To Die or Not to Die: Ten Tricks to Getting Better Medical Care


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He had been assessed by a social worker and recommended to Haven of Hope, something for which his family was very grateful. When a patient is close to death, Leung says, they can no longer use the toilet, so are moved to a special room, where they can pass away in a private space with family members around them. He has seen some patients face death courageously, reconciling broken relationships with family members and friends. It gave them privacy needed to say things that might not be said in a hospital, she says.


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The best and worst places in the world to die Leung, who was trained in Britain, says palliative care in Hong Kong has improved in the past 20 years. Although more doctors and nurses have become interested in palliative care, Leung says more psycho-social support would help improve services. When he set up the hospice 10 years ago, he wanted to do something he was passionate about before retiring, he says. Good end-of-life care brings dignity and comfort to the family. Working in this field has made me more at peace with my own mortality.

Being mortal is universal, but no one likes to talk about it. A good farewell is not only important for the dying person, but also therapeutic for the grieving family. We should embrace the last journey with love. Professor Joanne Chung Wai-yee, dean of the faculty of liberal arts and social sciences at the Education University of Hong Kong, helped consult on the project.

She was a hospice nurse in the early s, providing home care services in Sham Shui Po. Empathy is important, not just for the patient, but family members too. I try all means to seek different methods to relieve the suffering. She says for some, the pain they are feeling can make them contemplate things they may have done wrong in their lives. Helping them reconcile puts them at ease.

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Parkinson’s Disease and Caregiving

Some are good, some bad, so we try to focus more on the good things. At the terminal stage, they have conflicts and we help them through it. States currently considering assisted suicide laws [ citation needed ]. In Washington, physician-assisted suicide did not become legal until This lawsuit was first part of a district court hearing, where it ruled in favor of Glucksberg, [] which was the group of physicians and terminally ill patients.

The lawsuit was then affirmed by the Ninth Circuit. Eventually, the Supreme Court decided, with a unanimous vote, that medical aid in dying was not a protected right under the constitution as of the time of this case. A highly publicized case in the United States was the death of Brittany Maynard in After being diagnosed with terminal brain cancer , Maynard decided that instead of suffering with the side effects the cancer would bring, she wanted to choose when she would die.

She was residing in California when she was diagnosed, where assisted death was not legal. She and her husband moved to Oregon where assisted death was legal, so she could take advantage of the program. Before her death, she started the Brittany Maynard fund, which works to legalize the choice of ending one's life in cases of a terminal illness.

Is hospice care the right option for you or a loved one?

Her public advocacy motivated her family to continue to try and get assisted death laws passed in all 50 states. These studies, conducted in the Netherlands in , , and totaling cases of which cases were physician-assisted suicide and were euthanasia, showed complications of any category were of higher frequency in cases of assisted suicide than in cases of euthanasia.

All patients who participated in the study were determined in advance to be mentally competent. The authors conclude that the " From to a group of doctors in the Netherlands interviewed and studied physicians in charge of giving patients the life ending drugs used in assisted suicide cases. They found that from to the use of this method rose slightly as more patients were turning to assisted suicide as an end of life option.

From to the number of deaths from assisted suicide methods had risen from in to in They also discovered there was a number of physicians equal to about 0. More research can be found on the website of Living and Dying Well UK, an organization which researches and analyzes evidence surrounding end-of-life issues.

In the American television series House , assisted suicide is mentioned multiple times. The character Allison Cameron assisted in the death of a patient in the episode Informed Consent after its revealed he has a terminal condition. In the episode Known Unknowns , Dr. Wilson , an oncologist , reveals he indirectly provided a patient dying from cancer the code to increase his morphine level to a lethal amount leading to the patients death. In the episode The Dig , Thirteen reveals she assisted her brother in his suicide who was suffering from advanced symptoms of Huntington's disease and that was she was sent to prison for overprescribing.

In the same episode, House promises to assist her in killing herself once her own Huntington's symptoms get too bad.

10 Facts About Hospice Care for Family Caregivers

From Wikipedia, the free encyclopedia. Assessment of risk Crisis hotline list Intervention Prevention Suicide watch. Asphyxiation Hanging Train Cop Seppuku. List of suicides Suicide in antiquity List of suicides in the 21st century. Banzai charge Kamikaze Suicide attack Suicide mission.

Euthanasia and the slippery slope. Euthanasia in the Netherlands. Euthanasia in New Zealand. Assisted suicide in the United Kingdom.

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Assisted suicide in the United States. Legal under court ruling 1. Archived from the original on Archived from the original PDF on December 19, Retrieved 23 October Retrieved 4 October The New England Journal of Medicine. Journal of Palliative Medicine. Journal of Pain and Symptom Management. Retrieved May 2nd, Check date values in: Cambridge Quarterly of Healthcare Ethics.

Disabled Activists for Dignity in Dying. Retrieved 14 August The arts and science of rational suicide in the face of unbearable, unrelievable suffering: The EXIT euthanasia blog. The New York Times. Retrieved 4 August The Law and Professional Ethics". Retrieved 15 November Vulnerable populations, prejudice, and physician-assisted death".

Non-Ecumenical Studies in Medical Morality. Administering the Church — Church of Jesus Christ of Latter-day Saints. Retrieved 13 December Lawmakers Revisit Assisted Suicide Issue". Problems of bioethics - The Russian Orthodox Church". United States Conference of Catholic Bishops. Retrieved March 10, Retrieved 16 October Retrieved 17 October New England Journal of Medicine. Life, Death, and Pain". Sometimes a Small Victory.

