About Dying: What A Doctor Thinks People Should Know

[OneEyedDiva]

Dr. B.J. Miller treats patients in need of palliative and hospice care. Even though my husband was already in the ICU, I experienced (along with my one of my stepdaughters),having to choose which kind of care he should receive because my husband was no longer able to do it himself. He died two weeks later. Highlights from the article:

"Don’t wait for your doctor to bring up hospice​

You don’t need to be dying to receive palliative care​

It's okay to laugh

To the caregivers: Don't be afraid to leave the room

Patients may have deathbed delirium causing behavior to range from sweet to insufferable"
Read more here:
https://www.cnn.com/2019/07/18/opinions/doctor-advice-facing-death-miller/index.html

I sure wouldn't mind it if Dr. Miller was one of the last people I saw when I'm dying.


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[Alligatorob]

Don’t wait for your doctor to bring up hospice​

You don’t need to be dying to receive palliative care​

Good post, and you are very right.

Both of my parents died in hospice care, at home. Hospice was great, I was amazed at the services they provided. Pretty much everything we needed, except full time caretakers, and we did not need that.

In my mother's case she was in hospice care for about 6 months, it really did make keeping her home possible. I believe she was a lot happier.

In my father's case it was only about 10 days, we waited too long, he and my step-mother resisted it. That was too bad, things would have been better had we started sooner.

They did all kinds of things for us, delivering medications or medical equipment quickly and at anytime night or day, provided housekeeping help, an on-call nurse, and at the end help with the mortuary.

As I understand the rules to qualify for hospice in the US a doctor has to say that the patient is likely to die within 6 months, and be on palliative care. If the patient lives longer it doesn't matter hospice continues. The thing that would disqualify a patient is receiving treatment that is intended to cure. For example my mother had lung cancer, she decided that chemo was hurting more than helping so she got off of it. Had she gone back on hospice would have ended so long as the chemo continued. I am sure in some cases the difference between palliative and curative treatment is a gray area, not sure how that works...

Look into hospice early and find out what is available. It was 100% paid by Medicare, no copays, no questions.

 

[OneEyedDiva]

Good post, and you are very right.

Both of my parents died in hospice care, at home. Hospice was great, I was amazed at the services they provided. Pretty much everything we needed, except full time caretakers, and we did not need that.

In my mother's case she was in hospice care for about 6 months, it really did make keeping her home possible. I believe she was a lot happier.

In my father's case it was only about 10 days, we waited too long, he and my step-mother resisted it. That was too bad, things would have been better had we started sooner.

They did all kinds of things for us, delivering medications or medical equipment quickly and at anytime night or day, provided housekeeping help, an on-call nurse, and at the end help with the mortuary.

As I understand the rules to qualify for hospice in the US a doctor has to say that the patient is likely to die within 6 months, and be on palliative care. If the patient lives longer it doesn't matter hospice continues. The thing that would disqualify a patient is receiving treatment that is intended to cure. For example my mother had lung cancer, she decided that chemo was hurting more than helping so she got off of it. Had she gone back on hospice would have ended so long as the chemo continued. I am sure in some cases the difference between palliative and curative treatment is a gray area, not sure how that works...

Look into hospice early and find out what is available. It was 100% paid by Medicare, no copays, no questions.

I'm sorry to read about your parents but it's good they got the care they needed albeit too late for your dad. I didn't realize the hospice time frame was 6 months...for some reason I thought it was a shorter time period. My grandmother died from pancreatic cancer and had hospice care at home. She also didn't need round the clock care because between my uncle, his wife, me and other family members, we had it covered. One of my cousins even came from South Carolina to stay with her.

Your reply made me realize I needed to go back and make clear that those points were not mine but from the article.

 

[dseag2]

My mother was in Assisted Living and was in hospice care on and off for over a year. She rallied at one point so she was taken off hospice. I re-submitted the paperwork for her to go back on hospice when it was required. She passed away on November 9.

I agree with the "deathbed delirium" statement because as her body continued to shut down she continued to lose touch with reality and would cry out to "go home" or ask to get up from her bed. It was heartbreaking to see.

Unfortunately, the hospice company that took care of her for her last 6 months wasn't the best but the nurses at her Assisted Living community gave her lots of love and attention. I was also with her and made sure she received what she needed. The one bright spot of hospice was the Chaplain, who visited her frequently and used to sing hymns with her. I'm not religious but I know this meant a lot to her.

 

[Alligatorob]

I didn't realize the hospice time frame was 6 months...for some reason I thought it was a shorter time period

I was just citing my memory, it might be different, people need to find out for sure. Here is something I found with more specific criteria: https://www.crossroadshospice.com/hospice-care/hospice-eligibility-criteria/ We did not find it hard to qualify either of my parents. These are the requirements they list for Medicare:

• Medicare Part A coverage
• A diagnosis of six months or less to live
• A desire to pursue comfort care over curative treatment

 

[dseag2]

I was just citing my memory, it might be different, people need to find out for sure. Here is something I found with more specific criteria: https://www.crossroadshospice.com/hospice-care/hospice-eligibility-criteria/ We did not find it hard to qualify either of my parents. These are the requirements they list for Medicare:

• Medicare Part A coverage
• A diagnosis of six months or less to live
• A desire to pursue comfort care over curative treatment

You are correct. My mother was diagnosed to live for 6 months or less by her doctor and was put into hospice. She was a touch, determined woman and when she rallied she was then taken out of hospice for a couple of months. I was then advised that her doctor had determined she needed to go back into hospice. She lived for approximately another 6 months.

 

[JonSR77]

Dr. B.J. Miller treats patients in need of palliative and hospice care. Even though my husband was already in the ICU, I experienced (along with my one of my stepdaughters),having to choose which kind of care he should receive because my husband was no longer able to do it himself. He died two weeks later. Highlights from the article:

"Don’t wait for your doctor to bring up hospice​

You don’t need to be dying to receive palliative care​

It's okay to laugh

To the caregivers: Don't be afraid to leave the room

Patients may have deathbed delirium causing behavior to range from sweet to insufferable"
Read more here:
https://www.cnn.com/2019/07/18/opinions/doctor-advice-facing-death-miller/index.html

I sure wouldn't mind it if Dr. Miller was one of the last people I saw when I'm dying.

View attachment 210059
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so very sorry for your loss. take care.

 

[JonSR77]

classic Japanese Haiku, from Issa.. (on the death of his child) DEW EVAPORATES AND ALL OUR WORLD IS DEW ... SO DEAR, SO FRESH, SO FLEETING
ISSA​

 

[Remy]

I can tell you from experience how horrible it is to see people (usually of coarse the family) who cannot accept the inevitable and natural progression. Even for people in their 90's. They will try anything and blame anyone.

Many people never have the discussion. I have power of attorney for my stepfather, both medical and financial. Any health crisis at the end, he's on comfort care only. And actually he has stated this in the paper work when it was done at the attorney's office.