Hospice nurse Renee Beccue helps ease patients’ last days

Hospice care provides a team of physicians, nurses and other professionals to help manage the spiritual and emotional aspects of end-of-life care.

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Renee Beccue

Renee Beccue helps ease the process of dying.

She is an on-call registered nurse with Lower Cape Fear Hospice in Wilmington. Beccue, originally from Buffalo, N.Y., had primarily worked in intensive care units with burn patients.

She had accompanied doctors when they announced deaths of patients to their families and saw that this experience could allow her to transition into hospice nursing.

“Hospice and palliative care is a growing field,” said Beccue.

Part of what hospice care provides, is in-home equipment for patients, such as hospital beds, so they can spend their last days in the comfort of their own home. There is also a team of physicians, nurses and other professionals to help manage the spiritual and emotional aspects of end-of-life care.

And while hospice doesn’t provide in-home, around-the-clock medical care, it does have providers on call to help manage medical needs.

That’s where Beccue comes in.

Beccue doesn’t have a fixed caseload of patients, but she receives calls at night when hospice patients are in need of medical care that the family or caregiver feels is outside their capability. Beccue travels to a few counties for on-call needs, including Onslow and Pender as well as New Hanover.

The calls she receives can be anything from discussing fall prevention to pronouncement of death. Part of the medical care received in home is to help the patient remain in the home with fewer trips to the hospital.

“We try to prevent readmission to the hospital,” Beccue said.

Her care as a hospice nurse is twofold, therapeutic listening and education. Education consists of teaching the family or caregivers the basics of caring for a sick person who will continue to decline. Beccue calls this the “palliative care mindset, not curative.”

She teaches the family to change the bed and bathe the patient while he is still in the bed. Beccue says the care needs of hospice patients are constantly changing because they continue to get sicker. She also teaches the family what they can expect to see from the patient depending upon his disease.

Beccue also helps patients understand what they are experiencing. She consoles them and emphasizes the importance of “judgment-free” care as a hospice provider. Beccue realizes that many people are not familiar with the medical terms being used and she sincerely tells families and patients to call her with any questions.

Beccue primarily tends to the patients’ medical needs, but in the process of dying, people often work through a life review. Many patients do not truly grasp their prognosis for a variety of reasons until Beccue arrives at their home. She sometimes helps patients face the truth that she has been assigned to them because they have a prognosis of six months or less left to live.

“That’s when they cry,” Beccue said.

She tries to be the voice of reason and help them to understand that the feelings they are experiencing are normal. She can assist with adjusting medication when anxiety is overwhelming and to help mitigate physical pain.

Beccue says it’s important to allow patients to feel. “You can’t make a stage 4 diagnosis nice,” Beccue said.

She has seen patients move through bitterness, anger and unresolved issues and hospice does provide social workers to help counsel the patient through that process.

While death is frightening for many people, Beccue sees it as a part of living. And death isn’t all scary and sad. Many times she turns on music for patients, helps them sit by their favorite window and watch the birds they’ve enjoyed their whole lives. Also, the presence of beloved pets is important to comforting patients.

Some patients want to sit and look at the garden they worked in for years. Beccue says one patient asked to sit by the window and watch the golf course every day.

After years of being with hospice patients Beccue has learned a few tips about working with the dying. She recommends being upfront and honest about prognosis, allowing honest feelings about that prognosis and ultimately finding peace and joy in death, which is the ultimate rite of passage for all of us.

Complete Article HERE!

Hundreds Join Man And Dog For Their Final Walk On The Beach Together

It was a celebration of Walnut the whippet’s long life.

By Hilary Hanson

When Walnut the dog went on his final walk Saturday, he was far from alone.

Not only did the 18-year-old whippet have the company of his owner, Mark Woods, the pair also had the support of hundreds of people and pets who walked with them on the beach in Cornwall, southwest England, around 9:30 a.m.

On Tuesday, Woods posted about Walnut on Facebook, writing he was sad to say he planned to have the elderly dog euthanized on Saturday.

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“He has had an incredible life and having reached the grand age of 18 is ready for his final sleep,” Woods wrote. The dog’s health had deteriorated over the past several months. Walnut had become too frail to stand and he needed help eating, Woods told the Cornwall Guardian.

In his Facebook post, Woods invited supporters to join him and Walnut on Walnut’s favorite walk, along Porth Beach, on the outskirts of the town of Newquay. The post went viral, and when Saturday arrived, the turn-out was overwhelming.

Hundreds of people walked with Woods and Walnut on the beach, and countless others sent messages of compassion from around the world.

