Thursday, August 4, 2016

The High Price of Dying

My father passed away last year. A vibrant and healthy man through out his life, he was now suffering from cancer and experiencing the early signs of dementia. As I prepared to go home to Boston to be with him, I consulted a former colleague and renowned physician, who laid out for me what I could expect for my father moving forward: He would become weak and sick from chemo, would soon have a compromised immune system and become unable to fight an infection or common cold. As a result, he would most likely and ultimately end up in the ICU of a hospital battling pneumonia (a fight he would soon lose). And at the end of all of this, he would be reliant on machines to keep him alive for some indeterminate amount of time.

I knew this was not what I wanted for my father and more importantly, I knew this was not what he would want either. And so my family and I chose to move him to a wonderful hospice facility, where he peacefully spent his last few days free of machines, comfortable and surrounded by family in a beautiful and calm setting. While it was an incredibly difficult time, I was comforted in the choice we were able to make regarding my father’s end-of-life care.

As health care professionals, we are focused on patient outcomes and restoring their health. As an industry, what we sometimes fail to realize is that the best outcome can sometimes be dying. Each year, it is estimated that 30% of Medicare expenditures (over 50 billion dollars) are attributed to the 5% of patients that will die that year with one-third of those costs occurring in the last month of life.  Furthermore, most studies show that if the person is sick enough, this type of medical intervention does not have a positive impact. In fact, it can make those last days and months of life worse.

I believe that we need to not only provide opportunities to openly discuss end of life options with patients before it is too late, but also devote resources to offering patients and their families the kind of services and space they need in those final difficult days. It was what I was able to provide my father and what I think all families deserve. Don’t you agree?

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