[Magdalen] RIP Sir Terry Pratchett

[Ann Markle]

Jim, things are not really better.  I remember doing my chaplaincy
training, and my CPE supervisor called it "fighting over the dying:"  it's
more about billing now, than the denial of terminal illness.  Doctors and
the medical "system" want to keep billing for tests and procedures, even
when they know the cost-benefit ratio is less than good.  It's really not
about denial anymore; it's about greed.  The public's greater awareness of
hospice care probably results in more referrals now -- people ask for it,
for themselves or for loved ones, in part because of better access to home
health care and other benefits that hospice can provide or assist with.

Ann

The Rev. Ann Markle
Buffalo, NY
ann.markle at aya.yale.edu
blog:  www.onewildandpreciouslife.typepad.com

On Fri, Mar 13, 2015 at 1:52 PM, James Oppenheimer-Crawford <
oppenheimerjw at gmail.com> wrote:

> ​I wonder if anyone would refer to the palliative care team?
>
> I recall listening to a lecture by Kuebler-Ross. She was instructing some
> nursing students, and they got the idea of looking at cases of terminal
> patients.  Everywhere they inquired, however, the answer was the same: "No
> one is dying on this ward." This despite the fact that at that facility,
> there were a significant number of deaths on a daily basis.  This sparked
> the idea of looking into death and dying. In the few cases I have been
> familiar with, hospice services were called for when the patient was within
> a day or two of death, and it was utterly pointless. Things are better in
> that regard, I'm sure.  But I'm also sure that some induhviduals will
> simply refuse to admit the patient might be terminal until they cannot find
> a pulse.  I guess it's a natural defense mechanism, but still ...
>
> James W. Oppenheimer-Crawford
> *“A life is like a garden. Perfect moments can be had, but not preserved,
> except in memory. LLAP**”  -- *Leonard Nimoy
>
> On Fri, Mar 13, 2015 at 12:38 PM, <sally.davies at gmail.com> wrote:
>
> > ​...
> >
>
> ​
> > The best practice is to have a Palliative Care team in every hospital,
> > working alongside the regular doctors and effecting a seamless transition
> > that involves patient and/or family, nursing staff and medical staff all
> > working together to obtain the best possible outcome. Most hospitals can
> do
> > it - no extra staff need be employed, you just have to identify the
> people
> > who really care about this and equip them to play that role. But our
> > medical culture i.e. "my patient, my responsibility", does not favour a
> > team approach even when lip service is paid to that. This is in the
> Private
> > sector; the State sector here is mostly too overwhelmed, so we have the
> > opposite problem, needless loss of patients who could be saved with the
> > correct interventions.
>