So You Say You Want to Die in Peace

Article submitted by Bart Windrum, author and speaker. Bart’s recognized as a nationally contributing patient “activist” by IHI, the Institute for Healthcare Improvement, and authored an (unadopted) Colorado healthcare reform initiative. Bart’s two books are Notes from the Waiting Room: Managing a Loved One’s (End of Life) Hospitalization (in print) and How to Efficiently Settle the Family Estate (pdf and ebook). Both are available through his website www.HospitalPatientAdvocate.com.

Everyone wants to go to heaven. No one wants to die to get there.

90% of us say we want to die in peace, and define that as “at home.” To which I add, “with the dog licking my fingers.”

Most of us do not reach our goal. 50% die in hospitals. 20% die in other institutions. 35-45% of those enrolled in hospice are in for only the last 4–7 days of life. Since several days are taken up with active dying (when the body physically shuts down) and since hospice eligibility begins 6 months out from a prognosticated death, this tells me that another large percentage fail to die peacefully because the weeks preceding their brief hospice stay were likely devoted to curative treatment attempts. Factor in deaths due to accidents and homicides and I estimate that 10–15% of us actually die in peace according to our common definition.

Even those of us with advance directives or living wills declaring a desire to avoid protracted mechanized or institutional dying, that’s what we end up experiencing. I know this through exprience; this is what both of my parents’ endured in 2004 and 2005. I learned a few things from those two 3-week terminal hospitalizations, during which I shared responsibility for making pull-the-plug decisions that we never thought we’d have to make.

I learned what it really takes to increase our likelihood of dying in peace. I’d like to share some of that learning with you in this series. I’ll cover aspects of dying that seem never to get addressed by writers, reporters, presenters, and panelists, including:

how we misunderstand heroicism and heroic action
how to revision the last quarter of life from a medically heroic viewpoint
the multiple uses life support technology are routinely applied to
the forces that lead us onto a slippery slope culminating in curative and heroic treatment paths we had previously stated we wished to avoid
aspects of the culture of resuscitation that make avoiding erroneous resuscitation challenging
how and why deaths are timed in hospitals
why and how hospitals generally fail to provide care, and what they actually provide
several aspects regarding how to advocate (act as a proxy) in the hospital environment
the relationship of medical error to dying in America
why even palliative and hospice doctors fail to offer guidance far enough in advance to help us obtain a peaceful demise (where “demise” means peacefully experiencing the weeks and perhaps months leading to death).

These are challenging topics, and I will present them unvarnished, beginning next month.

More about the Author and www.HospitalPatientAdvocate.com

Bart Windrum is an author and speaker. Bart’s work is endorsed by a range of medical providers and policymakers, some of whom have invited him to address their organizations, and he is available to address yours. Bart’s recognized as a nationally contributing patient “activist” by IHI, the Institute for Healthcare Improvement, and authored an (unadopted) Colorado healthcare reform initiative. Bart’s two books are Notes from the Waiting Room: Managing a Loved One’s (End of Life) Hospitalization (in print) and How to Efficiently Settle the Family Estate (pdf and ebook). Both are available directly at his website, www.HospitalPatientAdvocate.com, where the complete purchase price supports this unique work.

Presentations from Bart Windrum

Bart presents to both lay and professional audiences. Topics include how to advocate when hospitalized; a lay person’s transformation into patient advocacy; revisioning end of life in order to achieve the peaceful death 90% of us say we want; how to efficiently settle the family estate. Bart’s been recognized as a nationally contributing patient advocate by the Institute for Healthcare Improvement (IHI). Tell Bart about your upcoming event.

Posted June 2012 on www.SeniorsResourceGuide.com