Medically speaking, we’ve come a long way. Innovations in hygiene, antibiotics, and vaccines have saved countless lives. Life expectancies have doubled since 1900. Medicine has made huge strides in cancer treatment, disease, and complex surgeries like organ transplants. But the one thing science can’t change is this: death is inevitable. Though no one can escape this fate, it’s something families have a hard time discussing.
The Death Positivity Movement
This idea began as an acknowledgment that death is a normal part of life. Mortality is a scary fact to face, but death positivity can be empowering for patients and their families. When families talk about death earlier, they can ensure that their final wishes are carried out. And while it’s hard to address what lies ahead, death positivity encourages patients with terminal illnesses to get the most out of the life they have left. Not only are there decisions to make about final wishes, but also with treatment and care.
What is palliative care?
When caring for terminal patients, the medical community used to rely on aggressive treatment. But evidence shows that these last-ditch efforts can cause pain, distress and even shorten patients’ lives.
A recent study of terminally ill lung cancer patients found that those who received palliative care — care to treat symptoms rather than seeking a cure — actually lived longer. Not only did this group outlive the “cure” group by over two months, they also had a better quality of life, spent less time in the hospital, and were more likely to have their last wishes clearly documented.
Caring for symptoms was traditionally more for terminally ill patients in hospice care. However, doctors are increasingly discovering the value of palliative, symptom-based care alongside more traditional, curative medicine. This allows patients to receive the best of both worlds nearing the end of their life.
Only 8 percent of Americans have a good understanding of what palliative care is. Despite these knowledge gaps, the death positivity movement is growing. Palliative care that relieves the symptoms and stress of a serious illness are now available at two-thirds of all American hospitals.
In a 2015 study of the best places to die, the United Kingdom topped the list as the best place to die, closely followed by Australia, New Zealand, Ireland, Belgium, Taiwan, Germany, The Netherlands and the United States, coming in at ninth place. As countries continue to improve the lives of their citizens, the index is a sign that they are also working to improve their deaths.
Early Conversations Make All the Difference
Though most people say they would prefer to die in the comfort of their own home, only 24 percent of seniors actually do. In their last month of life, half of all seniors receive emergency care, one-third are admitted to an I.C.U., and one-fifth will even have surgery.
This disconnect between wishes and reality often occurs because less than 22 percent of ailing, elderly patients have their preferences documented in their medical records.
Having the conversation sooner can help families be there for each other with love and support when patients need it most — towards the end.
Starting the Conversation
No one wants their loved ones to worry about their affairs when they’re gone. But most families don’t have the discussion until it’s too late, which leaves many personal decisions undecided.
The best way to ensure that your final days are lived according to your wishes is to have early conversations about palliative care and your end-of-life-goals. When patients make their wishes known in advance, family members are less likely to experience emotional trauma or advocate for aggressive care.
Living Out Your Wishes
Before a medical crisis develops, it’s important that doctors and family members know where someone stands regarding aggressive life-sustaining treatments like CPR, feeding tubes, and ventilators.
Only a third of all Americans have advanced directives, such as living wills, that detail their preferences for or against life-sustaining treatments. In addition to having a living will, it’s important to designate a medical power of attorney or healthcare proxy who will make decisions in the event of an emergency.
Planning for the Future
It’s also important to remember that the same things that ensure a good life — nutritious meals, strength exercises, and plenty of cardio — may also ensure a good death, and keep patients feeling younger and healthier for longer.
For more information about accessing palliative care and planning for end-of-life decisions, learn more about Brookdale’s wide array of hospice care services.