Dying should not be so hard

August 16, 2018 Ira Byock, M.D., FAAHPM

Dying is not easy under any circumstances. Unfortunately, modern medicine – for all its benefits – is not well designed to ease the process of dying and often adds needless suffering. The U.S. medical system is remarkably effective at saving lives, but the passion for cures can lead to excessive medical treatment as people near the end of life, adding burdens to dying patients and their families. Our widespread cultural reluctance to talk about dying often makes the experience even more difficult.

People who are incurably ill deserve palliative and hospice care

Palliative care and hospice care have been shown to vastly improve quality of life for people who are incurably ill and should be available to everyone who needs them. Currently, barely half of Americans with a terminal illness receive hospice care at home and too few hospitals are sufficiently staffed for palliative care.

There are signs of gradual improvement, but we must do more. All people deserve skillful and compassionate attention to their physical comfort, emotional well-being, spiritual concerns and personal dignity. Their families deserve respect, clear communication and both practical and emotional support.

Caring for body, mind and spirit

We founded the Institute for Human Caring in 2014 based on our conviction that patients deserve the best medical care, as well as emotional support and attention to spiritual experience and cultural beliefs. We call this “whole person care.”

This is not just about end-of-life care. Whole person care benefits people at every age and stage of life. It is, however, particularly valuable when people are living with serious medical conditions. Whole person care means that:

  • Patients are involved in decisions about their treatments and plan of care.
  • Families receive help supporting patients who are ill and assistance in coping with the strains of caring for a loved one.

Why whole person care matters - the Providence St. Joseph Health experience:

Making room for honest conversations

At Providence St. Joseph Health, we have embraced whole person care as the optimal care model and have shared our thinking and best practices with others. We are encouraged that more people are engaging in advance care planning, including preparing advance directives and initiating honest conversations with loved ones and caregivers about their preferences for care in life-threatening medical conditions.

Providers and policymakers can help

I have called on organized medicine to fix long-standing deficiencies in clinical practice and training to improve quality of care for patients who are seriously ill. Providence St. Joseph Health is asserting leadership in urging Congress to pass important legislation:

  • The Palliative Care and Hospice Education Training Act is a bipartisan measure that would improve clinical training in palliative care, while also increasing research and national education and awareness in this vital area of care. The House recently passed this important legislation, and we are urging the Senate to do so.
  • Legislation is needed to enable patients to receive hospice care while they are being treated for late-stage cancer or organ failure. Medicare and private insurers can support these very vulnerable patients – and their loved ones – by offering greater flexibility in coverage.

Together, we can help ease the burdens experienced by people who are seriously ill and dying. Let’s continue to move forward with proven care models and polices that reflect best practices.

This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.

About the Author

Ira Byock, M.D., FAAHPM

Ira Byock, M.D., FAAHPM, is a palliative care physician, author, and advocate for improving care for people of all ages and all stages of illness. He is founder and chief medical officer of the Institute for Human Caring at Providence St. Joseph Health. His books include “Dying Well,” “The Four Things That Matter Most,” and “The Best Care Possible.”

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