Walnut and Woods were inseparable during the dog’s life, he told local news station Pirate FM. Sometimes it even may have caused issues when others didn’t understand their strong bond.

“He has always travelled around with me, all around London and he stood by the swimming pool whilst I gave diving lessons,” he said. “We’ve been in all sorts of bizarre situations together, various girlfriends who have got upset because I always put him before them. I have always put him first and maybe I shouldn’t have but he is just such a special dog.” 

Woods announced on Facebook around noon on Saturday that Walnut had died. He thanked everyone for their kindness and support.

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“I read out a poem that was sent to me by one of the many well wishers just before Walnut had his last sleep and would love you all to read this as well to remind ourselves just how lucky we are to be alive and to share in the wonderful world that our pets give us,” he wrote.

Complete Article HERE!

Cry, Heart, But Never Break: A Remarkable Illustrated Meditation on Loss and Life

“Who would enjoy the sun if it never rained? Who would yearn for the day if there were no night?”

BY MARIA POPOVA

“Each day, we wake slightly altered, and the person we were yesterday is dead,” John Updike wrote, “so why … be afraid of death, when death comes all cryheartbutneverbreak-2the time?” Half a millennium earlier, Montaigne posed the same question somewhat differently in his magnificent meditation on death and the art of living: “To lament that we shall not be alive a hundred years hence, is the same folly as to be sorry we were not alive a hundred years ago.”

Yet mortality continues to petrify us — our own, and perhaps even more so that of our loved ones. And if the adult consciousness is so thoroughly unsettled by the notion of death, despite intellectually recognizing it as a necessary and inevitable part of life, how is the child consciousness to settle into comprehension and comfort?

Now comes a fine addition to the most intelligent and imaginative children’s books about making sense of death — the crowning jewel of them all, even, and not only because it bears what might be the most beautiful children’s book title ever conceived: Cry, Heart, But Never Break (public library) by beloved Danish children’s book author Glenn Ringtved and illustrator Charlotte Pardi, translated into English by Robert Moulthrop.

Although Ringtved is celebrated for his humorous and mischievous stories, this contemplative tale sprang from the depths of his own experience — when his mother was dying and he struggled to explain what was happening to his young children, she offered some words of comfort: “Cry, Heart, but never break.” It was the grandmother’s way of assuring the children that the profound sadness of loss is to be allowed rather than resisted, then folded into the wholeness of life, which continues to unfold. (I’m reminded of Maria Kalman’s unforgettable words: “When Tibor died, the world came to an end. And the world did not come to an end. That is something you learn.”)

cryheartbutneverbreak22This warmly wistful story begins outside the “small snug house” where four children live with their beloved grandmother. Not wanting to scare the young ones, Death, who has come for the old lady, has left his scythe by the door. Immediately, in this small and enormously thoughtful gesture, we are met with Death’s unexpected tenderness.

Inside, he sits down at the kitchen table, where only the youngest of the kids, little Leah, dares look straight at him.

cryheartbutneverbreak23What makes the book particularly touching, thanks to Pardi’s immensely expressive illustration, is just how crestfallen — broken, even — Death himself looks the entire time he is executing his mission, choked up with some indiscernible fusion of resignation and recompense.

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In the quiet, the children could hear their grandmother upstairs, breathing with the same raspy breaths as the figure at the table. They knew Death had come for her and that time was short.

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To stall the inevitable, the children devise a plan — believing that Death only works at night, they decide to keep refilling his coffee cup until dawn comes, at which point he would have to leave without their grandmother. Here, too, one is struck by the ordinariness of Death, for what can be more ordinary — and life-loving, even — than to enjoy a cup of coffee at the kitchen table?

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But Death eventually curls his bony hand over the cup to signal that the time has come. Leah reaches her own tiny hand, taking his in hers, and beseeches him not to take their darling grandmother. Why, she insists, does grandma have to die?

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Some people say Death’s heart is as dead and black as a piece of coal, but that is not true. Beneath his inky cloak, Death’s heart is as red as the most beautiful sunset and beats with a great love of life.

Death is once more overcome with kindness and compassion for the children, so he decides to answer Leah’s question with a story, hoping it would help them understand why dying is natural and necessary.

He tells them of two brothers named Sorrow and Grief, who lived in a somber valley and went about their days “slowly and heavily” because they never looked up, because “they never saw through the shadows on the tops of the hills.”

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Beyond those shadows, Death tells the kids, lived two sisters, Joy and Delight.

