Watch this video:
http://www.pbs.org/wgbh/pages/frontline/facing-death/
What surprised you? Was there a particular
story/person/situation which moved you or in which you would have acted
differently? I usually show this film at the very beginning of the
term. After taking the class, what has changed about your views of what
would you
want done at the end of life? Respond to these questions, then respond to 2 of your classmates.
It surprised me when they mentioned that more americans die in hospitals than anywhere else. People go to hospitals in the hopes that they will get cured and be able to continue living their lives. Instead they go there to die. The story that hit me the most was probably the woman who was suffering from dementia. My uncle is currently in the earlier stages of dementia, so seeing someone else suffer and go through the disease in worse conditions was really scary, thinking and knowing that he could eventually get that bad.
ReplyDeleteMamee, I can also relate to having a family member go through dementia and I know how scary it is now and it is even scarier thinking that it could get as bad as the woman in this video did.
DeleteI believe that a patient deserves to be in their homes or a peaceful hospice setting where they can truly relax and be ok with the fact that their life is coming to an end. I watched my grandpa die and know he was comfortable at his home and in hospice living. You can't get comfy in a hospital - all the noises, people coming in and out and doctors constantly wanting to treat you. That's why we should be more prone to keeping patients at home and away from hospitals when it comes to EOL decisions...
DeleteI have also had family members suffer from dementia, its an awful thing to witness. I was also surprised to hear that the majority of Americans die in hospitals!
DeleteMy grandpa had dementia and I agree, it was hard to watch and be a part of
DeleteI think what surprised me the most is how the advancements in medical care give us false hope. By having modern medicine we have created an image that we will live longer with the expectation that patients will surpass being sick and return to a normal life. When in reality it prolongs the inevitable. The film refers to these patients and families as “broken survivors”.
ReplyDeleteOne particular story that moved me was the story about John. He wanted to keep fighting off the possibility of death. He spent over 9 months in the hospital. He put up one heck of a fight to be able to live a little bit longer. I thought it was sad when they had to make the decision that they would take him to hospice where he would die one day later. His daughter was heartbroken as well as his wife.
I think that making a decision for a family member has to be very difficult. I think each individual needs to complete a living will and create documents so that their family does not hold the guilt of letting them go. I think at the end of my life I do not want to just exist, if I am unconscious and cant breath on my own, I feel it is time to let me go. I do not want to be kept on a ventilator or machines that prolong what will happen if they take me off of them. In the event that I am conscious and in the right mind I would want my family to give me chance at recovery. I don’t want to drag out my death and live in the hospital. I would rather die at home. In the situation where I don’t have a chance to recover, and if I am medically supported by machines I feel like my quality of life is missing and I would like to be removed from the machines. My wishes are to be comfortable and have everyone say goodbye. I think my final wish would be that Eli is taken care of by someone that will love him as much as I do.
Laura, I also think it was interesting to see how advances in medical care give us false hope- it really just prolongs life and doesn't really maintain the quality of life. I also agree with your views of dying- I hope that I go comfortably and I also do not want to drag out my life just to spend my time in the hospital.
DeleteYou bring up a good point about the advancements in technology. I agree they do give us false hope, that with all these advancements we can fix anything. When really they have just prolonged a life with the same outcome either way. Even in the video the doctor says we can keep anyone living on machines for as long as we want but that does not mean that when they are taken off that they will be fixed or can live on their own ever.
DeleteI like how you commented that medical advancements give us false hopes. we can be kept alive forever with machines but who wants to have that for themselves or loved ones.
DeleteWhat surprised me was that many people die in the hospitals and how much money people spend on end of life care. I knew it was expensive, but I was not aware of how much it truly is. This video also demonstrated to me how much society fears death and how hard it is for us to accept it. This video also makes me think about the debate we had in class- the quality of life versus the quantity of life. I also think its interesting how they addressed a "good death" because the person who is going through it you don't truly know if they are suffering or not but if the people around think the person is going peacefully it helps make the situation a little less difficult. I also think it was interesting how they talked about the patient not wanting to say they were ready to go because they didn't want to feel like they gave into cancer or let cancer defeat them.
ReplyDeleteThe particular story that moved me was the 86 year old with Dementia. She was incubated for 2 weeks and her daughters had to decide whether to remove her or not. I can relate to this particular situation because my great-grandma is also suffering from dementia. I know how hard it is to see her go through this and it is terrifying to think of her being in this situation. I think it is interesting how they decided to take a vote to take her off the respirator or not. The situation was not going to get better and her quality of life would not be great. The doctors advised the family not to get their morals involved and just see if she could breathe on her own and if not let her go peacefully. I realize this is something I may have to deal with in the future and I am fearful of what could happen.
