Quality of Life at the End of Life

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Studies show that a good ‘quality of life’ is as important to people in the last days of their lives as it is throughout the rest of life. Most people say they’d rather die at home than in a hospital, yet in Vermont death occurs more commonly in a hospital or a nursing home than anywhere else.

Why the discrepancy between what people want and what actually happens? Lawmakers have been gathering answers to that question from the public, from caregivers and medical professionals. They’ve just released recommendations on palliative care,end of life care and pain management that they say are more cost effective and more humane.

We talk with Senator Ginny Lyons, who co-chaired the Vermont study. Also, we hear from Dr. Allan Ramsay, director of Palliatrive Care at Fletcher Allen Hospital and Diana Pierce, President of the Hospice and Palliative Care Council of Vermont. (Listen)

Also on the program: VPR’s Steve Zind has just returned from Iran. All this week we’ll be hearing reports on what he saw, heard and discovered on this most recent visit to the country of his ancestors.(Listen)


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From Christine in Barre
Thank you so much for talking about this topic. My father passed away a year ago and our family was fortunate enough to have him at home when he died. I believe that it made the transition easier for him and I feel that being able to say goodbye to him in that setting made the memory of his passing a much more comforting one for me.

Hospice played a huge role in this process. They provide an incredible service to patients and their families and deserve tremendous support from individuals, communities and the government. Every family should be able to have the same experience that mine did.


From Aaron in Burlington
Great show. My father died last year from terminal cancer. The last three months were excruciating for him. He had full access to palliative care and died at home. However he desperately wanted to end his life months before it did. He was unable to do so. I watched, my family watched, in great distress as he slowly died a very painful death. What options will I have to end my life if I have a terminal illness?


From Elise, an R.N. in Stowe
Two very good resources for healthcare professionals and patients are: www.CAPC.org (Professionals) website for the Center to Advance Palliative Care and www.getpalliativecare.org (Patients and families) .


From Anne in Lebanon, N.H.
I got great, comprehensive education on palliative care and end
of life issues in medical school at the University of Minnesota, but
when I worked at Dartmouth-Hitchcock Medical Center, I had a much
different education. When working with attendings in oncology and in
the ICU, I was chastised a number of times for suggesting that the
palliative care team should be involved for even a consultation. It was
very frustrating, but my impression was that certain physicians just
wouldn’t give up. There was a lack of collegial working relationships
between interventional teams and the palliative teams. And no matter
what I thought, the head doctor’s word is the last word.

Also, I
observed that a lot of insurances wouldn’t pay for hospice care in
certain settings or instances, and that hampered our care plans, even
if everyone involved agreed what the best plan was.


From Theresa in New London, N.H.
I am a critical care nurse
working in adult ICU. Many times I have encountered extremely sick
patients who were at the end of their life related to a cancer
diagnosis. I have helped many families gain access to palliative care.
And many times I have found that the attending physician has not even
broached the subject of code status. I have also encountered attending
physicians who refuse to consult palliative care despite the critical
care medicine team’s request.


From an R.N. in Rutland
your speakers address the fact that many private insurances will not
cover the costs of palliative care both in the acute care setting and
in the home setting?


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