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They were bright and sunny and their days were full of happiness. The only shadow was their sense that something was missing. They didn’t know what, but they felt they couldn’t fully enjoy their happiness.

As Death is telling the story, little Leah nods her head, for she can tell what is to come — the two boys meet the two girls and they fall in love, two perfectly balanced couples: Sorrow and Joy, Grief and Delight.

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Death tells the kids:

It is the same with life and death… What would life be worth if there were no death? Who would enjoy the sun if it never rained? Who would yearn for the day if there were no night?

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Something difficult and beautiful has sunk in.

When death finally gets up from the table to head upstairs, the youngest boy is moved to stop him — but his older brother puts a rueful hand on his shoulder and gently discourages him.

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Moments later, the children heard the upstairs window open. Then, in a voice somewhere between a cry and a whisper, Death said, “Fly, Soul. Fly, fly away.”

They hurry upstairs, where their grandmother has died — a moment of great sadness, enveloped in warm peacefulness.

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The curtains were blowing in the gentle morning breeze. Looking at the children, Death said quietly, “Cry, Heart, but never break. Let your tears of grief and sadness help begin new life.”

Then he was gone.

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Ever after, whenever the children opened a window, they would think of their grandmother. And when the breeze caressed their faces, they could feel her touch.

Cry, Heart, But Never Break comes from the courageous Enchanted Lion, who have brought to life such daring and deeply nuanced picture-books as The Tiger Who Would Be King, Little Boy Brown, The Lion and the Bird, and Louis I, King of the Sheep.

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Complement this particular masterpiece with Oliver Jeffers’s The Heart and the Bottle, which explores what we stand to lose when we deny difficult emotions like grief, and Michael Rosen’s Sad Book, a beautiful meditation on loss, illustrated by the great Sir Quentin Blake. For a grownup counterpart in the same spirit, see Elizabeth Alexander’s The Light of the World. For an Eastern perspective, see how a Zen master explained death and the life-force to a child.

Complete Article HERE!

Dying: A Memoir by Cory Taylor review – facing up to ‘the great unmentionable’

An inquiry into western society’s dysfunctional relationship with mortality, and a luminous account of one writer’s search for a good death of her own

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Cory Taylor: ‘I had stumbled out of a land of make-believe into the realm of the real.’

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Most of us won’t get any say in how or when we die. But even knowing that, the question of what makes a good death feels important, even urgent. What is the best that we can realistically hope for, at the end? If you subscribe to an organised religion, you might focus on living virtuously in the hope of a posthumous reward. The rest of us need to know how to go about dying with some dignity and grace, amid the grubby imperfection of the real world. The Australian writer Cory Taylor managed it, and she has left us her wisdom and experience in this book, which is part memoir, part critical examination of western society’s dysfunctional relationship with mortality.

Taylor was 60 when she was told that what had started off as a melanoma was now incurable cancer. She had already witnessed the reality of “dying badly”: both her parents died in nursing homes after long and humiliating descents into dementia. The last time Taylor saw her mother, she watched as a nurse changed her nappy. “The look in my mother’s eyes as she turned and saw me,” she writes, “reminded me of an animal in unspeakable torment.” Taylor’s one comforting thought when she received her own terminal diagnosis was that she wouldn’t have to go like that: she had the time, and the mental capacity, to find her way towards a better death.

En route, she became something of an ambassador for the dying. When she first found herself in a ward of terminally ill people, it was as if she “had stumbled out of a land of make-believe into the realm of the real”. Death, she realised, was the great unmentionable; a “monstrous silence” that left those facing it lonelier then ever. There was very little help on offer to a non-religious person who wanted to die well. Why, she found herself wondering, do doctors avoid talking about death with their patients? Why is there so much funding for hugely expensive cancer treatments, even when they are ineffective, and so little for research into palliative care and support? And why have we allowed the debate about assisted dying to be dominated by religious groups?

Taylor was tempted by assisted dying. After several almost comically unhelpful interactions with medical professionals (her family doctor, referring her for counselling, wouldn’t describe her problem as “dying” but rather as “adjustment disorder”), she joined Dignitas and Exit International. She even got as far as ordering a euthanasia drug from China. But though the knowledge that she could end it herself was important to her, she couldn’t actually do it. In the absence of a supportive legal system, she would have had to take the drug alone, and she worried about the impact on her loved ones and the people who found her. She didn’t want the word “suicide”, with its connotations of mental turmoil and despair, on her death certificate.

