Strategies For Living > BLOG ARCHIVE Sooner or Later: Restoring Sanity to End-Of-Life Care / David McMillian, LPC, LMFT

Sooner or Later: Restoring Sanity to End-Of-Life Care / David McMillian, LPC, LMFT

Posted by: admin - April 19, 2010

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                                                              Monday April 19, 2010 Column


Forty years ago, Elizabeth Kubler-Ross opened a Pandora’s Box with her groundbreaking book On Death and Dying (Scribner, 1969) which at least started a conversation that desperately needs to be continued.The conversation needs to be continued because suddenly, or more often after a long illness, 7,854 Americans will die this very day; the same number will die again tomorrow and the day after that too.That number is irrefutable, because that’s the daily death toll in the United States.Yet, we don’t spend much time, if any, discussing how to die in peace and with dignity.We all seem to be engaged in a form of delusional belief that says that death is something that happens to other people, not to us. Somehow and some way, maybe we think that if we ignore it and don’t talk much about it, we can miraculously forestall it.Yet, when we do this, it leaves us and our loved ones unprepared for what happens to all of us sooner or later. And to complicate matters more, our fragmented healthcare system and troubled economy have left millions of Americans uninsured and uninformed about their rights as a patient, which complicates end-of- life care even more.  

I recently interviewed Damiano de Sano Iocovozzi, MSN, FNP, CNS, a unique gentleman who has a tremendous amount to share on this topic. I think Kubler-Ross would agree that its way past time to continue the discussion she started and that she’d be pleased with this author’s work.Iocovozzi is a family nurse practitioner who has worked with the terminally ill for more than 23 years and has written a new book titled Sooner or Later: Restoring Sanity to Your End-Of-Life Care (Transformation Media Books, 2010).You can hear our interview next Sunday morning on Newsradio 710 KEEL or anytime on www.strategiesforliving.com under Featured Podcasts.If we haven’t already, I think we all need to have conversations with our families and with our healthcare providers about what will indeed happen to all of us sooner or later, and this book helps us get the conversation started, at the very least in our own minds.  
Throughout this important little book, printed in large print for easy reading, are questions designed to help get us through the awkward and sometimes frightening conversations with physicians and other professionals about therapy and treatment especially regarding the effects on one’s quality of life as it nears an end.There’s a self assessment that will help sort through the often conflicting emotions of all involved, ultimately helping the patient to make sound decisions for the best quality of life possible.Clinical studies have found that:

• 87% of patients say they want as much information as possible.
• Patients want doctors to communicate truthfully with them about treatment options.
• End-of-life discussions can greatly decrease suffering and distress for both patients and their loved ones.
• Hospice patients live longer and more comfortably, usually passing away pain-free in their own beds at their own homes surrounded by loved ones.

Iocovazzi recommends strongly that we all become familiar with Advanced Healthcare Directives, which vary state by state.A good source for current directives in all fifty states can be found at http://www.caringinfo.org/, the website for Caring Connections, a program of the National Hospice and Palliative Care Organization (NHPCO), a national consumer and community engagement initiative to improve care at the end of life. On the bottom right corner of their home page, you’ll find a link where you can download the information for Louisiana or any other state’s unique advanced directives.Advanced Directives place us in control of what happens when life is coming to a close.  

Many of us are familiar with the term “code blue,” especially through television shows, but Iocovozzi is concerned whether we really understand what it is that happens to us and the likely results. To that end, there is an entire chapter graphically describing the reality of what happens during a code, and gives sobering information and statistics that certainly help us think through what we really want and how we wish to be cared for during this very special time in life that will be an opportunity for all of us, sooner or later.  

In the end (no pun intended), this is really a book about living well.If a human being has a life expectancy of about 72 years, we get about 26,000 days in our lives, a few more if we get lucky and a few less if not.When you look at the stark reality of those numbers, doesn’t it make sense to maximize the quality of life to the extent possible in each and every one of those days?Don’t you want to be the one making the decisions, if possible, about how you will spend each of those days?I promise you that this interview and this book will make you think.It’s not going to feed you any answers, because that’s for each of us to decide individually and with our families, but it will give you current and accurate information so that you can make wise choices.At the very least, let’s begin a conversation that can pay rich dividends for each of us, sooner or later.


                                        

                                           

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