Mike Vitez at the Philadelphia Inquirer has done a great story on palliative care at a community hospital. Mike weaves the deeply touching story of Mary Tole, a 74-year-old woman who spent two months in the suburban Philadelphia hospital with an undiagnosed illness. She spent much of that time in an intensive care bed in a coma.
Mike describes how the hospital’s palliative care team and Mary’s family struggled with how much treatment she should get, or whether she should be allowed to die as comfortably as possible. He also talks about the cost of her care–$775,000–Medicare’s role, and Mary’s out-of-pocket expense: $900.
This piece is an excellent antidote to all the foolishness and misinformation in the debate over “death panels” last summer. There is no more difficult or complex subject than end-of-life care. And Mary and her family still struggle to confront what happened to her, and what they will do when she again faces such a medical crisis.
As individuals, as family caregivers, and as a society, we need to address this issue head-on, and recognize there are no simple answers. Mike’s story helps us do that.
Congress made a horrible mistake when it allowed itself to be bludgeoned into dropping a provision of health reform that would have allowed Medicare to pay doctors to discuss end-of-life issues with patients.Mary’s story is an example of the price we all pay for not having that conversation.
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How about making every American’s e-health record have a living will in it? Every time I go to the doctor, he or she would ask me if I want to make any changes to my living will. While we’re living we need to keep death daily before our eyes.
Eric Schubert
Ecumen
changingagingblog.org
Eric;
You’ve got my vote, especially for putting living wills in EMRs. The question is, who would make people do this? After the death panel business last summer, it is clear Americans will not stand for government imposing such a requirement. And docs would surely object if they had to have this end-of-life discussion without getting paid for it (many would object even if they did get paid, or would do a lousy job).
Instead, it seems this is going to take a massive education effort. We all need to work a lot harder to help both patients and docs understand what advance directives are and why they are so important.
Cool front page article in yesterday’s Minneapolis Star Tribune on end-of-life tool being used by Minnesotans. Link below:
Key in its development was Edward Ratner, M.D., a professor in medicine at the University of Minneaota, specializing in Geriatrics and Home Care Medicine. He actually does house calls to seniors throughout the Twin Cities.
http://www.startribune.com/lifestyle/health/87173072.html?elr=KArksi8cyaiUncacyi8cyaiUiD3aPc:_Yyc:aUU
This gives me hope that a state could lead the nation in developing an end of life tool.
Eric Schubert
Ecumen
http://www.changingagingblog.org