End-of-Life Issues
Before today’s modern medicine, people usually died of three things: injury, infections or some type of nutritional deficiency.1 Painkillers may have come in the form of herbal tea or some other applied root, so pain was a fact of life. Life expectancy was much shorter than today, and people often died suddenly or after a period of not feeling right but not knowing why. Most of the time, people died at home surrounded by family and loved ones.
Today, not so much. Four out of five Americans die in either a hospital or a nursing home.2 With medical advances, we are a nation both capable of and preoccupied with keeping people alive, including by artificial means.3
In accepting our eventual death, we must face the responsibility of preparing our estate and our health care proxy paperwork to help control how we face death. However, many people fail to take these actions. Recent studies revealed that nearly three quarters of adults have no health care proxy, living will or advance directive, and only 42 percent have a will.4
Whether sick or well, young or old, it’s important to maintain a will, up-to-date financial beneficiary forms and health care directive documentation. If you could use help figuring out what legal paperwork you need to complete, we may be able to refer you to a qualified attorney in our professional network.
Today, advanced medical technologies help pull us through events that in a previous era would have been fatal. We can better manage pain and multiple chronic conditions. While it’s great to live longer and feel better, that shouldn’t prevent us from considering our end-of-life preferences. After all, everyone dies sooner or later. Have you thought about how you’d like to go? Have you asked yourself if you would want more procedures to keep you alive, more time in an intensive care unit, more CPR and/or to be kept alive by machine?
Whatever your decision, make sure your wishes are known, both in legal documentation as well as in discussions with your loved ones. So many times, an elderly person will become weary of all the treatments and just want to die in peace. And just as many times, his or her family members will not accept this decision. That’s a painful problem for everyone involved.
How much health care is too much? Research on Medicare beneficiaries indicates that almost one in three undergoes an operation within a year of their death and that this event can actually do more harm than benefit.5 Other studies have shown that people who received intense care during the last six months of their life were no more likely to live longer than those who did not.6
These end of life issues do not rest entirely on the shoulders of the elderly and ill. Our health care industry focuses on prolonging life. Our physicians are drilled to “first, do no harm.” Health care is driven by the fee-for-services payment model, so doctors and pharmaceutical companies are financially rewarded for ordering more tests and screens, performing surgical procedures and prescribing medications.7
Therefore, each individual has to decide for himself or herself when enough is enough. Among terminally ill patients, 80 percent say they don’t want to die in a hospital.8 Those who complete the appropriate paperwork may have the opportunity to make this decision for themselves.
Content prepared by Kara Stefan Communications.
1 Haider Warraich. Knowledge@Wharton. Feb. 19, 2018. “How Modern Medicine Changed the Way People Die.” http://knowledge.wharton.upenn.edu/article/modern-death/?utm_source=kw_newsletter&utm_medium=email&utm_campaign=2018-02-22. Accessed March 20, 2018.
2 Ibid.
3 Ibid.
4 Kelli B. Grant. CNBC. Nov. 15, 2017. “Got a will? Here are 11 more end-of-life documents you may need.” https://www.cnbc.com/2017/11/15/12-financial-planning-documents-to-handle-health-end-of-life-care.html. Accessed March 20, 2018.
5 Liz Szabo. NPR. Feb. 28, 2018. “Too Late To Operate? Surgery Near End Of Life Is Common, Costly.” https://www.npr.org/sections/health-shots/2018/02/28/589282187/too-late-to-operate-surgery-near-end-of-life-is-common-costly. Accessed March 20, 2018.
6 Ann Brenoff. Huffington Post. July 14, 2017. “Want Control Over Your Death? Consider A ‘Do Not Hospitalize’ Order.” http://www.huffingtonpost.ca/entry/do-not-hospitalize-orders_us_59666c35e4b0a0c6f1e54ed9. March 20, 2018.
7 Liz Szabo. NPR. Feb. 28, 2018. “Too Late To Operate? Surgery Near End Of Life Is Common, Costly.” https://www.npr.org/sections/health-shots/2018/02/28/589282187/too-late-to-operate-surgery-near-end-of-life-is-common-costly. Accessed March 20, 2018.
8 Ann Brenoff. Huffington Post. July 14, 2017. “Want Control Over Your Death? Consider A ‘Do Not Hospitalize’ Order.” http://www.huffingtonpost.ca/entry/do-not-hospitalize-orders_us_59666c35e4b0a0c6f1e54ed9. March 20, 2018.
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