Posts Tagged ‘end of life’

Life’s Journey

Friday, November 19th, 2010 by American Senior Fitness Association   View This Issue of Experience!

In this special issue of Experience! two outstanding authors address sensitive matters that can be expected to confront us along the intricate pathway of life. Included are thoughtful treatments regarding end-of-life considerations and the awareness of human mortality.

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Dare to Understand and Ask for Palliative Care

Friday, November 19th, 2010 by American Senior Fitness Association   View This Issue of Experience!

Today we are pleased to present the following article by Terry F. Katz, MD. Dr. Katz is medical director of The Center for Healthy Living in Teaneck, New Jersey. An internist specializing in the care of the elderly, Dr. Katz is associated with PMR, the Physical Medicine and Rehabilitation Center, PA, of Englewood, New Jersey. PMR is devoted to the diagnosis and treatment of medical problems related to pain and disability, and its multidisciplinary treatment teams provide comprehensive care for sports, spine, orthopedic, and neuromuscular conditions. For more information, click on www.Rehabmed.net.

The primary purpose of palliative care is to alleviate suffering and enhance the quality of life. The concept of medical palliation in its inception conjured up images of dying patients with a similar set of physical symptoms that required relief. As older people began living longer with incurable chronic disease, the concept of palliative care took on a broader meaning. Palliative care now includes providing care that addresses the physical, emotional, cultural, and spiritual issues that affect a patient and their family during the final phase of life. This stage may last days to weeks when associated with an acute event, or may last months to years as in chronic illness with progressive debility.

Providing quality palliative care requires a multifaceted approach that achieves best results when a team of nurses, social workers, physical therapists, religious counselors, and other therapists supply care under the supervision of a physician team leader. The expertise and involvement by all these individuals is important to identify and address the "whole person." Members of the palliative care team conduct their own evaluations over a period of time talking to the patient, family, and care providers to obtain the complete picture. The evaluation will elucidate team members as to social needs such as financial concerns, need for closeness, care-giving needs, and access to care; spiritual needs such as the degree of distress, role of spirituality, and the extent to which one has settled relationships; medical needs such as the role of further diagnostic evaluation and treatment of physical and mental symptoms; and finally therapeutic issues that illuminate the goals of care.

The evaluation is a constant process. Goals of care and treatment priorities shift with increasing disease burden, but treating physical symptoms is always paramount. Symptom management includes nondrug interventions such as physical therapy modalities and acupuncture, and pharmacological management with both traditional and alternative choices. Typically treatment is a combination that minimizes potential adverse reactions. After therapy is initiated, regular patient follow-up is important to assess relief of symptoms, effect of treatment on abilities to maintain usual activities, and measure whether the identified goals are being met.

The concept of a "good death" is central to the modern palliative care movement, but watching the diminishing physical capabilities and the death of someone close is never easy. The truth is: no one can escape the experience. We all feel the fragility of life and worry about our own future end-of-life experience. Embracing palliative care allows better management of symptoms and prevents unnecessary suffering for the patient, bolsters the family and care-givers with skills to adapt to the transitions and face the losses, and, in creating a more positive outlook on end-of-life care, can help so many groups of people.

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Facing Mortality Without Fear

Friday, November 19th, 2010 by American Senior Fitness Association   View This Issue of Experience!

SFA author Jim Evans is a 42-year veteran of the health and fitness industry and an internationally recognized senior fitness consultant. Today he discusses natural concerns that may arise with advancing age.

DEAR JIM: I have managed to outlive most of my friends and three wives to make it to age 92, and I feel pretty good for my age. I don’t drink or smoke, and I try to stay physically active. Still, I can’t help thinking about dying. I have seen so many of my friends expire after lingering for months with cancer, heart problems, Alzheimer’s disease, and other conditions, and I have to admit that it scares me to think that it could happen to me too — and the likelihood becomes greater with every passing year. Am I just being paranoid?

SCARED IN SCARSDALE

DEAR SCARED: No, you’re not being paranoid. The thought of dying becomes more commonplace as we get older and have a greater sense of our own mortality. And, as many of our friends and loved ones pass on, we think about it more often. However, you seem to be living a healthy lifestyle which has probably contributed to your longevity and could sustain you for years to come.

To put your mind more at ease, you might be surprised to know that most people in their eighties, nineties, and above are often healthier than those 20 years younger. Many medical afflictions usually happen to people in their sixties and seventies. Those who have reached their eighties and nineties — like you — are "survivors" who often carry on for years in comparative health.

With all of the current concern about Medicare, most people are not aware that the average Medicare bill for someone who dies by age 70 is three times greater than for someone who lives to be 90. In fact, the medical cost during the last two years of life — which are usually the most expensive — is typically just $8,300 for someone who dies at age 90 compared to $22,600 at age 70. It won’t be the centenarians who stretch the limits of Medicare but, rather, it will be the baby boomers turning 65!

It is not easy to put the thought of death on the back burner when so many of your peers are already deceased, but dwelling on it will not add years to your life either. You have been given a great gift to live so long, so continue to take good care of yourself and enjoy each and every day. Your healthy lifestyle has seen you through the years and should continue to serve you in good stead. Remember, it is not how long you live that counts but the quality of those years. With more and more people living longer, you are in good company.

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As Autumn Gives Way to Winter

Friday, November 19th, 2010 by American Senior Fitness Association   View This Issue of Experience!

The English poet and philosopher Samuel Taylor Coleridge(1772-1834), along with his close friend William Wordsworth, was a founder of the English Romantic Movement. Well known for his poem The Rime of the Ancient Mariner, Coleridge also shared his thoughts on the changing seasons of life:

"The one red leaf, the last of its clan,

That dances as often as dance it can,

Hanging so light, and hanging so high,

On the topmost twig that looks up at the sky."

– Samuel Taylor Coleridge

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