Religious, ethnic and cultural beliefs and customs
  • Seven Tips on Planning YourTomb Stone Memorial
  • Should Digital Remains Be Handled Like the Physical Kind
  • What to do if you can't pay for the funeral​


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    • Caring for Elderly Parent
    • Eating & Exercise
    • Emerging Technology & Concepts >
      • End of Life Options/Issues/Grieving >
        • VSED Primer
    • Entrepreneurship
    • Health Challenges
    • History of Aging >
      • Ancient Egypt, India, China
      • Before 1500
      • 1500s & 1600s
      • 1700s & 1800s
      • 1900s & 2000s
      • Early New England (1600s)
      • Quest To Look Young
      • Books
    • Housing Options & Aging in Place Guide
    • Insurance, Security, Fraud
    • Intergenerational Programs
    • LGBT
    • Positive/Successful Aging
    • Retirement/Estate Planning
    • Science of Aging
    • Support Resources
    • Travel
  • About
  • Contact