Anyone read the new book by Ira Byock?

Published

Specializes in BNAT instructor, ICU, Hospice,triage.

http://www.amazon.com/The-Best-Care-Possible-Physicians/dp/1583334599/ref=sr_1_1?ie=UTF8&qid=1333882171&sr=8-1

I think this is a new passion of mine. I did an info visit and the family just can't quit dialysis on dad. So my kids and my future grandkids are paying the consequences of trillions of dollars in debt. And this family is spending $50,000 per month (for the last 10 years) to keep this guy who cannot feed himself, does not know a penguin from a medication, from a family member. Suffers a lot of anxiety, has zero quality of life, but they want to keep him on this earth longer longer longer, instead of giving him a peaceful meaningful final chapter of life.

There is such a beautiful place waiting for us, and they want to spend incredible amounts of money, and cause pain and torture to keep him in this awful place? I just don't understand it, and I strongly feel the need to educate people on the importance of talking about these things with your medical POA in detail. SOOOO important that they know how you want to be treated and follow your wishes.

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Specializes in LTC.

Thanks for posting this link. Just put it on my Amazon wishlist.

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That reminds me!

Everything by Atul Gawande is an easy read and very inspiring about the quest to better healthcare:

Amazon.com: Advanced Search - Atul Gawande: Books

edit: I'm sorry. His books have little to do with hospice. BUT he did write this lovely piece on hospice last year: Letting Go- The New Yorker

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I love Atul Gawande's article in the New Yorker.

Our local paper has had a series on end of life care. I will quote one paragraph but any misspellings or misprints are my mistake. Honestly it wasn't a political article.

"Taking advance placement to heart one hospital system in Wisconsin has earned the reputation as one of the best places in America to die. Its end of life program was a model for a provision in President Obama's landmark health care legislation. The White House abandoned it after opponents raised the specter of death panels."

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I love Atul Gawande's article in the New Yorker.

Our local paper has had a series on end of life care. I will quote one paragraph but any misspellings or misprints are my mistake. Honestly it wasn't a political article.

"Taking advance placement to heart one hospital system in Wisconsin has earned the reputation as one of the best places in America to die. Its end of life program was a model for a provision in President Obama's landmark health care legislation. The White House abandoned it after opponents raised the specter of death panels."

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Specializes in nursing education.

Wow, the New Yorker article articulates so well what I have long believed, and have seen over and over in my health care career (in oncology, home care, long term care, primary care, less so in hospice but still even there). Over, and over, and over again..death is failure, do everything, no matter what it entails. So sad and so disengaged from reality.

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I think some families keep people like this alive firstly because they don't pay for it so therefore the cost is meaningless to them and they can use the property of the person and/or cash their benefit checks as long as they breath air. I'm sure some family member is appointed to direct the funds and "take care of ______"

If you want your wishes known make them clear in writing and have your attorney have copies of the paperwork in addition to family. I don't know when people are going to catch on to how necessary this is to do. I guess it doesn't get done because that would require engaging something called personal responsibility, something I rarely see much of anymore.

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If we're to give cost of care much weight in our healthcare decisions then I imagine cancer treatment, transplant surgery, and HAART therapy would be a lot less popular. Luckily, that's not the case.

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Specializes in PICU, NICU, L&D, Public Health, Hospice.

Family members, at the end of life for their loved one, are not necessarily "thinking" about money or reality or common sense...they are grieving and hurting and doing the best that they can.

They respond to the medical information and education that they have been provided over a period of time. Many, many of them have never been educated as to what to anticipate for gramma with COPD or Renal Failure or Heart Failure, etc, at end of life. Some of them have never discussed options with their loved one or health care provider. NEVER.

And so they spin, and get through it the best they can.

Our medical system is as much to blame for the expensive provision of care at the end of life as individual lay people are.

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Specializes in Oncology, Palliative care.

Wow, Atul Gawande's article is very long but interesting!

There is one statement in there that stood out for me:

"You live longer only when you stop trying to live longer".

I will be checking out that Ira Byrock book too, thanks!

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Specializes in Hospice.

The New Yorker article was really good. Thank you. Long but I highly recommend.

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