At the end of life, I don't want to be in pain or just relying on machines to keep me alive. I would rather my family let me go if I were to be in a situation that these patients were in after about two weeks. I just feel like at that point there is no hope and it gives my family the opportunity to say goodbye and also gives them some peace. This class has also made me realize the importance of a living will. A living will helps ease the pressure of family members and helps grant the dying person their wishes. I just hope that when it is my turn to go that all my loved ones will have their chances to get to say bye to me.
I do agree with you as well as the others that it is very shocking that many Americas die in hospitals. Also that we spend so much money. Its crazy to think that so much money is spent but nothing gets better, its a hard thought. I agree with you, that I do not want to live by machines. I hope the same that when the time comes, that I do have the time to say good bye.
Deletepeople would spend any amount of money necessary to have one more day with loved ones.
DeleteAllison, I do agree that people would spend as much money necessary to spend one more day with their family, I would too. I was just simply stating how surprised I am that the end of life is so costly.
DeleteWhat surprised me by the video is how long people will let their loved ones continue to live with machines even, though their may not be a good out come. Also I was a little surprised by how the doctors went about talking to the patients and their families. They did not just go in and say what they thought was right or what was going on. They talked through it with them and guided them, not controlling the situation. It was shocking how the families would just hold on to them for so long even though they knew what was happening. It was hard to watch them just have to guess what their loved one would want to do, shows the importance of an living will.
ReplyDeleteI did not clings to a particular story, but I would have treated some differently. In one case I wouldn't have kept pushing the person and I would have not used a breathing machine. Also I would have talked more about doing nothing and having time with my loved one instead of letting them go through so many procedures to try to prolong life.
I would say many of my view have stayed the same of how I feel about the end of life, but the class has shown me more things that need to be considered when it comes to the end of life. Also it has made me question the whole process, but I still would rather pass on my own when it was supposed to happen then to be hooked to machines and only live by them.
I agree. This video and story perfectly highlights why is so important to create a living will. I would hate to put that decision on my family.
DeleteI was also shocked as to how long people will let their loved ones go on living with machines. I liked that the doctors did not influence the patients decisions and talked through it with them as well. I think it is important to have a living well, that is just to hard of a decision to put on a loved one and they could wonder the rest of their life if that was what you wanted. I wouldn't want any of my loved ones to go through that.
DeleteI liked how you mentioned that the doctors really guided the family through the whole situation instead of telling them what they thought should be done. I think guidance in situations like this are very helpful because I'm sure the family's don't really know what is best, but with guidance it can lead them to the decision that they feel should be made.
DeleteMany people feel the need to treat themselves or family members simply because they are afraid of not doing something. Rather they would like to do in anything in their power, no matter how invasive or successful the treatment may be, in hopes that their loved ones will pull through and survive. Many doctors see further treatment for terminal illnesses as possible and viable while other doctors see it as invasive and unnecessary. Not surprisingly, More patients die in US hospitals every year than anywhere else. And the answer is? Unneeded medical treatment. My outlook has always been to do what the patient thinks is right and provide them treatments with honest insights on the outcome, no matter how favorable or not. It is important that the patient know, as well as the family members. No doctor wants to tell their patient that their condition is untreatable. it surprised me that the two daughters of the 85 YO woman with dementia disagreed on what they want to do with their mother. One daughter said she would take her off life support while the other would keep her on. That's why I think it is so important to have a living will and not allow that decision to be forced onto relatives. Tons of money is put into useless end of life treatments that prolong a life and bring down the quality of life to the point it is unacceptable and the person would have chosen to die weeks before. I think we need to refine and reform our medical treatments for EOL decisions and really fight for the best interests of the patients, rather than implementing a treatment for the sake of making money or prolonging death. The patient needs to be comfortable, at home, away from all the noise in a hospital. At home they can truly be comfortable.
ReplyDeleteJake,
DeleteThough I expect it is the motivation for a great deal of treatment that is provided when the end is inevitable, I was surprised to hear the woman say that doing nothing is scary. That seems like a flimsy excuse to prolong a loved one's suffering. What we observed in all the patients is that there comes a point in illness when doctors can see the end is near, whether the patient is currently up walking around or confined to the bed. I agree that these patients should be sent home while they are still aware enough of their surroundings to appreciate their family and being at home. If they are too advanced to be kept comfortable without being monitored by medical staff, hospice care facilities can offer a more home-like and peaceful atmosphere than a noisy hospital.
