Time Magazine teaches us How to Die

Some of you may have caught the stark red cover of Time magazine last week with the bold white font and minimalist design, which let you know lurking within those pages was a story that would let you know “How to Die.”  (Subscription required)  Now as you may recall, Time magazine was recently lauded/lambasted for the breast feeding cover featuring a 3 year old on his mother’s breast. So initially I thought this was Time magazine jumping into sensationalism again to increase magazine sales, but then on further thought would people really be stampeding the newsstands for this subject?

Upon reading the tagline “What I learned from the Last Days of My Mom and Dad,” the concept of the article became more clear. I have been noticing in the past year the increasing attention in books, news, movies, TV around caring for aging parents as it becomes a common topic for Baby Boomers. The author of this article Joe Klein gives you the essence of his article in the video embedded below (email readers click here for the original post).



The main theme of the article was the power of fee for service reimbursement causing health care professionals to push for more procedures and tests instead of taking the time to have hard conversations about the progressive frailty of dementia and aging. A feeding tube placed without much discussion, challenges in enforcing surrogate decision makers, and other situations that most hospice and palliative care professionals have heard about before.

The main turning point for Mr. Klein were ongoing discussions with geriatricians from Geisinger in Pennsylvania, Dr. Devan, and Dr Maxin. From a brief search on the web I don’t believe they are palliative care doctors but from their discussions they clearly are geriatricians in the Geripal mode. Of course you can’t have a mainstream media news article without some cliché photos, in this case Time opted for “empty nursing home hallway devoid of life except for a tree which might be fake” and “somber looking doctors in an otherwise empty room”. I don’t know Dr. Devan or Dr. Maxin, but I’m sure they are much more fun-loving people than this picture makes them appear.

The article is overall a fair representation of what many of our family member’s likely experience, but in reading the article, it felt more like therapy for the author than journalism. Did anyone else feel this way in reading it? Mr. Klein even notes:

“But we grieve in different ways, and my way, I guess, is to write about it – and also to examine the policy implications of how we treat the elderly.”

I do wish Mr. Klein choose not reinforce terms like ‘pull the plug’ and repeating that he was his parents’ “death panel” but I also realize that families I have worked with said these things and felt that way so I can understand. It was also a missed opportunity to do some education about hospice services for non-cancer diagnosis like dementia as his parents had. The two mentions of hospice are far from ideal. The hospice social worker is portrayed as a necessary villain because of a threat to call adult protective services when Mr. Klein’s father was not adequately caring for himself, his wife, nor his two sister-in-laws. The other mention of hospice is at the very end of the article just like in so many patients’ lives where hospice is only allowed to come in at the very end when the benefit could have been utilized for so much longer.

We are going to see many more articles like this. Join me in analyzing these stories and let’s talk about the impact on our field and how end of life issues are portrayed. We have a chance to make a difference by telling our own stories using the rich and inexpensive multimedia afforded by the internet and by working closely with the old guards of communication. Already there are internet message boards filled with talks about conspiracy, rationing, and a general disdain for life whenever anyone tries to discuss dying. There is a chance we may move backwards in humanities understanding of the balance of life and death. You all make a difference at every bedside you serve, but think about ways to bring that positive message to more people.

And if by chance you find any more cliché photos in news articles about end of life care, please send them to me at christian@pallimed.org. I would love to make a collection of them to help photographer be more creative. Feel free to offer alternatives to these cliché photos in the comments.