“It surprises me that I have any qualms at all,” she writes of that decision, “since I have never thought of myself as a person of particularly high moral standards.” Along with the precision of her writing, it is Taylor’s lack of self-righteousness that lends this book its very special quality. She doesn’t embark on a “spiritual journey”, set herself up as any kind of guru, or even offer answers as such. There is no phoney narrative of redemption – indeed, much of the narrative is devoted to exploring rifts in her family which remained irreconcilable to the end. There was a depressed grandmother, and a property dispute in her mother’s generation; then her mother and father divorced after many miserable years in which he dragged his family around the world on a series of wild goose chases. Taylor was estranged from her father when he died, and she wasn’t on particularly good terms with her siblings. “A different family might have managed to put all this history behind them,” she writes; hers did not.

In the absence of happiness ever after, we are bound to hope for some sense of resolution. Taylor, for whom writing was an obsession since childhood, focuses on remembering the experiences that shaped her character, and finding the right words to describe them. She is sparing about what she includes, but each scene has a luminous quality, a little like her description of the light in Fiji, where she lived briefly as a child: “so pure that it infused every object with an extra intensity, so that a flower was not just red, or a blade of grass just green.” We see the moment in which she first recognised desire (in the eyes of her mother, meeting a handsome Texan), and her first intimation of mortality, watching a kookaburra swoop down from a branch to kill a skink. We see her going to buy her Fijian school uniform, “pink, mint-green … open-weave cotton with its delicious sugary smell”.

She seems to say that our lives, in all their glorious messiness, are their own reward. “The accident of birth is just that. And so is everything that happens afterwards, or so it seems to me.”

Taylor died in July, shortly after this book was published in Australia, and there is no end note to tell us whether her desire for a good death was rewarded. Naturally, I googled it: she died peacefully, surrounded by her family. Somehow I knew that would have been the case. But then again, perhaps she just got lucky.

Complete Article HERE!

Why the grieving process often starts before death

“The feelings of loss don’t get any smaller but as our lives evolve and grow it becomes more manageable”

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By

I walked to the cemetery with a friend today. The sun was shining brightly. Blue skies, flowers, and golden sunlight.

It’s a beautiful cemetery, full of life, love and beauty. As we walked, we talked about death, dying and bereavement. We discussed how the process of dying isn’t just about the dying person but about everyone involved.

Someone who needs help to do things is not only receiving care, they are allowing their loved ones and carers to give. It’s a gift from both sides.

Dying people, in allowing living people to ‘serve’ them, are helping mould and shape their loved ones bereavement and grief process. I’ve heard countless stories of how comforted those left behind feel when they recall all the things their loved one consented for them to do at the end.

Are dying people unconsciously allowing their loved ones to feel helpful? Feeling useful in turn makes us feel wanted and secures our position as someone important and special.

My final gift to my grandfather was his physical care, his final gift to me was granting it. As sad as I felt that his life had ended, I knew I’d done all I could and I felt he knew it too. I believe my grief was gentler and his death was easier to accept as a result of the care he’d allowed me to give him.

Research shows the need for acknowledging the enduring bonds we continue creating with our loved ones after they have died, and the importance of accepting the changes in our feelings and thoughts during grief.

We don’t ever get over bereavement. The feelings of loss don’t get any smaller but as our lives evolve and grow it becomes more manageable.

Some days we will feel loss as acutely as the day it happened. Other days, we will feel more at peace with our reality.

Accepting bereavement in our life is difficult, but there is no escaping that grief is a part of life, in all the forms it takes – the ‘anticipatory’ loss and the actual loss. We grieve before someone dies and again, differently, when they do.

Grief is multi-faceted and complicated and its impact is felt in all aspects of our life. It has no quick fixes or shortcuts and it can be terribly lonely. Reach out, we’re all here to help:

Complete Article HERE!

Serving Veterans at the End of Life

We Honor Veterans: Serving Veterans at the End of Life

Over 4,300 hospice organizations and community partners provide Veteran-centered care to our nation’s heroes.

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As the nation prepares to celebrate our nation’s Veterans this Veterans Day, the National Hospice and Palliative Care Organization and the We Honor Veterans program would like to thank those who served and the over 4,300 organizations across the nation, committed to providing Veterans with the care and resources they deserve when dealing with a serious or life-limiting illness. We Honor Veterans partners address both physical and emotional needs, including the psychological toll of war and how it impacts the end-of-life journey. 

