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: 7.17.19
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: 7.17.19
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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 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).
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.
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
Funeral Costs & Customs; Estate Liquidation
The average cost for an American funeral is between $8,000 and $10,000. Learn more about: |