Thinking About Comfort Care

Originally posted

The sun is finally shining,  we are having double digit temperatures and it is the start of the week.  While today’s blog topic on end of life treatment  may sound like a downer, thinking, talking and preparing for it,  I feel is positive.

The New York Times article, ‘How to Make Doctors Think About Death’ is a well written piece by Theresa Brown, a hospice nurse.  It discusses the need to have guidelines and best practices for families and doctors as to when comfort care measures should/could/might  be introduced.  The focus on ‘comfort care’ is on alleviating suffering and managing symptoms as best as possible,  rather than on  actively treating the patient.

The author suggests that a simple treatment guideline might include: ‘ for patients who have one terminal illness that is either resistant to treatment or can’t be safely treated, combined with a second very serious illness or complication, along with a high degree  of physiological frailty, physicians should consider comfort measures instead of cure.’

The author opines that families may not understand that true nature of their loved one’s condition.  She adds that medical staff may not have enough time to spend with families and the patient themselves and do just that- explain what is going on and what choices are available to them.  Emotion can take over and we are all so very hopeful.  The hard truth, as the author points out is that ‘every single one of us will one day reach a point where our irreparable vulnerability, and decline, cannot be denied or reversed.’  We can only hope that particular time is very far off into the future. Ultimately we make our own choices or have chosen attorneys for personal care who share our beliefs and can follow our wishes.  Thinking about advanced care planning, having guidelines on choices and comfort care, I believe is a positive step.  Happy Monday and enjoy the sunshine today.

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