Debra Wertheimer, MD
$150 Purchase Price
End of Life Decisions and Concerns: The Resident’s Perspective
Residents in this program are filmed in long-term care facilities. When asked questions about their end of life decisions and concerns, it becomes very clear that these are difficult topics for them. It’s evident that they have not been educated about their options and hold a life time of fearful and not valid beliefs.
A fear expressed by many is that if they request hospice or to have no life-saving interventions, this would mean starvation, pain and isolation. No one has explained to them end of life pain management or the supportive nature of hospice which can now be provided in many long term care facilities at the request of the resident. The risks and poor outcomes of gastrostomy tubes and CPR for frail elderly have not been discussed with them.
When asked if they have had discussions with their family or health professionals about their choices, they give several reasons for not having done so. Firstly, they do not wish to burden family members. Second, they are so consumed with unspoken fears, they prefer not to think about end of life decisions. In their interviews, most residents request their preference for what they call “natural endings,” provided they will have comfort, pain management and support.
Brief commentary is provided by Debra Wertheimer, MD, who urges long term care staff and family members to have these important discussions with residents. She says, “knowing what options are available, knowing what support can be called in,” will be extremely helpful to residents, reducing fear and providing information for them to make the decisions which best reflect their wishes. This will also enable them to make advance directives which are essential for the staff caring for them.
Topics: advance directives, dignity, feeding tubes, communication
Audience: home health aides and nursing staff in long-term care, assisted living and hospice programs.
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