Prior to the development of antibiotics and other medical
advances, people often died quickly, usually of infectious
diseases or accidents. Today, the vast majority of Americans
have a more protracted experience with death. Families and
terminally ill patients, whether young or old, have a broad range
of physical, psychological, social, spiritual, and practical needs.
Today's newsletter focuses on some of these needs. We have touched
only briefly on grief and loss and will revisit that topic and other
end-of-life issues in future newsletters.
Click here to review archived newsletters (1997 to the present).
Regards,
Jack
John L. Miller, MD
1. THE ROBERT WOOD JOHNSON FOUNDATION Elements and Models of End-of-life Care
Suffering is best relieved by using a team to approach the many
elements involved in end-of-life care. Palliative care defines
a model of the relief of suffering and the improvement of quality
of life across the spectrum of illness. (You will need the Adobe
Acrobat Reader to access this document.) http://www.ama-assn.org/ethic/epec/download/plenary_3.pdf
2. THE ROBERT WOOD JOHNSON FOUNDATION Whole Patient Assessment
Patient assessment in end-of-life care should include the
following: disease history, physical symptoms, psychological
symptoms, decision-making capacity, information sharing, social
circumstances, spiritual needs, practical needs, and anticipatory
planning for death. (Adobe Reader is needed.) http://www.ama-assn.org/ethic/epec/download/module_3.pdf
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3. MAYOCLINIC.COM Anticipating End-of-life Needs of People with Alzheimer's Disease
Alzheimer's is inevitably terminal. Medications can ease symptoms and delay the progress of the disease, but there is no cure. Worse yet, Alzheimer's eventually robs people of the intellectual capacity to make decisions about their own medical care.
4. AMERICAN FAMILY PHYSICIAN Hospice Care in the Nursing Home
For eligible terminally ill patients, the Medicare Hospice
Benefit supplies an interdisciplinary team with skills in pain
management, symptom control and bereavement assistance.
7. MOYERS ON DYING On Our Own Terms
On September 10, 2000, PBS will begin a four-part series
led by Bill and Judith Davidson Moyers on end-of-life issues
facing Americans. The series will reveal the stories of the
dying, their families, and their caregivers. PBS will launch
a companion Web site to the series on August 28 at the above
Web address. http://www.thirteen.org/onourownterms/
8. CANADIAN MEDICAL ASSOCIATION JOURNAL Withholding Life-sustaining Treatment: Are Adolescents
Competent to Make These Decisions?
The majority of health care decisions for adolescents, including
those concerning life-sustaining medical treatment, are made
cooperatively by the adolescent, physicians and parents in a
supportive environment. Occasionally, the adolescent patient
will disagree with the parent(s), physician(s) or both. http://www.cmaj.ca/cgi/content/full/162/11/1585
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