Posts Tagged ‘doctors’

Coming to Terms with Fatal Disease: Talking with your Doctor

Friday, October 30th, 2009

The Doctor by Luke Fildes

The Doctor by Luke Fildes

If you do not die suddenly from an accident, heart attack or stroke, chances are you will die a slow death from disease or simply from aging. Unfortunately, in the latter case, doctors are well trained in every possible aspect of saving a life, but little on how to treat death and dying. So, if you are diagnosed with a fatal or chronic condition, how do you talk with your doctor effectively?

When you are diagnosed with a fatal illness or chronic condition, try to discover as much as possible about the medical facts about your condition. Most doctors are overworked, and many lack the skills to offer counseling for the emotional aspects of dealing with your illness. But, most doctors can provide facts about your condition. Additionally, you can use other resources, as noted below, to learn more about how to deal with your condition emotionally.

The following questions were gathered from Dr. Daniel R. Tobin’s book, Peaceful Dying, a step-by-step guide to preserving dignity, your choices and your inner peace in death and dying. These questions were designed to get as much information from your doctor about your condition as possible:

  • What are my treatment options?
  • What is my prognosis?
  • How long do you think I have to live? (while there is no surefire way for a doctor to predicit how long you’ll live, you can get a general idea of the life span of most people at your stage of disease)
  • What are the side effects of the treatments you are suggesting?
  • How much time do I have to make up my mind about which treatments to use? How will that time affect my treatment?
  • What treatments exist outside those offered by traditional Western medicine and where can I research such alternatives? (most doctors do not know much about alternatives, so you may have to search a little further to find answers to this questions)

Some tools you can use to find more answers include:

  • Get a second opinion and answers to your questions above.
  • Read more about your disease in books (written within the past five to ten years for the most updated information).
  • Join support groups for patients with your disease, and encourage your family members to do the same.
  • Surf the Internet for more information about your disease and treatments for that disease.
  • Seek counseling if needed with a specialist who understands grief, death and dying. This counseling can be invaluable for both you and your family.

When you are diagnosed with a fatal or chronic disease initially, the information you gather may be far different than information available to you as your disease progresses. Be sure to stay on top of new developments in your disease, as you never know when something might occur that either could ease your suffering or prolong your life.

In other words, while your doctor may be the best expert in his field, he may not know all the answers to your particular situation. You are responsible for your life and your death in many cases. So, take charge and live your life with dignity.

On a final note, sometimes diseases come on quickly and can incapacitate you without warning. Therefore, it might be wise to share this information with your family so that sharing in the responsibility becomes a family affair. When family members understand how to recognize and help treat H1N1, for instance, that knowledge may help to save a family member’s life.

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Posted in Causes of Death, Death & Dying, Grief and Grieving | No Comments »

New Reports: Caregivers, Doctors and Patients on Dying

Thursday, June 18th, 2009

Nearly two-thirds of Americans [PDF] believe the law should empower terminally-ill, competent patients to choose how they will end their lives. Yet, the AMA’s (American Medical Association) outspoken opposition to aid in dying has been cited by the Supreme Court and influences lower courts, state medical societies, and most important, legislatures.

The AMA claims to speak for doctors, and the media often echo that assertion, yet barely a quarter of the nation’s physicians are AMA members. Many medical and public health organizations have policies that support aid in dying, including the American Medical Women’s Association, the American Medical Student Association, the American College of Legal Medicine and the American Public Health Association. Still, according to a study recently conducted by Georgetown University Hospital, nurses, doctors and patients all feel some frustration, fear and abandonment during the end-of-life cycle for a patient in a hospital setting.

Nurses, in particular, who completed an End-of-Life Nurse Consortium Course, were asked about their training. Surprisingly, about 52 percent of nurses in the study said they never received this training, yet 43 percent reported they had been involved in one to three end-of-life situations within the previous six months.

Over 100 nurses attended the course, and while survey results are still pending, there have been some changes. All newly-hired nurses at the hospital now receive the training, and all of inpatient oncology and hematology nurses are required to take the end-of-life training course. The study found nurses that receive end-of-life education and training can positively impact the lives of patients and families facing difficult times, according to the report at WFTV. According to the news story:

Another study shows patients who are dying and their families report that feelings of abandonment by their physicians at the end-of-life have two components: a loss of continuity of care before death and a lack of closure near death or afterward. “Early on, patients and family caregivers fear that their physician, whose expertise and caring they have come to depend on, will become unavailable,” the authors write. Most physicians are not consciously aware of having abandoned their patients. Instead, they report lack of closure or a feeling of unfinished business. The report could help physicians structure care to maintain the professional value of non-abandonment, including use of non-hospice palliative care or closure-promoting communication strategies involving nurses and other members of the health care team. As end-of-life approaches, physicians should offer assurances that they’ll still be available and should maintain contact with the patient and caregiver, according to Anthony Back, M.D., of the Seattle Cancer Care Alliance, and colleagues.

Interestingly, patients with advanced cancer who discuss end-of-life care with their physicians appear to have lower health care costs in the final week of life than those who do not, according to a report in the Archives of Internal Medicine. Formal and informal caregivers who were interviewed after the patients’ deaths reported that those with higher costs also had a worse quality of death in their final week.

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Posted in Caregivers, Death & Dying, Death Practices, Hospice, Patients | No Comments »