living your best to the end

modern medsModern Medicine can keep you alive

Machines, medications and man-made parts: modern medicine continues to find and develop life-saving and life-prolonging interventions.

Advancements in heart research include:

  • Bypass surgery
  • Man-made implantable cardiac devices like pacemakers

When organs fail, there’s dialysis for kidney failure, and transplants for kidney, lung, liver and heart. Cancer continues to be researched, and survival rates and life expectancy has greatly increased. For neurological (brain) illness and injury, medications and interventions are emerging, and rehab helps with increased function. Even infections – which were regularly the cause of death in past generations – are now treated with antibiotics.

However,  as the body winds down, so-called ‘Heroic Measures’ may do more harm than intended.  CPR (Cardio-Pulmonary Resuscitation) Breathing Machines (ventilators), Feeding tubes and specific medications can be considered  Heroic Measures or seem more like Futile Treatment. When making decisions about any of these, it can help to understand the longer-term results and possible complications.

Vial of LIFE

What is the Vial of LIFE Program It may sound like the fountain of youth, or miracle life-saver in a vial. It is neither. Instead, it’s information about your health care and wishes, stored in your fridge with a fridge sticker to announce its presence. LIFE stands for Lifesaving Information for Emergencies The Vial of LIFE sticker on your fridge alerts Emergency Response Teams (EMS) Paramedics and other health care providers who may come to your home

Dementia – more than memory loss: it’s a broken brain

Dementia: Communication, hard-to-manage behaviours and safety A much needed re-framing of Dementia from Alberta Health Services clinical nurse specialists, Jennette Coats and Loralee Fox, who embrace care and caring for those with ‘broken brains’. I sat in on their extremely practical and sensitive strategy session for supervisors of Home-Care Workers organized by Revera Health Care.Whose patient population increasingly has one or more Dementia: Alzheimer’s, Lewy Body, Fronto-Temporal Lobe, Vascular Attendees included nurses, occupational therapists, social workers, personal support workers and physiotherapists who shared some of their own coping stories, dealing with their own parents with Dementia: “I could tell my mom all the awful stuff about my divorce. She’d forget as soon as I told her – so I got to ‘dump’ without guilt.” As the broken brain description implies, it’s more than just memory loss that caregivers cope with. It’s the responsive b behaviors – aggression, anxiety, agitation, wandering – that drains emotionally and physically. One of the strongest messages acknowledged the issue of time: Caring for someone with violent behaviours of dementia can take 50% more time Staying safe takes time: trying to be efficient can be self-defeating “Rushing through can cause emotional distress and increase anxiety, agitation, and aggression.” From the Gerio Psychiatric Education program in Victoria British Columbia, the acronym, ABCDE Apologies: One of the most powerful the calming strategies I’m sorry – I didn’t mean to upset you. I’m sorry – you’re right. I’m sorry I made you feel (angry, hurt, dismissed..) I’m sorry – I know you’re trying so hard. I’m sorry – this must be so hard for you. One of the...

Coalition for Compassionate Care Summit with ePatients

  ePatients: Engaged and Empowered and Invited The Coalition for Compassionate Care of California (CCCC) promotes high-quality, compassionate care for everyone who is seriously ill or nearing the end of life. What a human-centered, patient-centered goal. And now, the Coalition includes the patient’s point of view –  their  first Summit with ePatients : we who are not afraid to look beyond, ask beyond and search beyond what we’ve heard in doctor’s offices. It’s a given that the ‘e’ includes electronic (email, forums, searches) connectivity after all, in between doctor’s visits patients live their lives, and turn to the digital world for support comfort and information. Palliative approach: ripe for ‘ePatient engagement’ Since Palliative care focuses on all aspects of comfort (or as palliative doc, Daphna Grossman put it: doing ‘Nothing’ is not an option) patients and families have ample time to learn about what may be ahead, and put put mind to what’s important long before the end may seem nigh.  Comfort itself can mean many things, in addition to the all-important pain management.  The palliative approach: perfect opportunity for ‘engagement’. ePatient: Educate and Encourage and Evangelize about Palliative Care Great keynote by #ePatientdave with @KathyKastner in foreground at #cccc16! — Elizabeth Bailey (@PatientPOV) May 12, 2016 This is one of the many reasons I was so over-the-moon at the decision to invite patients to the Summit, and was even more so when I was selected. This, especially so because my fellow ePatients are living with chronic conditions – whether themselves or those they care for – where I am not. Rather I am immersed in the crises,...

Advance Care Planning: Women’s College Hospital and Kathy Kastner

National Advance Care Planning Day sees Women’s College Hospital as leaders: bringing the first consumer-created End-of-Life website to Family Doctors. TORONTO APRIL 16…Women’s College Hospital  (WCH) is the first to embark on a project with Family Doctors and patients to evaluate the only consumer-created website for end of life education,, developed by Kathy Kastner. With the trend to involve patients in all aspects of health care – from research to policy – selected WCH Family Doctors will ask their patients to help evaluate BestEndings, via paper or electronic survey. Feedback and input will be used to improve the overall user experience. Dr Chen championed in ‘Dragon’s Den’ type pitch session. Dr Chen, Assistant Professor, Department of Family and Community Medicine, University of Toronto, is winner of the 6th annual Excellence in Education awards recognize WCH staff who demonstrate a commitment to education, create an environment that enhances understanding and teamwork and who have a broader impact on WCH’s and women’s education and interprofessional activities. “Women’s College Hospital is leading the way by hosting a project like this. Working together is the first step to creating a mutual understanding of improving patient-doctor end of life conversations and being able to care for and treat patients in the best way possible. “ Says Dr Chen. “Kathy has a history of creating award-winning patient-centered education: she brings a ‘layperson’s perspective to end of life issues, along with curating evidence-based resources and an electronic Advance Directives form.” About Kathy Kastner: With a background in journalism and entrepreneurship, Kathy pioneered North America’s first hospital-based patient-education television networks, implemented for 20 years in top teaching hospitals...

I want to die in my sleep like my grandfather… not screaming and yelling like the passengers in his car.

Will Shriner


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