A little change of pace for the blog today . . .
Years ago, my dad had a stroke and since there were no other viable options we moved him to the Chicago area. He was not a happy person in those years, being a part of the generation where a physical disability was tantamount to not being a whole person. We had ongoing issues finding appropriate facilities for his care.
Finally we discovered a facility in a Chicago suburb which had been the infirmary for a Catholic order. As the number of potential patients declined, the order was forced to open it to the public by economic realities. I was concerned that the basic tenets of the Catholic church would conflict with my dad's desire not to have extraordinary intervention to prolong his life. I was very wrong.
For years we had been fighting the attitude of the traditional medical community that their mission was to "heal" by extending life. This principle is changing, but there are still a lot of people in the medical community who simply cannot comprehend that someone might not want to avail themselves of any possible treatment to extend their life, no matter the cost or side effects. For example, my dad's primary care physician recommended surgery at one point, but the surgeon told us that it was almost certain that the procedure would be fatal.
The people in the Catholic facility truly understood the ideas that we were having so much trouble with elsewhere. Much to my surprise, they did not consider a Do Not Resuscitate order tantamount to euthanasia. In fact, the wishes of the residents were unobtrusively encoded on the doorway of each room so that the staff could quickly determine how to react to medical crises based on the wishes of that specific individual.
The article that triggered this blog entry describes a facility much like the one that we experienced years ago. It should be required reading for all politicians involved with ruminations on health care reform. The contrast is stark between the "normal" way of dying in a hospital and the convent. We can't replicate this environment completely, but there are a number of lessons we should learn by observing it. A few quotes from the article:
As she lay dying, Sister Dorothy declined most of her 23 medications not essential for her heart condition, prescribed by specialists but winnowed by a geriatrician who knows that elderly people are often overmedicated.
. . .to clarify goals of care long before a crisis: Whether feeding tubes or ventilators make sense. If pain control is more important than alertness. That studies show that CPR is rarely effective and often dangerous in the elderly.
Some days, Dr. McCann said, he arrives with his “head spinning,” from hospitals and intensive-care units where death can be tortured, impersonal and wastefully expensive, only to find himself in a “different world where it’s really possible to focus on what’s important for people” and, he adds, “what’s exportable, what we can learn from an ideal environment like this.”
“Every time I speak to a group about the need to improve the dying process, somebody raises their hand and says, ‘You’re talking about killing old people,’ ” Dr. Carstensen said. “But nobody would accuse Roman Catholic sisters of that. They could be a beacon in talking about this without it turning into that American black-and-white way of thinking: Either we have to throw everything we’ve got at keeping people alive or leave them on the sidewalk to die.”
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