Dr. David Tribble The New England Journal of Medicine published a study recently in which 151 lung cancer patients received either usual treatment or usual treatment plus palliative care. The palliative care recipients had better quality of life scores; were more likley to have decided against resuscitation; received less chemotherapy; and survived, on average, almost 3 months longer. Previously, a study has shown that the simple act of a clear conversation about prognosis and options led to better symptom control and fewer oncologic interventions without shorter survival. Another showed that for patients with 5 specified cancers and congestive heart failure, hospice care is associated with a longer survival. We who practice palliative medicine do so not because we support giving up, but because we have experienced the improvement in life that comes with adequate symptom control, and with thoughtful decision-making on the value of some therapies whose life-prolonging benefits are open to question. Now we have, in multiple studies, solid evidence that palliative medicine not only does NOT shorten survival, but actually is the best chance of extending it for some. Electing palliative care is not an act of surrender. It is, for many, the best opportunity for survival that is not only the most comfortable, but also the longest. Active medical intervention for cure or disease modification does not necessarily equate to longer survival or to better qualitative survival. I look forward to the concurrent care demonstration projects (a combination of curative and hospice care), both for the opportunity to provide good palliation (comfort measures) to those not yet ready to abandon disease-modifying treatment and for the opportunity to look at this survival issue on a much larger scale. Dr. David Tribble is Alive Hospice’s chief medical officer. http://alivehospice.org/blog/2010/09/03/hospice-care-is-not-surrender/
Friday, September 3, 2010
Hospice for the Gallaghers, hospitality from the Gallaghers « The In Box
Imagine for a second that your doctor is telling you point-blank that you're going to die.
Now imagine that there's a reporter standing on your doorstep, asking you to talk openly and candidly about that experience.
This is exactly the situation that Bill and Tomi Gallagher have faced since last winter.
"I think we didn't realize that Bill wasn't going to get better until the doctor said it very frankly," Tomi says. "So you kind of have to face that."
The Gallaghers signed up for hospice care with High Peaks Hospice and also agreed to meet with me every week or two to talk about their experience.
That kind of generosity isn't exactly rare in the North Country.
But it is a kind of trust that does sometimes give me pause about the work I do.
When someone shares with me a story this important and sensitive and difficult, it's a blessing and a gift to be sure. But it's also a daunting responsibility.
So in case it doesn't come through loud and clear in the series The Hospice Path that begins today, here are the two big take-aways.
First, hospice can be incredibly valuable for people trying to find as much richness as possible at the end of their lives. Here's how Tomi puts it:
"We needed some help and direction in kind of trying to continue on with life. I mean, hey — let's not pull the lid over yet, you know?"
Secondly, the Gallaghers are people who find a way to give and show hospitality even when their own challenges are monumental.
I think you'll hear how open and vulnerable and honest they've been in describing this time in their lives.
But you'll also get a sense for their courage.
My hope is that their story will help others in the North Country to understand that there are people and services available when their own crisis comes.
If you've had experience with hospice and feel comfortable talking about it, please post comments below.
This entry was posted on Monday, August 30th, 2010 at 6:30 am and is filed under Uncategorized. You can follow any responses to this entry through the RSS 2.0 feed. You can skip to the end and leave a response. Pinging is currently not allowed.
Tuesday, August 31, 2010
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