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About Death and Taxes
Today is National Healthcare Decisions Day (NHDD)a day devoted to recognizing the importance of expressing your choices about your health care through advance directives, by creating a living will and designating a medical power of attorney.Prepared Patient: Advance Directives: Caring for You & Your Family
Heather Rubesch first remembers talking with her mom, Linda, about end-of-life care as a teenager. "When I was 14, I had an aunt who passed because she did not receive a kidney transplant. As a family, we had that conversation-if something happened to one of us, organ donation was what we wanted to do," said Rubesch, 37, a business and marketing writer from Kansas City, Mo. Decades later, when Heather got the call from the hospital, informing her of her mother's terminal condition, she was shocked to discover she was expected to make immediate decisions about her mother's end-of-life care.Listening to My Mother
I can't deny it I miss the mother I once had. Even at age 80, she was vibrant, loving, and independent. And she was strong. For nearly 20 years she provided care to my father, who before his death struggled with normal-pressure hydrocephalus and macular degeneration. What an incredible woman!Can Good Care Produce Bad Health?
For those of you who haven't yet heard, I have recently been diagnosed with Stage IV inflammatory breast cancer. This rare form of breast cancer is known for its rapid spread. True to form, it has metastasized to my spine. This means my time is limited. As a nurse, I knew it from the moment I saw a reddened spot on my breast and recognized it for what it was.I'm Dying To Know
In some ways, I consider myself lucky. I know this is a strange comment from someone diagnosed with Stage IV breast cancer. I say this, though, because the first steps on my journey with end-stage cancer were undertaken with the help of a team of health care professionals who excelled not only in medicine, but also in communication.|1st Person: Hospice, My Husband and Me
As Jerome Rafferty, diagnosed with a progressive form of dementia and an incurable, antibiotic-resistant infection, became more ill, his wife, Renata Rafferty, used hospice services at home initially to assist her in caring for him.Guest Blog: Death Panels and Decision Making: A Radio Interview
Diana Mason, former editor-in-chief of the American Journal of Nursing, interviews Program Officer at The John A. Hartford Foundation, Amy Berman, and The New York Times blogger and nurse, Theresa Brown. Amy Berman was diagnosed with Stage IV breast cancer earlier this year, and in this interview, she says, 'Nothing was off limits.'Guest Blog: Making Hard Decisions Easier
Shortly after I was diagnosed with inflammatory breast cancer a scan showed a hot spot on my lower spine. Was it the spread of cancer? My oncologist scheduled a bone biopsy at my hospital, Maimonides Medical Center, in order for us to find out.Thoughts on Life, Death and Facebook
For more than three weeks I have been hanging around the ICU. Lara, my friend and colleague, is poised between life and death, having rejected her five-year-old transplanted lungs. She awaits the gift of a chance for life from another donor. Lara wants so much to live. During her last conversation with me before being placed on a ventilator, she talked about her fear. Now breathing and most everything else is done for her. Drugs keep her oblivious to the suspense.Guest Blog: Can the Blind Lead the Seeing?