A new video released by the We Honor Veterans program features William, a Veteran of the US Navy and a volunteer with the Veteran-to-Veteran volunteer program at Sangre de Cristo Hospice and Palliative Care in Boulder, Colorado.  The Veteran-to-Veteran volunteer program, a We Honor Veterans initiative, pairs veteran patients with volunteers who have also served their country and share a unique and honorable bond.  “Veterans will talk more with a Veteran than they will to most everybody, except a spouse maybe,” William states in the video.

NHPCO, in collaboration with the Department of Veterans Affairs, created the We Honor Veterans program to empower hospice and other non-hospice community partners across America to meet the unique needs of seriously ill Veterans and their families.  Partners engage in activities including utilizing a military history checklist at admission, pinning ceremonies and certificate presentations, as well as outreach to other community organizations.  

“The We Honor Veterans program has helped healthcare professionals and volunteers understand and serve Veterans at the end of life for over five years now,” said J. Donald Schumacher, NHPCO president and CEO. “We continue to add more partners to the program each year –a testament of the overwhelming commitment to serve our nation’s heroes with the dignity they deserve.”  

There are four levels of distinction that program partners can earn based on their involvement with Veteran education and interaction with the Veterans and family members they are caring for. The goal of these levels is to ensure the very best care is being provided to those who have served our nation. 

As we celebrate our nation’s heroes this Veterans Day – and every day of the year – we must not forget that it is never too late to give them a hero’s welcome home.

Learn more at WeHonorVeterans.org.    

 

Complete Article HERE!

Aid in dying is about control more than pain, research shows

Supporters of “death with dignity” have succeeded in legalizing medical aid-in-dying in five states by convincing voters, lawmakers and courts that terminally ill patients have the right to die without suffering intractable pain in their final days or weeks.

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When Gov. Jerry Brown signed California’s law in 2015, he said: “I do not know what I would do if I were dying in prolonged and excruciating pain” and that it would be a “comfort to consider the options afforded by this bill.”

Yet the latest research shows that terminally ill patients who seek out aid-in-dying aren’t primarily concerned about pain. Those who’ve actually used these laws thus far have been far more concerned about controlling the way they exit the world than controlling pain.

The research suggests that patients’ motivations are more complicated than they’re often portrayed and could affect or shape how people vote on the issue in other cities and states.

Colorado voters will decide on a ballot initiative to legalize physician aid-in-dying in November. The city council in Washington, D.C., voted to legalize the practice this month, though a final vote must still be held.

“It’s almost never about pain,” said Lonny Shavelson, a Berkeley, Calif., physician who specializes in the care of the terminally ill and who began writing prescriptions for lethal doses of medication in June, when California’s law took effect. “It’s about dignity and control.”

Pain ranks near the bottom of a list of patients’ concerns in Oregon (PDF) and Washington (PDF), the first two states to legalize physician-assisted dying, which provide the most complete details about people’s motivations. Only 25 percent of the 991 Oregon patients who died after taking lethal prescriptions from 1998 to 2015 were concerned about pain or had inadequate pain control, according to reports filed with the state by their doctors. In Washington, 36 percent of 917 who died were concerned about pain.

In contrast, at least 90 percent of patients in both states were motivated by a loss of autonomy, state records show. Forty-one percent of patients in Oregon and 53 percent in Washington said they feared burdening the people they loved. Montana, Vermont and California also permit aid-in-dying, but haven’t released detailed information about patients’ motivations.

Seeking Control

Compassion & Choices, an advocacy group that supports aid-in-dying, focuses heavily on the need to relieve dying patients of pain.

One of the group’s new ads promotes the District of Columbia’s Death With Dignity Act as giving “a dying person the option to avoid the worst pain and suffering at the end of life.” The widower of Brittany Maynard, a 29-year-old California woman who became the best-known advocate for the right to die, has spoken publicly in support of the legislation. Maynard, who had an aggressive brain tumor, moved to Oregon in 2014 in order to use that state’s aid-in-dying law. She died that year after using a lethal prescription.

“The dying process is what Brittany feared,” said her husband, Dan Diaz. “She was afraid that her final few days on this green earth would be ones where she was tortured by the tumor.”

Mary Klein, a 68-year-old resident of the District who is fighting advanced ovarian cancer, said she wants choices at the end of her life.

“I want to have the option to control my own body and control my own life,” said Klein, a retired journalist and artist who appears in a video supporting legislation to legalize aid-in-dying in the city, created by Compassion & Choices.

Although Klein says she may also enroll in hospice care, which focuses on the needs of people with six months or less to live, she wants to have an alternative if the services don’t meet her needs.

