The unwavering focus on treatments for sustaining life can leave someone who is living with an advanced disease physically uncomfortable, feeling lost and confused, not knowing how to get through each day or how to plan for the future.
Nearly everyone who is asked where they would want to spend their final days says at home, surrounded by people they know and love and who love them. That's the consistent finding of public opinion surveys and, in my experience as a doctor, remains true when people become patients. Unfortunately, it is not the way things turn out. At present, just over one-fifth of Americans are at home when they die. Instead, over 30 percent die in nursing homes, where, according to opinion polls, virtually no one says they want to be. Hospitals remain the site of over 50 percent of deaths in most parts of the country, and nearly 40 percent of people who die in a hospital spend their last days in an ICU (intensive care unit), where they will likely be sedated or have their arms tied down so they will not pull out breathing tubes, intravenous lines, or catheters.
Dying is hard, but it does not have to be this hard.
Reprinted from The Best Care Possible by Ira Byock by arrangement with Avery Books, a member of Penguin Group (USA) Inc., Copyright © 2012 by Ira Byock.
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No Man's Land
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