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Good EndingsMichael Glenwood

Good Endings

I met a patient I’ll call “Hazel” in the 1970s. She was like the grandmother I wish I’d had, so caring and thoughtful. Hazel went from one major catastrophe to another until she told me she no longer wanted further treatment. She wanted to be allowed to die.

 I reported that to the ICU team. The next morning on rounds, doctors stood outside her room, presented her case and then went on their way. They didn’t even say hello. The chaplain stopped them and said, “She doesn’t want treatment, and now we don’t even say good morning to her?”

They all went back and said hello, but I remember thinking, “There has to be a better way.” That’s how I got interested in end-of-life care.

I’ll give you another story. “Anne” was really worried that she’d be forgotten after she died. We talked about things that were important to her, and one turned out to be a collection of beautiful scarves. She went home and attached to every scarf the name of a loved one who should receive it after she died. Simple, right? But she was a different woman afterward—this was about Anne’s truly facing up to the fact she was going to die and taking control.

I can’t emphasize enough how important it is that we pay attention to the end of life and help people make the most of the time they have.

Helene Goldberg, MPH ’81, RN, CS-P, has worked with dying patients since the 1970s and is now a nurse psychotherapist specializing in loss and grief.

Comments

  • Wes Loombard

    VT 02/21/2013 08:38:39 PM

    Thanks for a great article on death & dying! I agree...lots to talk about and for sure hospice at home gives the patient & family a lot more dignity and saves everyone a ton of money! Keep up the good discussions!--Wes

  • Dawn Walcott

    Wolfe Street 03/12/2013 09:00:36 AM

    I really enjoyed your article. I went through home hospice care two times with my sister and mother. It was a horrendous experience both times. The home nursing left a lot to be desired and the stress on me was horrific and left lasting trauma.

    Maybe research can improve this, but I would not want to put such a burden on my children having experienced it first hand.

    It is not for the faint of heart.

  • Lael Duncan, MD

    San Francisco 03/12/2013 12:04:35 PM

    Mr, Duffy, this is an excellent piece. Bringing long range planning into the picture as we consider goals of care for any individual is critical. As an expert in Advance Care Planning, and knowing how it can be of help to the patient, family and system, I concur with your recommendations. Planning and some anticipation can relieve many of the burdens of end of life care, emotional, logistic and financial. These important interventions must move up stream in our public health system if they are to have real impact.

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