Many of you know that eight months ago I was diagnosed with Stage IV inflammatory breast cancer, which has spread to my spine. My incurable diagnosis means that I live with a chronic disease, just like millions of older adults.Benefits of End-of-Life Planning
Two new studies have found there are numerous benefits when people discuss their end-of-life preferences with their clinicians and caregivers.Think Silver Not Pink for Breast Cancer Awareness Month
Because cancer is primarily a disease of aging, we shouldn't be thinking pink for Breast Cancer Awareness month'we should be thinking silver.The Costs of Long-Term Care
Does long-term care insurance have a future? In this roundup, Nancy Folbre, Don Taylor, and Trudy Lieberman offer their forecasts and perspectives on its costs.A Visa for the Dying: Travels to Another Country
People who are dying have much living to do, whether it is measured out in days, weeks or months, and the demarcation lines between the living and the dying might as well be drawn in pencil. But the truth is that it's important to talk about dying and what it means to each of us.The Waiting is the Hardest Part
That old Tom Petty song, 'The Waiting is the Hardest Part,' keeps running through my mind. Four of my friends are waiting to hear the results of medical tests taken last week.1st Person: Hospice, My Husband and Me
As Jerome Rafferty, diagnosed with a progressive form of dementia and an incurable, antibiotic-resistant infection, became more ill, his wife, Renata Rafferty, used hospice services at home initially to assist her in caring for him.Four Perfect Questions
I remember when my father-in-law passed away nine years ago. A nervous young doctor had the uncomfortable task of telling him that nothing more could be done about his leukemia and it was perhaps time for hospice.Advance Directives: Rarely Easy, Always Important
Three essays discuss the critical importance of advance directives'even when implementing them is tricky.Guest Blog: The End of Life Horror Show: We Can Do Better
Recently, New York Magazine published an agonizing first person cover story by Michael Wolff, 'A Life Worth Ending,' about the terrible choices and harsh reality of illness at the end of his mother's life. The summary slug for the piece says it all: 'The era of medical miracles has created a new phase of aging, as far from living as it is from dying. A son's plea to let his mother go.'Shifting to Palliative Care: Help Us Change our Pace
It is easy to understand why the medical machine the clinicians, the tests and assorted medical procedures is poised to provide constant often heroic interventions to save and prolong life.A Recommendation to Minimize Costs Backfires
My mom passed away last December to Stage V breast cancer metastasized to her liver. During this battle she developed ascites (an accumulation of fluid in the peritoneal cavity) as her liver failure progressed. This accumulation of fluid was not only extremely uncomfortable but painful as well.A Physician's Perspective on Shifting to Palliative Care: Help Us Change our Pace
Last week's essay, Shifting to Palliative Care: Help Us Change our Pace, provoked the following commentary from my friend and colleague, James Cooper -- to which I responded.Guest Blog: Hospice and Palliative Care: A Basic Primer
I've talked to hundreds of people about the health care options and decisions they face at the end of life. It's a challenging time and understandably many have little knowledge, while others have misconceptions, and some have bitter disagreements.My Mother's End-of-Life Discussion That Changed How She Died
I am a physician. The hardest thing I've ever had to do was to end my mother's life. She was diagnosed with breast cancer at the age of 47. After a seven-year battle that involved multiple surgeries and countless rounds of chemotherapy, she decided that she had fought long enough.Prepared Patient: Advance Directives: Caring for You & Your Family
Heather Rubesch first remembers talking with her mom, Linda, about end-of-life care as a teenager. "When I was 14, I had an aunt who passed because she did not receive a kidney transplant. As a family, we had that conversation-if something happened to one of us, organ donation was what we wanted to do," said Rubesch, 37, a business and marketing writer from Kansas City, Mo. Decades later, when Heather got the call from the hospital, informing her of her mother's terminal condition, she was shocked to discover she was expected to make immediate decisions about her mother's end-of-life care.Palliative Care: Easier Said than Done
If we want our end-of-life wishes to be properly carried out, we have to prepare in advance and our clinicians must also be prepared to help us realize them.“Go-to-Guy for All Things Medical” Tested at Mom’s End-of-Life
My father, sister and I sat in the near-empty Chinese restaurant, picking at our plates, unable to avoid the question that we'd gathered to discuss: When was it time to let Mom die?Some Caregivers Find Hiring a Professional Advocate Helps
Not long ago, I was chatting with a friend about my mom, whose life had revolved around work since my dad died 17 years ago. I was worried that my mother might be lonely, but worse, I didn't know how I would care for her at such a distance if she got sick.Why Everyone Deserves Palliative Care
