Sunday, March 14, 2010
I couldn't wait until next month's palliative care grand rounds and so I had to post a link to each of these three wonderful blog posts to make sure you knew about them.
One from Joanne Kenen at The New Health Dialgoue from the New America Foundation:
In the article "This is Why We Need Palliative Care" Joanne comments on an article in the journal Health Affairs called "Shock Me, Tube Me, Line Me." An exceprt from her post:
End of life, he writes, can be done better. He’s correct. It can. "Give me a motorized wheelchair and a feeding tube if I need them, along with a tracheostomy to help me breathe and dialysis to filter out toxins. Those do nothing to stop a good mind and a strong spirit, while permitting both to overcome obstacles of blood and flesh." That's his opinion and his wish.
And two from GeriPal:
Patrice Villars a nurse practioner writes on "Maintaining Relationships: Stop Using the Words ‘Terminal’, ‘Dying’, ‘Hospice’, ‘Advance Directives’ and ‘Bereavement’ that Push Others Away"
An exceprt from GeriPal:
Our audience – patients and families – often don’t want to hear about dying. Death and dying is scary. Scary equals reactionary sound bites (i.e. death panels) that can dash any hope we have of reasonable reform and ongoing open relationships. (Ex. Advance directives talks with your physician = dying = fear = death panel = killing Granny and babies with Down’s syndrome). And guess what other words also equal death to our audience? Terminal. Advance directives. End-of-life. Hospice. Yes, and even bereavement. As long as the majority of our patients/families (to say nothing of our health care colleagues) associate palliative care with dying, they will not have access to our services.11 comments on that one so you know it got people stirred up.
Whoa, this is a lot to take in. You mean don’t use the words we have been using for decades to demystify the fear and denial of death in our culture? Isn’t this who we are? What about the movement we have come to birth, nurture and protect? Really, stop using those words?
Brad Stuart, MD has an enthusiastic rallying cry for palliative care, hospice and health care reform titled: "Talking Palliative Care and Death: Get Up, Stand Up, Grow Up"
"Why has dying become “radioactive?” Because Sarah Palin, PR master, made it that way with her Death Panel comment on Facebook. With one (more) semi-conscious crazy-ass remark she made “fear of death” the brand for all end-of-life considerations. And because optics is everything in our surface-obsessed culture, the world bought it. Are we following the world on this one? Uh-oh – I smell fear in the room. In fact a subtle scent of fear pervaded many of the meeting rooms in the Hyde Center last week. Did you notice?
Let’s talk bottom lines. Below are four fundamental reasons why I believe palliative care is critically important to health care reform. Forget radioactive. Talk about it. Just persevere. Outlast the resistance: this is a basic spiritual principle. Don’t be cowed. If the system is to wake up, that process needs to start in our own minds.These three articles are as important to our field as any editorial written in JPSM, JPM, NEJM or JAMA. And now you can make your voice heard go comment on these posts! Share them with your boss and team.