END-OF-LIFE CARE: Study Says Last Days Need To Improve
Many older American women face "a bleak picture of poverty, chronic pain, disability and isolated death" at the end of their lives, according to a new report issued by the Alliance for Aging Research. Newsday reports that former first lady Rosalynn Carter and Dr. Kathleen Foley, director of the Project on Death in America, yesterday joined other experts to discuss the end-of-life issues highlighted in the report. Dr. Robert Butler, a professor of geriatrics at Mount Sinai Medical Center in Manhattan, said, "Many people are not dying the way they want to or the way they should." He added that the panel's findings were "excellent and painfully true."
Long But Miserable?
According to the report, "there has never been a time in history when people lived so long." Men still "die an average of six years sooner" than women and "are often cared for by their wives," who many times exhaust all their savings and "reach poverty levels to get medical benefits for their dying spouses." Newsday reports that the study found that "25% of women 65-74 living independently in their individual communities had some disability," and the rate jumped to 41% for those over age 75. The report found that "about 75% of the nation's elderly died in hospitals or nursing homes, even though many have told loved ones their wish was to die at home, surrounded by family and friends." The study also found that people in the Northeast and South "were twice as likely to die outside their home compared to those in the Northwest."
According to Newsday, "only 30% of people have advanced directives, ... a legal form that dictates how a person wants to die and what medical measures to take in the event a person can't speak for herself or himself." Advocates "are fighting to pass the Family Health Care Decision Act, which would allow family members to make decisions based on the wishes of dying loved ones." Dr. Terri Fried, a geriatrics expert at Yale University School of Medicine, said if the bill becomes law people will "still have a very hard time." She said, "There is a large element of guilt and worry, and people are reluctant not to have intensive levels of care. The fallback position is to do more rather than less." Butler and Foley agreed that "there needs to be far more education about death and dying issues, especially among health professionals." Foley said, "We need to dignify the dying process" (Talan, 4/29).