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September 2015

Dying at What Cost – And in Peace or in Pain?

Washington Watch

 

Doctors are different than you and I. They know how to die. They do not tell family and colleagues to do “everything you can” to save them.

 

This may surprise you, but doctors often choose less end-of-life care for themselves than the average patient – an important lesson for seniors as they discuss end-of-life care decisions with family members. In July, the Centers for Medicare and Medicaid Services (CMS), which administers Medicare, announced it will change its longstanding policy and begin reimbursing doctors and other health professionals, for the first time, for talking to patients with advanced stage diseases about their options for treatment.

 

In addition, Medicare announced it is conducting a five-year, 40-state experiment, allowing hospices to offer end-of-life care and counseling to dying Medicare patients at the same time those patients receive treatment to extend their lives. In the past, patients who are terminally ill must choose one or the other.

 

In November, 2011, Dr. Ken Murray, a Los Angeles doctor, wrote a powerful essay on the website Zocolo Public Square about the way doctors choose to die, a sharp contrast to how most of their patients do.

 

The post has since gone viral, and tens of thousands of people have likely read it. But for any senior or family member considering a hospital stay, or thinking about end-of-life decisions including living wills or advanced care directives, this is must reading.

 

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Bird Watching vs. Football Watching

The Grumpy Old Man

 

As another football season approached a few years ago, I happily prepared to settle in front of the TV. I was relishing countless hours watching superhuman behemoths violently collide amidst the exquisite ballet of a perfect spiral sailing 40 yards and coming gently to rest precisely on the fingertips of a speed demon sprinting flat out. But, unfortunately, in the middle of all this ecstasy, a depressing thought seeped into my head. I tried to block it but it was too late I got blindsided.

 

So here's the thought: if you do the same things over and over year after year, no longer learning and growing, you might as well be dead. Was I really prepared to spend the next several months in a state of semi-consciousness as one game blended into the next?

 

Don't get me wrong. I love football. It's a harmless way to channel destructive testosterone surges into an outlet slightly less controversial than punching people who disagree with you. But enough is enough. From 5 year olds decked out in so much protective armor they can hardly move, to 45 year olds on the disabled list while still making 30 million dollars a year, there's enough football in this country to send the American Orthopedic Association into a state of permanent ecstasy.

 

So once that nasty thought was implanted, I knew there'd be no football for me this season without a depressing cloud of guilt hanging over the stadium. I needed to grow! Find something intellectually stimulating! I pondered my dilemma and kept coming up empty. Take a course – too old. Run a marathon – too lazy. Play an instrument – too talentless. Then I happened to glance out the window. There, sitting on an unpruned shrub, was a bird. I had no idea what kind of bird it was. But it was obviously a messenger. I could see the contemptuous look in its eyes. "You pathetic couch potato," it said. "I fly, I explore, I travel thousands of miles on my own gas. What do you do?"

 

An idea struck like a linebacker in an all-out blitz. I'd find out about the life of that bird. In fact, I'd become a BIRDWATCHER! 

 

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