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"Hope is not a plan." Dt. Atul Gawande

Fri, Apr 21st 2017 03:35 am
Dr. Atul Gawande
Dr. Atul Gawande

In 2015 PBS Frontline premiered their documentary, "Being Mortal." The film follows New Yorker writer and Boston surgeon, Atul Gawande, as he studies relationships that exist between health care workers and patients as they near the end of life. The documentary mirrors Atul Gawande's book, Being Mortal: Medicine and What Matters in the End, as it explores how patients with terminal diagnoses are often cared for and how many doctors, Gawande included, are not properly trained or prepared to confront sensitive situations such as chronic illness and nearing death.

Niagara Hospice is sponsoring a community screening of the film on Friday, April 28 at 2:00pm at the Wheatfield Community Center at 2790 Church Road in Wheatfield. The documentary, like the novel, explores the concepts behind palliative and hospice care. Towards the latter part of the film Gawande shifts to end-of-life medicine, promoting hospice as a model of care. Highlighting one of the most important questions that is typically asked in these situations, "What are your priorities if your time is limited?" Gawande explains that by centering conversations on this question, health care providers can empower patients to live their lives fully.

Viewers of the program are challenged to examine how they think about death and dying. Being Mortal shines a light on how patients, families, and doctors all experience the end stages of life, and encourages conversation about how to live life to the fullest extent possible. Gawande recognizes that there is no perfect solution when it comes to end of life care. However, he simply asks us all to commit to creating better options for patients to have a purposeful and good life until the very end.

"Too many patients come to us with only weeks left to live, or who are actively dying," said Danielle Burngasser, RN, CHPN and Niagara Hospice Director of Homecare and Intake. "These are the patients that break our hearts; knowing we could have done so much more for them and their families had someone just had the hospice conversation with them sooner."

Hospice care is appropriate for individuals with a prognosis of approximately six months or less to live - if the disease were to run its normal course. Some patients live beyond six months. Several studies have shown that people with a terminal illness who choose hospice care often live longer and with better quality of life than those who do not take advantage of their hospice benefit. Hospice services are a fully covered Medicare benefit. Most other insurance providers also cover hospice care, so cost of care should never be a barrier to accessing what is known as the gold standard of end of life care that we are all entitled to.

How will I know? Burngasser said that's the question many ask when faced with serious illness. It may be: "How will I know my caregiver needs more help?" Or, "How will I know all the services available to me and my family?" Or it may be, "How will I know it's time to call Hospice?"

"Sadly, too many families do not experience the full benefit of hospice care. Too many still tell us they wish they had called sooner," said Niagara Hospice Director of Marketing, PR and Volunteer Services, Tricia Degan. "Educating our communities is a big part of ensuring families understand what hospice is, and what it is not. Hospice is not about giving up; it's about getting help, changing goals, and choosing how you want to live as you near the end of life. Hospice helps put you in the driver's seat to ensure you live life the way you choose to live it, until the very end. And we can help sooner than most people think."

Degan said there will be a panel of professionals from several disciplines of care available to answer questions immediately following the program. Advance care planning materials such as Health Care Proxy, organ donation, Living Will, and Do Not Resuscitate (DNR) forms will also be available.

The Being Mortal screening is open to the community at no charge. Light refreshments will also be provided. Leave a message at 280-0742 to register or visit the Event Calendar page at NiagaraHospice.org for more details and a flyer that can be shared. "We encourage people to bring friends and family so we can all be part of this national conversation on how to live life to the very fullest as we near the end," said Degan.

A message from Dr. Atul Gawande:

Hello Niagara Hospice Community,

Let me begin with congratulations on your 10-year (Niagara Hospice House) anniversary. The work you do is so important for seriously ill people and their families. I'm honored that you have chosen to celebrate with Being Mortal.

This project emerged from both my professional experience of being a surgeon and my personal experience of facing serious illness in my family. My key lesson is that medicine and society has failed to recognize that people with serious, life limiting illness have priorities in their lives besides just living longer. The most effective way to learn their priorities is to ask them. But we ask less than one third of the time before people die. When we don't ask, our care can end up out of alignment with what matters most to individuals — and that results in suffering. When we do ask, however, care can be markedly different. People experience more control over their care, less suffering, including anxiety and depression, and spend more time at home instead of the hospital. And they do not live shorter. They often live longer.

Our job then has become clear: we must assure that all of us receive care that recognizes our goals and priorities for quality of life as well as quantity of life when we face serious illness. After all, the goal is not a good death. The goal is a good life, all the way to the very end.

Thank you very much for watching.

- Atul Gawande

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