“The dominant reasons for wanting euthanasia or assisted suicide are psychological and involve control factors,” said Ezekiel Emanuel, chair of medical ethics and health policy at the University of Pennsylvania. He noted that most of those who’ve used aid-in-dying laws are white, well-insured and college educated. “These are people who are used to controlling every aspect of their lives, and they want to control this aspect of their lives.”

A study of 56 Oregon patients interested in physician aid-in-dying reached similar conclusions. Although patients were concerned about the risk of future pain, they ranked “current pain” as unimportant, according to the 2009 study in Archives of Internal Medicine (now known as JAMA Internal Medicine). Patients told researchers they were primarily motivated by a desire to “control the circumstances of death and die at home,” as well as a loss of independence, poor quality of life and their inability to care for themselves.

The patients interviewed “look forward to this period in their terminal illness, this time in which they will be not in control, when they will be dependent on others, when they will have a bunch of physical symptoms that will undermine their quality of life, and they want to avoid that,” said Linda Ganzini, a professor of psychiatry and medicine at Oregon Health & Science University.

Critics of aid-in-dying laws have for years warned that they could set the country on a “slippery slope,” in which lethal prescriptions are dispensed not just to the terminally ill, but to anyone with a disease that harms their quality of life. Those fears haven’t come to pass. But physician Ira Byock, who specializes in palliative care, said aid-in-dying laws are creating a slope of another kind. Instead of helping only terminally ill patients in physical pain, they’re being used by patients in psychological distress.

“It’s a bait and switch,” said Byock, executive director and chief medical officer for the Institute for Human Caring of Providence Health and Services, based in Torrance, Calif. “We’re actually helping people hasten their deaths because of existential suffering. That’s chilling to me.”

Although right-to-die campaigns suggest that excruciating pain is often unavoidable, Byock said that “we can relieve the suffering of almost everyone that we care for if we have the time to prepare.”

Hospice staff are on call 24 hours a day to help patients in pain, Byock said. Palliative care and hospice teams also can train family caregivers how to administer emergency pain medications that take effect before nurses can arrive.

Hospice may have alleviated some patients’ concerns, said physician Thomas Smith, director of palliative medicine at Johns Hopkins Medicine in Baltimore. Just 64 percent of Oregon patients and 82 percent of Washington patients last year actually used the lethal medications they were prescribed. Others died without taking them.

“Many people who have the prescriptions don’t use them,” Smith said. “That suggests to me that some people find meaning and purpose and adequate symptom control, not just that they are too weak to take the pills.”

Many Kinds Of Suffering

Barbara Coombs Lee, president of Compassion & Choices, said it’s difficult for people to predict how they will feel as they face a deadly illness. While a healthy person might not imagine being able to tolerate physical disability, people facing the prospect of an early death are often willing to accept harsh treatments or a reduced quality of life in exchange for more time.

That change in perspective could help explain why some of those who advocate for the right to die, including those who obtain lethal prescriptions, never actually choose to hasten their death, Coombs Lee said. But she said that having the prescription on hand can ease patients’ anxiety and give them peace of mind, because they can control the timing and method of death.

Coombs Lee also notes that people can suffer in many ways beyond physical pain. Maynard’s brain tumor caused her to suffer frequent seizures, for example. Coombs Lee also described the case of a dying woman who took a lethal prescription after she began leaking fecal matter, which prevented her from ever feeling clean.

Coombs Lee quotes the woman, Penny Schleuter, in her book, “Compassion in Dying: Stories of Dignity and Choice.” Schleuter said the pain from her cancer could be controlled. But, she added, “I like doing things for myself, and the idea of having somebody take care of me like I am a little 2-month-old baby is just absolutely repulsive. It’s more painful than any of the pain from the cancer.”

Coombs Lee said, “everyone who is terminally ill has some kind of nightmare that would be worse than death to them. They want to achieve sufficient control to avoid that nightmare for their family.”

Dan Diaz said people shouldn’t underestimate how devastating it can be to lose one’s autonomy.

“If I find myself in a situation where I can’t go to the bathroom on my own, where someone has to change my diapers, where I can’t feed myself, where I can’t care for the people around me, where other people have to move me around to keep me from having bed sores, I would then submit, is that really living?” Diaz asked.

Some people who pursue physician-assisted death “don’t want to be in a hospital, don’t want to be connected to tubes,” Coombs Lee said. “They say, ‘I want to be at home with those I love. I don’t want to be delirious or unconscious at the end of life.’ Those are all things that play into their fears about what their disease might descend into.”

Complete Article HERE!