By Stephanie O’Neill
Dr. Kendra Fleagle Gorlitsky recalls the anguish she felt performing CPR on elderly, terminally ill patients.
It looks nothing like what we see on TV. In real life, ribs often break and few survive the ordeal.
“I felt like I was beating up people at the end of their life,” she says. “I would be doing the CPR with tears coming down sometimes, and saying, ‘I’m sorry, I’m sorry, goodbye.’ Because I knew that it very likely not going to be successful. It just seemed a terrible way to end someone’s life.”
Gorlitsky now teaches medicine at the University of Southern California and says these early clinical experiences have stayed with her.
A lot of time and money has gone into trying to improve end-of-life care.
Gorlitsky wants something different for herself and for her loved ones. And most other doctors do too: A Stanford University study shows almost 90 percent of doctors would forgo resuscitation and aggressive treatment if facing a terminal illness.
It was about 10 years ago, after a colleague had died swiftly and peacefully, that Dr. Ken Murray first noticed doctors die differently than the rest of us.
Hawaii ranks 49th in the nation for use of home health care services during the last six months of someone’s life. Videos from ACP Decisions show patients what their options are at the end of life.
“He had died at home, and it occurred to me that I couldn’t remember any of our colleagues who had actually died in the hospital,” Murray says. “That struck me as quite odd, because I know that most people do die in hospitals.”
Murray then began talking about it with other doctors.
“And I said, ‘Have you noticed this phenomenon?’ They thought about it, and they said, ‘You know? You’re right.’ ”
In 2011, Murray, a retired family practice physician, shared his observations in an online article that quickly went viral. The essay, “How Doctors Die,” told the world that doctors are more likely to die at home with less aggressive care than most people get at the end of their lives. That’s Murray’s plan, too.
“I fit with the vast majority of physicians that want to have a gentle death and don’t want extraordinary measures taken when they have no meaning,” Murray says.
A majority of seniors report feeling the same way. Yet, they often die while hooked up to life support. And only about 1 in 10 doctors report having conversations with their patients about death.
One reason for the disconnect, says Dr. Babak Goldman, is that too few doctors are trained to talk about death with patients. “We’re trained to prolong life,” he says.
Goldman is a palliative care specialist at Providence Saint Joseph’s Medical Center in Burbank, Calif., and he says that having the tough talk may feel like a doctor is letting a family down. “I think it’s sometimes easier to give hope than to give reality,” Goldman says.
Goldman, now 35, read Murray’s essay as part of his residency. He says that he, too, would prefer to die without heroic measures, and he believes that knowing how doctors die is important information for patients.
Related Continuing Education Courses:
End of Life: Helping with Comfort and Care is a 1-hour CE course. End-of-life care is the term used to describe the support and medical care given during the time surrounding death. Such care does not happen just in the moments before breathing finally stops and a heart ceases to beat. An older person is often living, and dying, with one or more chronic illnesses and needs a lot of care for days, weeks, and sometimes even months. Generally speaking, people who are dying need care in four areas—physical comfort, mental and emotional needs, spiritual issues, and practical tasks. This course is intended to make the unfamiliar territory of death slightly more comfortable for everyone involved. This publication is based on research, such as that supported by the National Institute on Aging, part of the National Institutes of Health. This research base is augmented with suggestions from practitioners with expertise in helping individuals and families through this difficult time. Throughout the booklet, the terms comfort care, supportive care, and palliative care are used to describe individualized care that can provide a dying person the best quality of life until the end.
Mindfulness: The Healing Power of Compassionate Presence is a 6-hour online CE course. This course will give you the mindfulness skills necessary to work directly, effectively and courageously, with your own and your client’s life struggles. Compassion towards others starts with compassion towards self. Practicing mindfulness cultivates our ability to pay intentional attention to our experience from moment to moment. Mindfulness teaches us to become patiently and spaciously aware of what is going on in our mind and body without judgment, reaction, and distraction, thus inviting into the clinical process, the inner strengths and resources that help achieve healing results not otherwise possible. Bringing the power of mindful presence to your clinical practice produces considerable clinical impact in the treatment of anxiety, depression, PTSD, chronic pain, high blood pressure, fibromyalgia, colitis/IBS, and migraines/tension headaches. The emphasis of this course is largely experiential and will offer you the benefit of having a direct experience of the mindfulness experience in a safe and supportive fashion. You will utilize the power of “taking the client there” as an effective technique of introducing the mindful experience in your practice setting. As you will learn, the mindfulness practice has to be experienced rather than talked about. This course will provide you with an excellent understanding of exactly what mindfulness is, why it works, and how to use it. You will also develop the tools that help you introduce mindful experiences in your practice, and how to deal with possible client resistance.
Spirituality & Adults in Later Life is a 2-hour online CE course. This online course provides an accessible tool kit for health care providers and therapists to use in attending to the spiritual well being – as well as the physical, social, and emotional needs – of older adults in their care. Included are ready-to-use exercises and techniques for promoting spiritual self-awareness in seniors, as well as vignettes from the author’s own years of experience. The author makes a clear distinction between spirituality and religion, emphasizing the importance of helping older adults come to terms with the numerous losses they experience in later life. Among the tools described herein are the spiritual inventory, an assessment of spiritual needs, the value of forgiveness and legacy, a discussion of spiritual deterrents, the importance of cultural sensitivity, and how to promote spiritual growth in a group setting.