I was surprised when they said that most Americans die in hospitals. I think that it is crazy that we can keep people alive for so long. I think that it is every important for everyone to get a living will so that their family and the healthcare workers know what you want. In the video it says that 95% of the patients in the ICU can’t communicate so their decisions are being made by other people. This makes it easier on the family because then they know what you want and don’t have to make that hard decision. It would be so hard to make the life/death decision for your loved one when you don’t know what they would want. It also surprised me that how advancements in medicine are a good thing but they also give us false hope. They often make people think their loved ones will get better even if there is no chance that they will. The family wants to keep them on machines because they believe that their loved ones will get better but they are just prolonging the suffering of their loved ones. I feel like a lot of people want to prolong their loved ones life even if the best thing is to let them go. I know that I would have a very hard time making this decision myself. I would never want to be in the position of choosing if my loved one lives or dies. That is why I think that it is critically important for everyone to make a living will so that their family members don’t have to make that decision. The story of Diana really hit me. She was only 31 years old and was basically on complete life support. She had said that she never wanted to be on machines but her family didn’t want to let her go.
ReplyDeleteI agree, its crazy how long we can keep people alive now just with machines! People should definitely have living wills so that family members can honor their wishes and aren't made to chose for them.
DeleteI want to have the "end-of-life" conversation with my family, because I know that I do not want them to be in that difficult situation, where they do not know what I want and they have conflicting feelings on what to do. I do not want my family to have to suffer over me, just as I would not want to have to suffer over a decision like this as well. Whether we want to be kept on a ventilator or not is an important conversation that everyone needs to have, regardless of age or health condition. And most importantly, our wishes need to be respected, unlike the situation with Diane.
DeleteI completely agree with you about how it is critical to create a living will. If the living will is created, I really think that it would relieve the family a lot because they wouldn't have to be responsible with dealing with their family members end of life decision. It will also be what the patient/family ultimately wanted in the end.
DeleteI think the thing that surprised me most from this video was hearing that the largest majority of Americans die in hospitals. I guess it shouldn’t be as surprising as it sounds because the number of terminally ill diagnosed patients is always on the rise but this revelation makes the concept of going to the hospital to get better almost seem foreign. A quote that stood out to me from the film was “I think doing nothing is a very important consideration” I think people are often times to focused on prolonging life no matter the quality that they don’t even consider that doing nothing is also an option. In the video there was a thirty-one year old patient who had been diagnosed with scleroderma and did not want to be on any life prolonging ventilators however her family was not ready to let her go yet and went against her wishes. Before taking this class I probably would’ve sided with the family and empathized with their unwillingness to see their loved one go but now that I have taken this class and considering for myself what type of end of life care I would want in such a situation I wonder why a family would want to go against their loved ones wishes. I understand its hard to let go, I have been in the situation with one of my family members but if you take the time to consider something before hand especially since she was diagnosed with a terminally ill condition then I feel her wishes should be honored.
ReplyDeleteI also found the quote "I think doing nothing is a very important consideration" to stick out. I agree with you that sometimes people are just to stuck on living and prolonging that life, and they don't consider the quality of life they will have. I also agree that the patients wishes should be honored no matter how hard it is.
DeleteMany aspects of this documentary surprised me, however there were two that really shocked me, those would be that more people die in hospitals then anywhere else and that, at any given time 100,000 people are chronically ill on ventilators over the country and that costs 20 to 25 billion dollars for care of these people. I never realized how many people were going through this at one time or how many people actually die in hospitals, the fact that people are coming to the ICU to basically die according to one doctor I found shocking, and I wish it wasn't that way. I was touched by John's story, he never gave up until the end, would never say he was going to die, he just never accepted that as an option. Unfortunately in the end he ended up passing, but they tried everything they could and to know that they tried has to make his loved ones feel better along with him before he passed, because that's what he truly wanted; to fight. I would not have done anything differently in that situation, I believe it should be the patients choice, if they are able to make that choice, to chose what they want to do to try to survive. I think that is how I would be if I was in that situation, and his strength was inspiring. One quote that stuck out to me was "why give up? What is that going to do?". I think that couldn't be more true, if there is even the slightest chance you could be the one to beat the odds, why would you give up? You have a chance to live, a chance to get more time with your family, if they give up they will just be dead, so why not try until you cant try anymore? After taking this class my views have changed about what I want done at the end of life. At first I would have said at all costs keep me alive, I don't care if I am kept alive by machines and am unresponsive, I want to be alive. However now I would put my quality of life first, if I am going to have a horrible quality of life, I don't want that. I want to be able to communicate and be awake and responsive, I no longer want to be kept alive by machines. I feel like every patient is different and whatever that person wants, no matter how hard the decision is for the family, should be honored.
