The Amateur's Guide To Death & Dying
Enhancing Life Near Death
I’m delighted to announce that I will be sharing the airwaves with my friend and colleague, Chris MacLellan, from Be A Healthy Caregiver fame. We’ll be on blogtalkradio Tuesday, 01/08/13 at 1:00pm eastern time and 10:00am west coast time.
Find all the information HERE!
Come and join the conversation; you’ll be so glad you did!
And be sure to visit Chris on his site, The Purple Jacket and follow him on Twitter @TheBowTieGuy.
See Ya Tuesday!
A gift Americans owe to themselves and their country in 2013 is lessons on how to die.
Doctors 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!
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.
Complete Article HERE!
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.
and
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!”
I am so pleased to announce The Midwest Book Review review of The Amateur’s Guide To Death And Dying.
Thank you, Mr. Cox and your staff, for this wonderful review. We can’t think of a better holiday gift than a superlative review.
HAPPY HOLIDAYS TO US ALL
by Lisa M. Krieger
In her last two months, Gayla Caliva stargazed and savored Jamaican food. She enjoyed picnics and her book club, trips to the zoo, the aquarium and the beach.
Her bucket list overflowed with forbidden foods. “And why shouldn’t it?” she reasoned.
She canceled her mammogram. “Teeth cleaning? Let it go!” she said.
How will you respond, when death calls your name?
Caliva chose comfort care over combat, rejecting life-prolonging dialysis for a life-affirming ending.
As a retired nurse, the free-spirited San Jose woman had seen plenty of bad deaths, and knew her failing kidneys would assure a more gentle demise, providing her the gift of time to say goodbye. How much time? Nobody could say.
But at 70, with no prospect of a cure, and influenced by her mother’s six-year dependence on dialysis, she foresaw only exhaustion when doctors gave her a choice in July.
“I didn’t have to think about it, because I already knew,” she said. “I didn’t want dialysis. Now I think, well now, I’ve signed my death sentence or something. I thought it would be scary. I can’t believe how unperturbed I was, how easy that came.”
She vowed to enjoy the dwindling days, savoring moments with her best friend and fellow nurse, Ann Raynor, and daughter, Diane Caliva.
The clarity of her decision also gave her loved ones the ability to celebrate her final days, more than suffer her death.
“It made you almost shift into those same gears,” Diane Caliva said. “It was like, OK, I’m just going to go with her on this, because she’s embraced it.”
Her mother’s one call for help was to Pathways Hospice, based in Sunnyvale. Like Caliva, 1.1 million Americans a year choose hospice care, in which nurses monitor patients and provide pain medication to ease them through life’s final journey, often at home.
Others come to a different conclusion, seeking treatments to prolong life that can buy precious time: a family graduation or wedding, perhaps.
The hard part is getting the information to make the right choice. A recent national study, published in the Oct. 25 New England Journal of Medicine, found that patients often fail to understand the limitations of treatment. Chasing miracles can delay the transition to comfort care, the journal concluded.
Gayla’s end in September was not, as she once dreamed, a romantic scene of winter sun streaming through the window, listening to the love duet from Puccini’s “Madame Butterfly.”
She slept a lot. She had trouble breathing, and there was confusion, with some agitation and pain. But her discomfort was brief and controlled. She was home, not hospitalized.
She died, like she lived, on her own terms.
“Live like a washrag? Weak as a kitten? All your food tastes like crap? That’s not a quality life,” she said. “I didn’t want that. Nope, not for me.”
Complete Article HERE!
Meditation on Death
Thich Nhat Hanh
Vietnamese Buddhist monk
Nobel Peace Prize nominee
The meditation on death is the meditation on life itself.
When the cloud is about to be transformed into rain, it does not panic, like us. Knowing that being a cloud is a wonderful thing – the cloud is also aware of the fact that becoming green is another wonderful thing. So when the moment comes for the cloud to become green, it will sing happily at becoming drops of water falling on the vegetation, becoming part of the river, penetrating into the earth, and becoming a source of life for many other kinds of beings. It is a very beautiful adventure also. And then, sometime later on, it may resume the form of another cloud. No fear.
One autumn morning I was contemplating one beautiful leaf that was about to fall down. The leaf was very beautiful. It had the red color, the yellow color…. I was standing there, in a meditative mood; I was looking at the leaf; I was questioning the leaf, and to see whether the leaf was afraid of falling down to the ground. I heard the leaf saying that it began to appear in the spring. It had been on the branch many, many months. Through spring and summer it had worked hard to nourish itself and the tree.
It is now not like spring. It has done a lot of things in order to nourish the tree, and it could see itself in the tree. A leaf is something like a factory, fabricating a kind of sap, using sunshine, using gas; using water and mineral substance brought up by the roots – in order to manufacture that kind of sap that can nourish the tree.
Somewhere I read this statement: It takes 30 good leaves to make a good apple. It concerned an apple tree. An apple, in order to be a good apple, would need the support of at least 30 good leaves. Every one of us would need at least 30 leaves in order to be a good apple!
And so the leaf has worked hard in order to nourish the tree. And now it is about to fall down. “I am not afraid,” the leaf said. “I am in the tree; I am the tree; this is only a small part of me. I know that when I fall down, I continue to do my job. And when I decompose and become the soil, I continue to be with the tree. There is no fear.”
And there – a little bit of wind – and the leaf left the branch, went to the ground…joyfully, like dancing.