How we can change end-of-life medicine

A gift Americans owe to themselves and their country in 2013 is lessons on how to die.

our-livesDoctors know this. They don’t spend their final hours like the other 2.4 million Americans who die every year. They’ve seen patients hooked up to tubes in hospital beds, suffering unnecessary pain and indignity, while tens of thousands of dollars are spent on every medical option to extend lives that are clearly near the end. According to a Johns Hopkins study, most doctors have advance care directives, reject CPR and live their final days with dignity, at home and in hospice, surrounded by loved ones.

The Mercury News’ Lisa M. Krieger has spent the past year grappling with our approach to death in America. Her insightful, heartfelt series, “Cost of Dying,” concludes Sunday with a practical analysis of how to change end-of-life medicine. She encourages us to take charge of our own deaths, tell doctors what we want, reject treatments that we really know can’t help and — this is most important — consider suffering, not death, the enemy. Expanding access to hospice care is a key to all this.

Pain can be managed very well today. Most Americans could die in peace at home. But nearly 80 percent die in hospitals or nursing homes, even though surveys show these are the last places the vast majority wants to be. About 20 percent die connected to tubes in intensive care units, the least humane and most expensive end of life care.

We need a culture change in our approach to death. We need to focus more on dying with dignity and less on extending life to the last possible minute. This will be better for individuals, and it will be better for America: Our health care costs are killing our economy, and pointless end-of-life care is a big part of the reason.

This country spends nearly twice as much per capita on health care as any of its competitors in world markets, but by most measures, it achieves poorer results than European counterparts. A major reason is that the 5 percent of Medicare patients who die every year consume almost one-third of all Medicare expenditures. And one-third of those costs are incurred in the final month of life, when there is no chance of a real recovery.

The number of Americans 65 and older will double in the next 20 years, putting more pressure on our medical system. People understandably worry that treatments that could benefit them may be less accessible, but the enormous amount of money paid to extend suffering at the end of life benefits no one.

Today 75 percent of Americans could die comfortably at home with hospice care. But we have to make that choice personally, talk frankly with doctors and family — and work to change family and community attitudes.

All we need is the will.

Complete Article HERE!

Let’s talk about dying

Lillian Rubin lives and works in San Francisco. She is an internationally known writer and lecturer, who has published twelve books over the last three decades. Last evening her latest essay appeared in Salon. It’s brilliant and a must read.  This courageous woman breaks open a discussion we are all literally dying to have. But so much in popular culture avoids and even prohibits this essential death talk. I commend Lillian for breaking this cultural taboo. Perhaps now others in the media will do likewise.

Lillian Rubin

Complete Article HERE!

Holidays and the Meaning of Life

Just got a holiday card from a dear friend. He sent me a hilarious collection of HOLIDAY EATING TIPS. There were 10 in all. Here is a sampling:


1. Avoid carrot sticks. Anyone who puts carrots on a holiday buffet table knows nothing of the Holiday spirit. In fact, if you see carrots,leave immediately.. Go next door, where they’re serving rum balls.


9. Did someone mention fruitcake? Granted, it’s loaded with the mandatory celebratory calories, but avoid it at all cost. I mean, have some standards.

but the kicker comes at the end…

“Life should NOT be a journey to the grave with the intention of arriving safely

in an attractive and well preserved body,

but rather to skid in sideways, chocolate in one hand, and wine in the other,

body thoroughly used up, totally worn out and screaming,

“WOO HOO what a ride!”


Providing end-of-life care for special dogs

By Kim Bromley

IN JANUARY 2011, an old female dog was found across the highway from the Marin Humane Society. It had the appearance of an African village dog, emaciated, sick and having very few usable teeth. It also was the sweetest, gentlest, most affectionate dog many of us had met in a long time. A microchip scan revealed the dog’s name: Princess.

sad-sick-dog-by-This-Years-LovePrincess’ guardians were no longer interested in caring for the animal. The dog’s blood panel was unremarkable, and urinary tract infection it had was treatable. But the dog needed to get out more frequently at night than staff could manage, so Princess went into an overnight foster program in which its foster guardian picked the dog up at the shelter around closing time and brought it back the next morning before opening. In late March, I became one of the dogs overnight foster guardians.

Despite a zest for life and a love of people and other dogs, Princess continued to have minor but annoying health issues that included vomiting and diarrhea. The animal’s adoptability was in question.

It was inevitable that my husband and I developed a deep affection for Princess. So when we were asked to take the dog home for end-of-life hospice care, we agreed. The dog’s lack of appetite and continuing digestive problems along with a wet cough suggested the animal might not live much longer. Two months was one specialist’s guess.

As people who believe in gentle and dignified death, we were honored to offer refuge and peace to a sweet old dog and to make its final days warm and comfortable. My first order of business was to find something delicious for the dog to eat. Our resident dog eats a raw diet, and so it was the easiest thing in the world to give a chicken patty to Princess. The dog loved it and ate it right up. And after a few days its cough cleared up along with the vomiting and diarrhea. Could it be that the animal had a grain allergy? Because of the dog’s age and foster status, we never had Princess tested but we were struck by the coincidence.

After a few weeks we tried longer walks with Princess, something more robust than just a stroll around the block. The dog soon became part of my Saturday morning hike — a one-hour, 2.5-mile trek up and down fire roads in Pacheco Valley. Princess was a champ. The dog loved to ride in the car, visit friends and meet other dogs. We took the dog to the beach and on a couple of our dog vacations. In short, the animal thrived for another year. Princess was the salt of the earth and sweet like a homemade dessert. We started calling the dog Betty — for apple brown Betty. Sometimes, Betty Jean.

Eventually, Princess Betty Jean did show real signs of decline. Her legs began to fail, and walks became fewer and shorter.

After conferring with the Humane Society veterinarian we concluded Princess’ time had come.

On a beautiful fall day 16 months after she’d come to our house for hospice care, Princess went to her final sleep surrounded by those who had loved and cared for the dog since the day it arrived at MHS.

Complete Article HERE!

This Sexy-Christmas-Themed Funeral Home Ad Will Break Your Brain

Thanks to the folks at Gawker, we have this gem.Funeraria López

We all know that sex sells — but how about sexy funeral home employees dressed in skimpy two-piece Santa outfits?

Funeraria López in the Guatemalan city of El Progreso bravely volunteered to find out.

The result? Well, let’s just say Christmas came early this year.

Complete Article HERE!