A Racial Gap in Attitudes Toward Hospice Care

Dateline Buffalo: Twice already, Narseary and Vernal Harris have watched a son die. The first time — Paul, at 26 — was agonizing and frenzied, his body tethered to a machine meant to keep him alive as his sickle cell anemia  progressed. When the same illness ravaged Solomon, at 33, the Harrises reluctantly turned to hospice in the hope that his last days might somehow be less harrowing than his brother’s.

This is a fine article about hospice use in the black community. about why it is less frequently sought, and why blacks distrust the health care system.

Helping Patients and Doctors Talk About Death

"Medicare announced plans in July 2015 to reimburse doctors for talking with patients about what treatments they want — and don’t want — toward the end of life. This sensible, long-overdue proposal is likely to have a very wide impact. About 80 percent of people who die in the United States each year are covered by Medicare, and Medicare policies are often followed by private insurers, some of which already pay for these advance-planning conversations.

"Virtually all experts agree that medical professionals will need additional training. Many doctors are uncomfortable talking to patients about planning for death."

See NY Times Editorial.

How to Talk About Dying

by Ellen Goodman, NY Times, July 1, 2015

This is an extraordinary essay.  Well worth studying.  It’s common sense that we need to be reminded of.

Excerpts:

The difference between a good death and a hard death often seemed to hinge essentially on whether someone’s wishes were expressed and respected. Whether they’d had a conversation about how they wanted to live toward the end.

So, a small group of us — each with his or her own story — started the Conversation Project, a nonprofit, out of the belief that surely we could make this easier. (also see the Conversation "starter kit." Our partners at the Institute for Healthcare Improvement gathered experts frustrated at the pace of change who believed that the health care system wouldn’t change until the culture changed. So we are trying to change the culture.

There is now, finally, a real momentum for improving end-of-life care. The signs range from the Institute of Medicine’s report, “Dying in America,” to the success of Atul Gawande’s book “Being Mortal.”

There is also a growing public awareness of the need to break through the reluctance that has kept us tongue-tied for so long. A survey we did last year showed that 90 percent of Americans now think it’s important to have the conversation. But the same survey showed something else: Only 30 percent of us have actually had these conversations. So the gap remains huge.

From all the stories shared with us, we know that what people need most is help getting started. They need a travel guide to take the first steps down an unfamiliar and difficult road. So we created a ConversationStarter Kit.

Dying is not just a medical experience, it is also a deeply human experience.

How Therapicts Grieve

A therapist may spend hundreds of hours, perhaps more than a thousand, hearing about a patient’s most exalted aspirations and most murderous, hateful fantasies. During this time, the patient may endure excruciating losses, unbearable shame, bitter sadness and great triumphs. You may accompany patients through torturous adolescence into adulthood. Or you may meet them in middle age and be with them as they age and eventually die. You collaborate in a deep process of discovery.

Few encounters are this deeply honest, and therefore intimate. The attachment engenders profound feelings, a particular kind of love.

Dr. Robin Weiss' sensitive essay in the NY Times (July 5, 2015) is a good source of insights.

Mother Describes Giving Birth To Stillborn Son

After Dr. Eleni Michailidis delivered a stillborn son, she and her husband sought to honor their infant and the experience. She tells her story in this video.

This is a moving video -- from the heart.

The Farewell Party

From the NY Times Review by Stephen Holden

“The Farewell Party,” an Israeli comedy about euthanasia, steers a careful course between humor and pathos while playing down overtly political and religious arguments for and against assisted suicide. The first feature of its creative team, Tal Granit and Sharon Maymon, “The Farewell Party,” which won them an Ophir Award (the Israeli Oscar) for best direction, is set in a Jerusalem retirement home in which one resident, an amateur inventor, devises a “mercy-killing machine.” News of the device leaks to the home’s other residents. That inventor, Yehezkel, a robust bear of a man (Ze’ev Revah) and his wife, Levana (Levana Finkelshtein), a couple in their 70s, are distressed by the acute suffering of their friend Max (Shmuel Wolf), who is dying of cancer and against his will is kept alive by doctors. Max’s wife, Yana (Aliza Rozen), entreats Yehezkel to assist Max, however he can, in ending his agony.

I have not seen this yet.

An Unpleasant Truth About Youth Suicide?

Joe Flood, an English teacher at Pine Ridge, tells an important story.

Suicide epidemics come to the Pine Ridge reservation every few years with varying degrees of national media attention and local soul-searching. What the news media often misses though, and what tribal members understand but rarely discuss, is that youth suicides here are inextricably linked to a multigenerational scourge of sexual abuse.

This is an insightful and important essay that has relevance to First Nations people and other youth suicides.

Read: What’s Lurking Behind the Suicides?

May 17, 2015 New York Times