Being Mortal By Ivan Ilyich

Death is inevitable. It is one of the only certainties in life. Regardless, people are often uncomfortable discussing death. Nyatanga (2016) posits that the idea of no longer existing increases anxiety and emotional distress in relation to one’s mortality. Because of the difficulty in level of care for end-of-life patients, the patient and the family often need professional assistance for physical and emotional care. Many family caregivers are not professionally trained in medicine, and this is where hospice comes into play. Hospice aims to meet the holistic needs of both the patient and the patient’s family through treatment plans, education, and advocacy. There is a duality of care to the treatment provided by hospice staff in that they do not attempt to separate the patient’s care from the family’s care. Leming and Dickinson (2011) support that hospice, unlike other clinical fields, focuses on the patient and the family together instead of seeing the patient independent of the family. Many times in hospitals, the medical team focuses solely on the goal of returning the patient back to health in order for them to return to their normal lives. They do not take into account the psychological and spiritual components of the patient’s journey and the journey that the family must take as well. For treatment of the patient, Leming and Dickinson agree that hospice does not attempt to cure patients, and instead concentrates solely

The movie “Wit” is a great educational tool for healthcare professionals in terms of dealing with terminally ill patients. It teaches that nurses and medical professionals should always remember that their patients are not a case nor illness nor experiment but rather human beings with souls and pains. Palliative care is one of the most disputed issues of worldwide importance. While bureaucrats in different countries are making laws on the use of palliative drugs, patients with excruciating pains learn how to “take deep breaths and be strong” (Nichols & Brokaw, 2001). That is what nurse Susie Monahan from “Wit” advises her dying patient Vivian Bearing suffering from unbearable pains due to stage IV ovarian cancer after eight painful rounds

According to Allen et al. (2012), “millions of people with chronic illnesses endure unrelieved pain, uncontrolled physical symptoms and unresolved psychosocial or spiritual problems.” This issue occurs because palliative care is often considered a form of end-of-life care. Palliative care is a treatment that can be used for patients who suffer from chronic illnesses and diseases while receiving curative treatment. (Horowitz, Grambling & Quill, 2014) purposely states the misconceptions of palliative care and advocated for seriously ill patients that education must bring under control the misconceptions. Some patients do not receive appropriate symptom management because the palliative care treatment needed is often confused with end-of-life care. However, end-of-life care attempts to relieve pain and suffering when a disease is no longer responsive to curative treatment. Pain and suffering could ultimately be controlled or even eliminated through the proper utilization of palliative care. Patients who are not referred to palliative care in a timely manner is more likely to have poor quality of life, uncontrolled symptom management and increased amounts of visits to the emergency room during the disease process. Patients with life limiting illnesses bear the burden of increased discomfort and increased suffering. Nurses experience clinical practice issues and difficulties in the clinical setting during the delivery of comfort and symptom management. These issues

The present-day misconception of palliative care possibly comes from the circumstance that palliative care was used interchangeably with hospice care until the 1980s. (Clark & Seymour, 1999). Clark and Seymour (1999) extensively write on the beginnings and evolution of palliative care. They describe the progression of palliative care as a whole and explain the movement from palliative starting out as supplemental care to terminal patients to the concept division of palliative and hospice care. They describe the differences in each and explain why palliative is its own concept that differentiates from hospice care. In 2002, the World Health Organization defined palliative care as “an approach” that increases the quality of life of

Many patients that are terminally ill are suffering day after day with no hope of relief. They are forced to endure more torment and pain from their

In almost every case of a terminal disease, pain is intolerable and seeing someone in such agony is heartbreaking. For example, Brittany Maynard, a 29 year old brain cancer patient who had to move to Oregon so she can avail of the Death with Dignity act. “Maynard knew that her form of brain cancer would be excruciating. She would endure swelling of the brain that would very likely cause seizures, painful headaches and the gradual loss of bodily function. Doctors know that for about 5 percent of the population, no amount of morphine can block the agonizing pain the terminally ill endure” (EDITORIAL: Dying with dignity). Palliative care can often be provided for the dying patients and alleviating pain to provide comfort for the dying has always been the priority. “Palliative care focuses on relieving the symptoms, particularly the pain, of incurable illness.” (Palliative Care) But, in relieving pain through the prescribed medications there are also side effects that are caused by the prescribed pain suppressors and two examples will be lethargy and it compromises breathing. In most cases the effectivity of the pain medication may no longer alleviate the pain. If a patient will be in such agony for the remaining days or weeks the quality of life is no longer present. The agony of pain prevents a patient from performing even just the bodily functions.

In nursing, the goal of care is usually to restore the patient back to the highest level of health possible. In some cases, however, the goals of care change when a curative approach is no longer appropriate. The new goals of care could simply be palliation and pain control rather than a restoration back to full health. This type of care is called palliative care. Palliative care is not the same as end-of-life care, but the two go hand-in-hand at times. The goal of end-of-life care is a “good” death, good being defined by the patient. Palliation is part of that “good” death. Both palliative care and end-of-life

A patients suffering cant be relieved all the time despite flawless palliative care, continuing to live causes misery that can only end with death.

There is a need for evidence on palliative care because improving strategies could potentially improve the patients end of life care and could ensure that they die in a dignified

Hospitals are seen as a place of treatment and cure; death may be viewed as a failure.

In Being Mortal, Atul Gawande uses his experiences as a surgeon, professor and public health professional to discuss many facets of Western end-of-life care and the process of growing old in a modern age. Overall, I have found that three overpowering themes in this novel are security versus autonomy, a need for pragmatism surrounding the concept of death, and our medicalized society’s devaluation of hospice and palliative care. Regarding these themes, I have chosen to reflect on my grandparents, death in the West and social role valorization, respectively.

Suffering is a constant companion of humans today; people experience it every day, whether it be emotional or physical, internal or external. Living with a terminal illness is also living with suffering, both because of the physical pain that is felt, and also the emotional blows the patient experiences every day. A terminally ill patient has a monumental part of their life taken from them. Few aspects of life still remain in their control, because of doctors, family members, and the illness itself. However, there is a practice that places a final decision, the right to choose the circumstances of death, with the patient. Physician-assisted suicide (PAS), or physician

Dr. Ira Byock’s latest book, The Best Care Possible: A Physician’s Quest to transform Care Through the End of Life, is a remarkable book written from a personal perspective as one of the foremost palliative-care physicians in the country. Dr. Byock shares stories of his experience with patients in his clinical experience to illustrate how end-of-life care affects each person. He explains what palliative care really is and how to make humane choices in a world obsessed with conquering death. Byock presents an agenda for end-of-life care that stresses compassion, dignity, and each patient being viewed as a unique case with the opportunity to partake in shared decisions amongst a team of professionals and family members. Dr. Byock is an advocate of dying well in a society marked by a fear of death; his highly personal account provides thought-provoking vignettes of how people struggle to make the right decisions in the winter of their lives. Byock urges society to embrace the reality of death and transform the medical community into an environment that will allow patients to live the last of their days in comfort with dignity and peace. This book is a vitally important piece of literature for everyone to devour with fervor. Everyone needs to understand the inevitability of death and the environment end-of-life care can present in what will be the final moments of life.

I have always believed that health cannot be optimized through the treatment of disease only. Rather, health should be addressed on a biological, physical, psychological, social, and spiritual continuum. Palliative care addresses an often-overlooked aspect of the patient experience, which is symptom management of their chronic illnesses. Health care professionals tend to treat acute episodes of

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