Oct 9 2012

How to Live.

From the TV shows we’ve been watching to Monday's New York Times op-ed by Bill Keller, it’s clear that something is going on. Something big. Something powerful. 10,000 baby boomers A DAY are turning 65. We've gone from the "sandwich generation" term to the new phrase: the "club sandwich" because we're taking care of kids, siblings, parents, aunts/uncles, and some grandparents. So, perhaps it’s time to have a conversation about how we want to live. Shift the focus. Empower ourselves to be a part of our future - whatever that may be.

In Monday's op-ed, Keller writes eloquently about the end of his father-in-law’s life before exploring the differences between a health care system that allowed his father-in-law peace at the end of his life and our own in the United States:

When they told my father-in-law the hospital had done all it could, that was not, in the strictest sense, true. There was nothing the doctors could do about the large, inoperable tumor colonizing his insides. But they could have maintained his failing kidneys by putting him on dialysis. They could have continued pumping insulin to control his diabetes. He wore a pacemaker that kept his heart beating regardless of what else was happening to him, so with aggressive treatment theycould— and many hospitals would — have sustained a kind of life for a while.

But the hospital that treated him offers a protocol called the Liverpool Care Pathway for the Dying Patient, which was conceived in the 90s at a Liverpool cancer facility as a more humane alternative to the frantic end-of-life assault of desperate measures. “The Hippocratic oath just drives clinicians toward constantly treating the patient, right until the moment they die,” said Sir Thomas Hughes-Hallett, who was until recently the chief executive of the center where the protocol was designed. English doctors, he said, tell a joke about this imperative: “Why in Ireland do they put screws in coffins? To keep the doctors out.”

Keller asked an end-of-life specialist in the United States about the chances of something like his father-in-law’s experience happening here. The specialist said: “Zero.”

Keller explores why that might be, delving into the political controversy that arose a couple years ago over the so-called “death panels.” Here’s what we think though: dying in the U.S. doesn’t have to be that different from the Liverpool process.

We too can know the peace that Keller’s father-in-law did when he told his daughter: “I have fought death for so long. It is such a relief to give up.”

While we may not have a special protocol like the Liverpool Care Pathway for the Dying Patient, we do have advance medical directives, which not only allow you to make your own healthcare decisions in case you’re in a situation where you can’t speak for yourself, but also prepare you for the end of life. Directives are a document too many of us avoid. And the conversation about them with our family and friends is something some prefer to not do, but planning ahead and starting the conversation now is too important to not do.

Need help starting the conversation? Check out our conversation starters.

Have you had the conversation? Share what you learned and provide tips for others still trying to have the conversation.


Advance Directives Bill Keller Conversation New York Times Sandwich Generation

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