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 MDs know limits of treatment and the need to plan 
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Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
Post MDs know limits of treatment and the need to plan
Some of us were talking at last night's caregiver support group meeting about whether MDs, in general, seem in favor of or opposed to feeding tubes, and whether MDs will honestly answer a family's question as to their advice as to what they'd do if their family member lost the ability to swallow.

There's an article in last Saturday's Wall Street Journal about one person's view of these matters. The author, a retired physician, believes that doctors tend to choose less treatment at the end of life for themselves, and are reluctant to impose their "views on the vulnerable" when families ask "what would you do?"

Here's an interesting statistic about CPR from the article: "A study by Susan Diem and others of how CPR is portrayed on TV found that it was successful in 75% of the cases and that 67% of the TV patients went home. In reality, a 2010 study of more than 95,000 cases of CPR found that only 8% of patients survived for more than one month. Of these, only about 3% could lead a mostly normal life."

Robin

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http://online.wsj.com/article/SB1000142 ... 33962.html

LIFE & CULTURE
FEBRUARY 25, 2012
Wall Street Journal

Why Doctors Die Differently
Careers in medicine have taught them the limits of treatment and the need to plan for the end
By Ken Murray


Tue Feb 28, 2012 1:28 am
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3173
Location: WA
Post Re: MDs know limits of treatment and the need to plan
Yes, this is typical among the medical profession, I think. I worked with a surgeon who had DNR literally tattooed on his chest.

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Tue Feb 28, 2012 1:42 am
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Joined: Fri Jan 15, 2010 9:33 pm
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Location: Vermont
Post Re: MDs know limits of treatment and the need to plan
Wow - those are some very powerful statistics! Lynn

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Lynn, daughter of 89 year old dad dx with possiblity of LBD, CBD, PSP, FTD, ALS, Vascular Dementia, AD, etc., died Nov. 30, 2010 after living in ALF for 18 months.


Tue Feb 28, 2012 8:55 am
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Joined: Tue Dec 29, 2009 2:28 pm
Posts: 463
Location: Minnesota
Post Re: MDs know limits of treatment and the need to plan
VERY interesting statistics. I had no idea CPR had such a low success rate. I've got to review my directive and make sure it says "no CPR." Especially if they, as portrayed on TV, push family members away from the patient.

Mom's passing a few weeks ago was beautiful. Pneumonia diagnosed on Tuesday, passed at 11:05 p.m. on Thursday. No panic, no commotion. The most activity that took place was from the staff (a steady stream of them) coming to say goodbye. And her daughters' presence and touch.

An interesting thing about doctors' and NPs' advice: Both Mom's doctor and NP said her passing was imminent. The nursing staff in the dementia unit has been trained to be upbeat, so they kept telling my sister what she wanted to hear - that there was a chance of recovery. (Yet when I spoke with them, they agreed with me that it was time.) Because of what the staff said, one of my sisters drove home - 100 miles away - that night. She will always regret missing that moment. My advice to people is take the doctors' and NPs' advice, especially if you have confided in them that it won't upset you. Nursing home staff are trained to keep the spirits up and don't understand what a blessing a passing can be. The palliative doctor and NP do understand and will be up front about what is happening.

At least that's what I experienced.

Kate

P.S. - I'm forwarding the article to our eldercare attorney. I think he'll find it interesting.

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Kate [i](Cared for Mom for years before anyone else noticed the symptoms, but the last year of her life was rough and we needed to place her in an SNF, where she passed in February 2012)[/i]


Tue Feb 28, 2012 2:44 pm
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Joined: Wed Dec 30, 2009 1:46 pm
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Location: WA
Post Re: MDs know limits of treatment and the need to plan
Well said, Kate!

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Tue Feb 28, 2012 3:10 pm
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Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
Post Re: MDs know limits of treatment and the need to plan
You might check out "Hard Choices for Loving People" as I think the CPR statistic is the same. The authors of that booklet are opposed to feeding tubes for those with dementia.


Wed Feb 29, 2012 12:02 am
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3173
Location: WA
Post Re: MDs know limits of treatment and the need to plan
I think most of the successes from CPR are with drowning children. Every time I've renewed my CPR certification for health care workers, we are told that the odds are very poor for a good outcome, particularly with older people.

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Wed Feb 29, 2012 12:18 am
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