ReplyDeleteBriana, I also really liked John's story! It was crazy how he, as well as another patient, Albert, were so strong, even after having been through many chemotherapy treatments and even transplants. Albert's first transplant even failed, but he kept fighting. It is incredible the amount of strength these patients can have when faced with death.
DeleteI really liked this Frontline Program, especially because the end-of-life talk is something that I will have to deal with often as I become a nurse. My first comment was that I do agree with how the fact that this new medical technology can allow a machine to sustain every organ for ever, but this creates so many complications for the end-of-life decision. It raises the question: when is enough enough?
ReplyDeleteThe story with Martha, the French (I believe) woman with dementia, particularly surprised me the most. I did not particularly like how the family decided to leave the decision as a vote, but I guess in that situation there was no really other obvious choice. One of her daughters wanted to remove the ventilator and see if her mother could breathe on her own, but the other daughter wanted to keep her alive on the machine because she did not want to be the one to make the decision that could end her mother's life. Ultimately, the decision is made to remove the ventilator and Martha is able to breathe on her own. However, at the end of the video, it is revealed that a day later, Martha needed a tracheostomy and has been on a ventilator for over a year. A year, in my opinion, is a crazy amount of time. After taking this class and having thought a lot about my own choice for end-of-life care, I, like many of the patients in this video, would want to exhaust all my possible options. But when every stone was turned and ever possible treatment was tried, I would not want to be kept on a ventilator for more than a month to half a year. I would say six months, just so all my family and friends would have had time to visit and just as a little bit of hope that maybe a new treatment was found or something. But I don't want to live on a machine for the rest of time. Because if I am unresponsive and not breathing on my own, I would not be living on a ventilator for the rest of my live, because I think my life would be over at that point.
I really enjoyed this program on frontline. I think that it really brings into perspective all the decisions that have to be made during the end of life care. One story that stood out to me was the elderly grandmother that they were debating what to do if they took her breathing tube out and she couldn't breathe on her own. Without consulting what she would of wanted, the family voted on what would be best for her. I don't think that that is the correct way to go about making such an important decision. Choosing between doing a tracheotomy or just letting her stop breathing should be based on more than just a family vote. Another thing that surprised me is when the husband who had 2 failed bone marrow transplants decided that his best option was to do it again. After two failed attempts, his body is weak and doing another transplant could kill him anyway. So, just living the rest of his life that he has left with the strength he has could be a better option than being the weak person he might be after treatment and the end result could still be the same. After taking this class I have realized the importance of quality of life. I knew that quality of life was a good option and important thing to consider, but I never realized how it really helps in the dying process. Being able to die without being weak and hospitalized is a good choice to consider. I never realized how important of a choice that would be.
ReplyDeleteI agree, this class has helped me realize the importance of the quality of life and the role it plays in the process of dying. You never really think about it until you are forced to think about death in different ways.
DeleteI also thought it was odd that the family took a vote for the fate of their grandmother. Yes, they love her and want the best for her but I feel like their wishes took precedent to hers. They didn't discuss what she would have wanted and rather what they thought was best for her. I wasn't really shocked by the father that got another bone transplant because I feel like as a parent in that situation they would do anything to live longer with their kids, that is how my dad acted in his cancer treatment.
DeleteThe frontline video was very interesting, I actually enjoyed watching it. I was really surprised by how many people die in the hospital and with how long some people will go with leaving their loved ones living by the means of a machine. The statistics on the matter are actually kind of shocking to me, not to mention the cost of it all. The story I think that stood out to me the most would probably be the patient with dementia. I was shocked at how the family chose to come to a decision regarding the end of her life. The fact that they just put it to a vote threw me off, I feel like that is kind of demeaning to the loved one. They should have been able to give it more thought and come to a common decision as a family. However, I do feel that making a decision for a family member on a matter such as this would be very difficult. This is why I think that living wills are so important, that way there is no “vote” and the family has no doubt as to what their loved one really wants. I would definitely not want to be kept alive by a machine. Speaking from experience, I feel that life support machines make things a lot harder for the family to make a decision and come to terms with what is happening.
ReplyDeleteEmily,
DeleteI was also very shocked by the fact that they voted. I wonder how often this happens-it had never occurred to me that families might employ this method to decide whether their loved ones would live or die. I think they said one of the family members was a nurse. Does her vote count for any more because she understands the situation better than a family member without medical training and experience? When my family is faced with these decisions, I hope that we can discuss the matter with minimal emotion and collectively make a decision that we believe the debilitated person would consider most ideal.
