Author says Vermont has a lot to learn about dying

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(Host)    Journalist Stephen Kiernan says Vermont has a lot to learn when it comes to dying.

His book, Last Rights: Rescuing the End of Life from the Medical System, was published a year ago. And since then the Vermont writer has traveled all over the country talking about the need for more holistic end of life care.   

Tonight, Kiernan addresses the issue in Rutland. 

VPR’s Nina Keck has more.

(Keck)   Americans used to die more suddenly  from things like heart attacks, strokes and car accidents.   But thanks to dramatic improvements in medical technology, better drugs, air bags and 911 emergency services – Americans are living longer and, according to Stephen Kiernan, dying more slowly.

(Kiernan) "In some ways that’s terrifying – we’re watching our mortality walking toward us step by step.  But on the other hand we have this interval of time when we’re ill, but we’re still very much alive."

(Keck)   Kiernan says that window of time presents a huge opportunity for people to get their affairs in order;  mend relationships, visit with loved ones and find personal or spiritual peace.   But all too often, he says, a patient’s physical or emotional pain is not controlled well enough to do that.  

(Kiernan) "Medical people – doctors and nurses – are largely untrained in how to care for people who are dying slowly.   They are incredibly expert at people who are in critical situations.   But when it comes to sitting down and listening – and saying what do you need?   Saying you’re pain is getting bad now, but if we manage it you’re going to be asleep all day – how do you want to balance it?  And listening. . .  That’s not a skill that they’re taught."

(Keck)   Stephen Kiernan says Vermont is way behind when it comes to providing good end of life care, and patients pay the price.

(Kiernan)  "Pretty hard to mend a troubled relationship if you’re in a lot of pain.   Pretty hard to attain spiritual calm if we can’t get a decent breath.  So we really need to change the care so the medical part is right. Then that enables all sorts of terrific opportunities at the end of life."

(Keck)   Doctors point out that even if they want to provide good care, it’s hard to find time for emotional end-of-life conversations.  Still, health care providers say things are improving in Vermont.  Rutland Regional Medical Center, for instance, has created larger and homier comfort suites for seriously ill patients and their families.  They also have a designated palliative care team, as does Fletcher Allen hospital.   It’s a good start, says Kiernan. But he says patients and doctors, alike, need to do more to ensure that a person’s last days are as fulfilling as possible.

For VPR News, I’m Nina Keck in Rutland.

(Host outro)    Vermont Author Stephen Kiernan will speak Thursday evening at 7 at the College of St. Joseph’s in Rutland.    The event, which is free of charge, is sponsored by the Rutland Area Visiting Nurses and Hospice.

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