I am completely mesmerized by how our advances in technology have like an eclipse blinded us to the need for the human touch in healthcare, especially when tending to those with chronic illness. Also, as my parents are living the latter stage of their lives, and I just lost my mother in law last week, I am equally curious how do we plan for a good death?
To that end, I’ve just started reading, The Conversation: A Revolutionary Plan For End-Of-Life Care. It’s author, Angelo E. Volandes is a doctor and shares this at the beginning of the book:
“Despite its focus on the twenty first century American approach to dying, the true subject of this book is life, because a life well lived deserves a good ending. When asked where and how they want to spend their last few months, nearly 80 percent of Americans respond that they want to be at home with family and friends, free from the institutional grip of hospitals and nursing homes, and in relative comfort. However, only 24 percent of Americans older than 65 die at home; 63 percent die in hospitals or nursing homes, sometimes tethered to machines, and often in pain. The reasons for this discrepancy between the type of medical care people want at the end of life and the type of care they actually receive are many, and include hospital culture, medical reimbursement schemes and legal concerns; but the discrepancy is largely due to the failure of doctors to have discussions with patients about how to live life’s final chapter. This is one of the most important problems facing American medicine today.
Despite the billions of dollars that are invested in new technologies in Americas finest hospitals, the most important intervention in medicine today happens to be its least technological; timely and comprehensive discussions with patients as they near death. Without this open conversation about death, patients are traumatized needlessly, leaving their families with the emotional scars of witnessing the hyper-medicalized deaths of their loved ones.”
Last week I also watched the new PBS documentary “The Quiet Revolution.” It shares the story of a small town doctor who knows relationships are the vital part of medicine, as is community. The documentary begins with how he tends to his patients, almost all of whom suffer with diabetes. The second story highlights a telehealth company in Mississippi, the state that’s won America’s first place for obesity several years running, helping people with diabetes bring their disease under control. The third story portrays healthcare in Alaska for native people and the rise of one young native woman who has created innovations for the community.
It’s barely a whisper and still hardly done in medical schools to offer training in communications and talking with families, yet here and there there is a small groundswell of those who know that putting the care back into healthcare is what we so urgently need to do, especially as we are living longer and living with one or more chronic illnesses as we age.