At the end of the documentary, they stated the statistic that 100,000 people are on a ventilator in the US at any given time and the cost of sustaining them is estimated to be 20-25 billion dollars annually. While I knew the numbers were very high, The $20-25 bill. does surprise me a bit. The key to lowering these numbers is to disseminate more education about end-of-life options. When a patient is placed on a ventilator (except during surgery), there is typically no hope of them ever returning home. Even if they are able to return home, they are faced with a progressive illness in which suffering will escalate. If individuals understood this before they are in an emotional situation with a dying family member maybe they would be less likely to prolong life when there is no hope.
ReplyDeleteIt always surprises me when families wish to prolong the suffering of their family members. In the case of the 31 year old woman with scleroderma, she explicitly stated to the health care team that she did not want to be maintained by machines. This request did not offer specific parameters about the length and extent of treatment she was comfortable with. However, it is clear to me that she would not want to be kept alive using all the resources possible to maintain her body function. I understand it must be very difficult for her family to let go of her, especially at her age. Scleroderma is a progressive disease and there are likely to be more amputations and evolving organ issues. When there is no hope for return to normal functioning, life should not be maintained artificially.
I entered this class with pretty firm opinions about what I wish for myself regarding end-of-life decisions. Quality over quantity summarizes my beliefs. There is one point which I am now slightly wavering. I was very certain that I supported PAS at the beginning of this class. The issue is clearly bigger than personal ethics, extending into the arenas of political and financial motivation. Through reading and discussion in class, coupled with some personal experience, I am not certain it is an appropriate option for all patients. Palliative care can make the end of life very comfortable for terminally ill patients. I would like for my loved ones to remember me as healthy, not suffering. If palliative care can provide that for myself or other terminally ill patients, I believe PAS is unnecessary in those cases. It may be more emotionally damaging for the family to recall that the person chose to end their life, leaving questions about how long they would have lived had not chosen PAS. Palliative care can (in many situations) allow the patient to be comfortable and spend time preparing themselves and their family for their death.
I was surprised by an earlier statement that was made in the beginning of the film. It said that today more Americans die in hospitals than anywhere else. I think that regardless of the situation, I think that it's the patient's final decision and wishes on what should happen to them at the end of life. But in the situation with the woman with dementia, the daughters had to come to the decision on what to do. I couldn't imagine having to go through that with my own mom. I would just want the best for her and what she would have wished for. So I think knowing what the patient want sis very beneficial and having a living will would really help the problems that family's have to face with end of life decisions. To be completely honest, I never really thought about end of life decisions prior to taking this class. I guess that has to be due to the fact that I've never personally been in a situation where it came down to a life or death type of decision that had to be made for a person in a particular situation. But after taking this class I would have to say that no matter what the situation, it's the patient's choice about what they want done at the end of life.
ReplyDeleteI didn't find it surprising that most American's die in a hospital. If you think about it, if you are sick you go to a hospital for treatment. Sometimes there is not enough treatment and they keep you just to make sure you are comfortable as you pass. I work in health care in open heart surgery. the people I see are very very sick and without surgery would surely die soon. some people are just too sick to survive the surgery and unfortunately pass away in our care. Hospice is a part of most hospitals and that is solely for the dying.
ReplyDeleteMy views have evolved more on what I would want done for me at the end of life because I don't want my family to drag out my death if is no hope of me having an life after.
Yes you go to the hospital when you are sick, however it is supposed to help you get better, not keep you there until you die. That is why it did shock me that most Americans die in the hospital. I know hospice is for the dying however the hospital should be for people to get better
DeleteI also agree that many people go to the hospital to find treatments, not to die. I mean it certainly is a possibility but I would think that more people would die in hospice rather than hospitals.
DeleteIt surprised me that most Americans die in a hospital and how much money is spent on end of life care. The stories of Albert and John really touched me because they were both cancer stories and a lot of members of my family as well as friends have suffered from various forms of cancer. The fact that these men have suffered for so long and still remain optimistic is inspiring. Albert was very realistic and it touched me when he said his emotions have been all over the place because often times with cancer we only hear of the physical toll it takes on patients and the emotional toll it takes on their family and not so much the emotional toll it takes on the patient too. Albert was very realistic in his situation yet remained optimistic of his fate. At the beginning of this course I would've said that I would take all means necessary to sustain life, but now I am not so sure. I wouldn't want to be on life support for any extended period of time, a month would be long enough for me. I don't see that as a high quality of life and for me that is most important. If you talk to anyone whose family member died after a long suffering end they would say that is not how they want to remember them or how hard it was seeing them like that, no one usually says wow thank god I got to watch them lay in a bed for 6 more months without sign of life in them.
ReplyDelete