Life is full of surprises, but statisticians tell us that most Americans who make it to age 65 can expect to live to almost 85, and about 1 in 4 will live past 90. Unfortunately, because palliative care is a relatively new specialty, it is often misunderstood by patients, families and even some physicians.I Wish I'd Known Earlier...Palliative Care Is Not a Mandate Not to Treat
When I signed up for palliative care in 2011, I thought I’d made my last medical decisions. In the future I’d take the least-invasive, lowest-cost approach to medical care and forego dramatic, expensive treatments. If only life with advanced cancer were so simple!Expecting Great Beginnings – and Endings
It tickles me to report that I live with incurable cancer and I am expecting. I am expecting that the cancer will take its toll, that I will need to make choices about my health and care, that I will need the support of my family and that I will need resources.Going Online for Caregiving Help
"You don't get a manual when you become a family caregiver," says Constance Adampoulos. CFAH's latest feature offers advice, practical tips and links to expert online resources to help people manage caregiving's challenges...A Better Health System for Frail and Disabled Elders
Let's stop telling the public that exercising and eating blueberries are guarantees for avoiding frailty and disability. Let's start talking about how to maintain our quality of life as we age and inevitably encounter health problems.Engagement From Patients' Perspective: Different Than Docs, Employers, Health Plans
The Prepared Patient Blog published over two hundred articles in 2013 about what it takes for people to get the most from health care and how the system can be improved to make it feasible for us to do so. Here's a recap of what engagement looks like to us – whether we are sick or well, whether we are caregivers or loved ones: Engagement is not easy and we can't do it alone. Patient engagement is not the same as compliance. It is not a cost-cutting strategy, and it is not one-size-fits-all.Society of Behavioral Medicine Announces Inaugural 'Jessie Gruman Award for Health Engagement'
Dedicated to promoting behavioral medicine research and the application of that knowledge to improve the health and well-being of individuals, families, communities and populations, Society of Behavioral Medicine created this award to recognize an individual who has made a pivotal contribution to research, practice or policy in the field of health engagement.Pulling the Plug on DNR Orders
Recently, a friend commented that she was not sure whether or not to agree to a DNR order for her 90-year-old mother. Complicating her decision was the knowledge that her mother had chosen a DNR status when she was cognitively intact, but then reversed her decision at the time of acute illness, believing that DNR meant she would not receive vigorous medical treatment. This is incorrect, and physicians are confused as well...What Would Mom Want?
We've watched it many times on television or in a movie: The patient lies in the intensive care unit, gravely ill, with the family at the bedside. The doctor walks into the room and asks, "What do you want us to do?" and opens up a huge can of worms that is, in fact, ethically incorrect. The first priority that a physician has is to their patient...What Employers and Purchaser Representatives Told CFAH About Patient Engagement
"Employers have an opportunity to reduce barriers and support engagement because they sponsor health plans and can provide access to information, tools, technologies, incentives, and more. Employers have more ability to influence engagement than they often believe they have." – Michael Vittoria, Vice President, Corporate Benefits, MaineHealth, Portland, MEGetting Bumped to First Class Health Care
I am writing this post while seated comfortably in a motorized leather recliner with a window view and lots of other perks. What a legacy we would leave Saskatchewan citizens if we could figure out how to extend this first-class patient care to all patients and their families wrestling with chronic disease...Seeing the Government's Star Ratings Is One Thing, Believing Them Is Another
Just a few years ago it seemed that advocates for health care transparency had scored a big victory. The Centers for Medicare and Medicaid Services (CMS) announced that they would rate nursing homes by awarding five stars to the best and fewer stars to lower-quality facilities. It turns out, though, that five-star nursing homes may not be delivering five-star quality...'Be a Prepared Patient' Gets a New Look
Finding good health care and making the most of it is critical for each of us. Yet all too often, reliable, unbiased information is hard to find and understand. On the redesigned Be a Prepared Patient website, we have collected trusted resources and tips to help people navigate their way through health and health care decisions and experiences...Home Health, Palliative Care, Hospice: What's the Difference and Who Needs Them?
I recently spoke with a gentleman with a significant illness whose main goal is to stay home. He decided to utilize our skilled home health services and home medical equipment. Over time, he transitioned into our palliative care program and currently is in our hospice program. Here is information on what these services are and who may benefit from them...
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