Tuesday, January 31, 2006

A physician on futile end-of-life care: ". . . the health care equivalent of Hail Mary passes."

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Comments:
End of life care is a tragic waste of money. About 50% of the healthcare dollar is spent in the las months of a patients life. We torture 85 year olds with ventilators, central lines, surgeries, dialysis. Why? Because families want to feel "that everything was done" even though they would never want to be tortured like that themselves. And they can find lawyers that will back them up
# posted by Anonymous Anonymous : 1:59 PM
 
Been there, done that, I was a family member where my mother wanted everything done. However, at no time did anyone offer me an alternative. At the very end (after medical mistake after mistake) when my mother was on dialysis, a ventilator, and had a peg surgically implanted to feed her, when she was tied down to the bed like an animal because of the itching she had from the dialysis, I had to bring up the possibitity of hospice. The hospital wanted to continue to keep her alive, and on all these machines and ship her off to a place so far away the family could never get there. Senior care gets messy and there need to be guides and options given to the patient and the patient's family. If you want to see more of my journey, go to gag@judyanddan.com.

Judy who would like to be able to do something!
# posted by Blogger Judy : 4:20 PM
 
Weird article...comments about end of life care costs then veering off into a plan whose primary proposal is to limit patients' access to docs. Less care = cheaper care & computers will solve all our problems.

Care at the end of life will always be messy and expensive. A lot of money is spent but often at the time it's not clear that the person is dying and that the money will be 'wasted.' Expanding palliative care into places like the ICU will help prevent situations like Judy's mother's, but as long as death is seen as avoidable and a failure, and as long as medicine feels its mission is to stop death, situations like Judy's mother's will continue.

--Drew. Pallimed: a palliative medicine blog
# posted by Blogger Drew Rosielle, MD : 11:13 PM
 
I've been a physician in massachusetts for 8 years now, and I didn't even realize we have palliative care in this country. I saw it when I was a med student in Canada, it was a great system, but palliative care in the US seems non-existent. Either you want "everything done", or there's something wrong with you seems to be the credo here. As for Judy, I mean no disrespect, but the hospital where your mom was probably was worried they'd be sued if they didn't "do everything"
# posted by Anonymous Anonymous : 12:43 AM
 
By generalizing about "85-year-olds on vents" you risk denying worthy elderly patients the aggressive care they need to overcome serious illnesses that may be curable.

Furthermore, some of these elderly may have been healthy all their lives, and prolific taxpayers to boot. One can argue that they earned the right to use "end of life" healthcare dollars if they wish to try to fight for their lives.

Here's what happened to my father and myself when doctors didn't care to honor the family's wish that "everything be done" because they knew better:
http://users.starpower.net/neustadter/menu.html
# posted by Anonymous Anonymous : 6:09 PM
 
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