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Retrieved 18 November Retrieved 28 February Retrieved 16 April Quebec's end-of-life care law explained". Retrieved January 5, Retrieved 11 November A Natural Right to Die: Twenty-Three Centuries of Debate. Retrieved 22 July Moving from First- to Second-Order Analysis? German Federal Ministry of Justice. Retrieved 9 July In Birnbacher, Dieter; Dahl, Edgar.


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Giving Death a Helping Hand: Physician Assisted Suicide and Public Policy. Archived from the original on June 13, The World Health Organization. House of Lords Hearings. Swiss Criminal Code in German. House of Lords, Zurich. Zurich votes to keep assisted suicide". Retrieved 12 August Euthanasia, Ethics and the Law: From Conflict to Compromise. Abingdon, UK; New York: The Crown Prosecution Service". Archived from the original on September 27, Archived from the original PDF on June 17, MPs reject 'right to die' law".

Retrieved 12 June Retrieved 28 November Charlotte Lozier Institute, 15 May Washington State Department of Health". Assessment of suicide risk Crisis hotline List of suicide crisis lines Suicidal ideation Suicide intervention Suicidology Suicide prevention Suicide watch. If you notice cognitive changes, it is valuable information to discuss with the care recipient and to share with their doctor.

If the disease progresses beyond minor symptoms, drug treatment may be indicated. The most commonly prescribed medication is L-dopa levodopa , and this helps replenish some of the depleted dopamine in the brain. In those older than 75, dopamine agonists should be used cautiously because of an added risk of hallucinations. Other drugs are also used, and new drugs are continually being tested.

It is common for multiple drugs to be prescribed because many of them work well together to control symptoms and reduce side effects. Contrary to past beliefs, starting Sinemet in newly diagnosed people does not lead to early symptoms of dyskinesia involuntary movements such as twitching or jerking. It is very important for people with PD and their family caregiver to work closely with their doctor s and to seek advice from a movement disorders specialist, who can best manage the more complicated aspects of the disease.

Over time, physicians add combinations of drugs, and more frequent dosing is required as the disease progresses. People with PD need to pay close attention to the times they take their medications and note the length of time the medication helps their symptoms and how long the medication effects last before wearing off. This information helps the physician better determine the amount of medication and the schedule for its use. As with all medications, side effects can be a problem.

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For some, starting Sinemet may cause dizziness or nausea. For other medications, side effects may appear after several years. Sometimes these hallucinations can be frightening. There is a well-described side effect from dopamine agonists that everyone who starts this class of medication should know about. Agonists and higher doses of Sinemet may cause impulse control behavioral problems. These behaviors vary, but may include: Often reducing or stopping this class of medications stops the behavior.

These behaviors can be so embarrassing for the care recipient and their family that too often the topic is avoided when talking with the doctor. Odd as it may feel, keeping track of unusual impulse behavior to report to the neurologist can provide critical medical management information. Sometimes, in the most advanced stages, a choice has to be made between motor function and cognitive function. High doses of medications may be required to manage the motor symptoms, but these same doses cause hallucinations or paranoia.

The DBS system consists of leads precisely inserted into a specific brain target, the neurostimulator pacemaker implanted in the chest, and extension wires that connect the leads to the neurostimulator. Though implantation of the system DBS surgery requires a neurosurgical procedure, the treatment itself consists of long-term electrical stimulation. Advantages of DBS include its ability to reduce the high doses of medications avoiding the systemic side effects of medication , its adjustability stimulation settings are programmed non-invasively using a wireless programmer by the clinician or a patient programmer , and its reversibility can turn it on or off.

Individuals whose condition meets these criteria are advised to seek a comprehensive evaluation from an experienced DBS team. The best candidates who have the most robust response to DBS tend to be younger than 70 years of age, with few center of the body symptoms such as swallowing and balance problems. Although there is no evidence that non-medical activities can affect disease progression, physical activity may assist with management of the symptoms of the disease while helping to increase enjoyment of life by staying active, having fun, and learning new skills.

Innovative programs are increasingly available. For example, one popular program started in New York and replicated in other states and countries offers dance classes for individuals with PD. Professional dancers teach the classes in a large dance studio with live piano accompaniment See the References section of this fact sheet for more information on these and other programs. They can recommend how hard you should be working intensity and the duration of the activity. A recommendation from your doctor to consult with a physical, occupational, or speech therapist is often useful.

These professionals can assist you in evaluating how to use non-medical interventions in a way that best suits your needs. In the simplest terms, Lewy bodies are abnormal clumps of proteins that develop in nerve cells. This loss affects memory, thinking, language, judgment, and behavior.

A few of the signs of dementia in PD include slowed thinking, a more passive or apathetic personality, memory problems, and trouble with decision-making. One particularly troubling symptom for a caregiver is when a care recipient experiences vivid hallucinations or delusions—seeing or hearing things that are not really present but seem very real to the individual. Frightening or dangerous hallucinations may call for a medical intervention. Use of certain antipsychotic medication can have highly debilitating side effects due to a hypersensitivity to these drugs by many LBD patients.

Highly cautious use and careful monitoring by your doctor is critical should the use of these drugs become necessary.

To Die or Not to Die: Ten Tricks to Getting Better Medical Care To Die or Not to Die: Ten Tricks to Getting Better Medical Care
To Die or Not to Die: Ten Tricks to Getting Better Medical Care To Die or Not to Die: Ten Tricks to Getting Better Medical Care
To Die or Not to Die: Ten Tricks to Getting Better Medical Care To Die or Not to Die: Ten Tricks to Getting Better Medical Care
To Die or Not to Die: Ten Tricks to Getting Better Medical Care To Die or Not to Die: Ten Tricks to Getting Better Medical Care
To Die or Not to Die: Ten Tricks to Getting Better Medical Care To Die or Not to Die: Ten Tricks to Getting Better Medical Care

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