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Monday, November 30, 2015

Lessons in End-of-Life Care From the V.A.

By David Casarett
The New York Times
November 11, 2015

Here are two excerpts:

Sheila had just received a “patient experience” survey that asked for her opinions about her recent stay in one of our hospitals. He read off some of the questions, in a voice that was tinged with a mix of anger and amusement. Those questions were about the quality of the food (“unimpressive”), the availability of parking (“O.K.”), and the cleanliness of the rooms (“perfect”).

But, he said, “You didn’t ask us about what really matters.”

What he meant, he explained, was that these questions didn’t reflect what was important to a 73-year-old woman with incurable breast cancer who knows she’s going to die in the next six months. And they didn’t assess how well we were supporting her husband, who was overwhelmed with being a caregiver and advocate, a father and grandfather. We asked for their opinions, but we didn’t ask the right questions.

(cut)

We need to be asking these questions. National surveys could easily be modified to include questions that are important to patients like Sheila. We could include questions about emotional and spiritual support, control over decisions, adequacy of information and respect for dignity. Those sorts of questions are arguably important for all of us, but they’re particularly relevant to those who are facing advanced, incurable illnesses.

The entire article is here.