In the book Being Mortal by Dr. Atul Gawande, he discusses the many grievous trials people face near the end of life. Gawande uses the many experiences that he has had as a doctor and the experiences in his own family to give insight into the good and bad end of life decisions. Reading all of Gawande’s experiences has made me realize the large amount of illness and death I have faced in the last 5 years and helped me to reflect on the outcomes of those events and some of the dilemmas faced by my family. From nursing homes to old age to even terminal cancer in those who are not elderly, all of these topics were extensively covered by Gawande and have been a part of my everyday life. To start, a slight background on a few of the events that …show more content…
Gawande helped me to reflect on. My grandmother, Bea, lived alone into her eighties when she started to develop Alzheimer’s. She was placed in assisted living then later moved to the memory-care ward. Next my other grandparents were also living in their home into their eighties. My grandfather took care of my grandmother who was confined to a wheelchair due to a stroke eight years prior. Suddenly my grandfather fell, breaking his hip, they were both then placed in a nursing home, where my grandmother soon passed. My grandfather is now in assisted living. Last, though not the last family member who felt the effects of being mortal, is my step-mother, Kari. She had developed pancreatic cancer, a cancer that typically gives less than a year to live. Her cancer was caught early enough that surgery was an option that could drastically beat back the cancer; which was then followed by various degrees of chemotherapy and medications. When my grandma Bea moved into assisted living, it fit the protocols that Gawande had described happening to most elderly people (106).
Bea had very little input into the timing of her move and her kids ultimately made the decision. This was not because her kids wanted to be mean, it was because her memory was already starting to fade. She would call my father late at night wondering when her husband was going to be home; all the while not remembering that he had died twenty years prior. Her physical health was also deteriorating: she had a few minor falls that never broke anything but did need help getting back up. Like Alice in Being Mortal, my grandmother felt like she was placed in a prison (73). After a while, her memory continuing to fade, she was placed in the memory-care ward that was in the assisted living location; it was here where Gawande’s statement, “they might have called the service they provided assisted living, but no one seemed to think it was their job to actually assist him with living,” was becoming clear (105). In this part of the home she was in, there were few activities for the residents, there were no animals or children coming to visit, and they were no longer allowed to go outside alone or even to other parts of the building alone. It was here that her autonomy was lost and soon after, so was she. The home she was in is regarded as one of the top in the area but unlike many of the homes that Gawande visited, they didn’t believe that “you didn’t need to sacrifice your autonomy just because you needed help”
(139). The experiences of Bella and Felix that Gawande wrote about fit the story of my other grandparents almost perfectly. Grandpa had fed, bathed, dressed, and helped grandma with her daily life for over eight years; just like how Felix was taking care of his blind wife and her daily tasks (50). “If you break your hip… it will be a disaster” (228). The turning point in this care system came like many others, my grandpa’s fall and broken hip (73). He could no longer provide for her and was then forced to live in a nursing home with her. Prior to this event, he was just like Harry R. Truman; it would take more than a volcano to make them move out of their house (67). Both required such extensive 24-hour care that moving in with my mom was not an option for them. I noticed that in many of the stories Gawande shares, the more intense the care a parent needs, the more difficult it would be for a child to support them. Now that my grandpa is alone and in a more communal assisted living, he is starting to become more personable. He eats lunch with a group of guys there and also is starting to join in a few activities. While reading Being Mortal it became clear to me that in either of the cases of my grandparents, no one sat down with them through the process and asked them the hard questions that Gawande found so crucial. From the standpoint of pancreatic cancer, my step-mother was given a “medical equivalent of a lottery ticket” (171). It is still clear that the cancer will eventually take her life or at the very least drastically shorten it, but compared to the few months that most people are given, she has a whole new life. So far her cancer has followed much the trend of the graph on page 27, many ups and downs with an uncertainty of how far the next dip will go. Yet with all this (somewhat) good news, we have never sat down and had the tough conversations of when she thinks enough would be enough: when to resuscitate, what she wants to do before death, or any of the other questions that Gawande found to be so vital (179). Before the diagnosis, my dad and step-mom always were geared towards family but afterwards, they have even more so. They make time to go on trips (the doctors try their best to accommodate) and they also try to have dinner with one of their kids each week. My step-mom also spends a lot more time with her 16 year old daughter. She still drives her around and hangs out with her around the house, no small feat to do with a 16 year old. Just as Gawande had predicted, our perspective on life and how long we have left, changes the goals that we set. Even with the change in goals, the close run with death, and the constant hovering of death, there is still little talk about what decisions should be made. Gawande provided many examples where these conversations could relieve some stress on the family because they know that the decision they made was one that the loved one approved of (184). Being Mortal has made me look back at many of the existential crises that my family has faced the past few years, as well as helped me to recognize how to tackle the future crises. While currently living day to day, eventually that day will become the day we find death and our
In most facilities an initiative lifestyle has been organized to give people with dementia a voice in how and where they are cared for (White). This is how things should be everywhere in the world when it comes to people with dementia. People affected by this disease don’t need people to tell them what to do or make decisions for them, they need the freedom to do it themselves so they don’t give up. Although incapacity is common, many persons with dementia are capable of making their own medical and research decisions (Kim, Karlawish, and Caine). At the early stages of dementia, a will needs to be made so medical wishes can be granted. When people are given the freedom of choice, they are much happier, they live longer, and they have a better attitude about the disease they are suffering from. Individuals that get dementia did not get it by choice, but they live through it day by day with strength and the ability to live
Lisa Genova’s grandmother, who was 85 years old, had been showing signs of dementia for years; but she was a smart and independent woman who never complained, and she navigated around her symptoms. Her nine children and their spouses, as well as her grandchildren, passed off her mistakes to normal aging. Then they got the phone call when Lisa’s grandmot...
On the topic of Atul Gawande’s novel Being Mortal: Medicine and What Matters in the End, an ongoing issue has brought into question what we should do with the elderly and ill that are in need of care. On the one hand, some argue that they should be put in nursing homes and seek treatment for their problems because they can no longer take care of themselves. From this perspective, the elderly have a greater chance of getting injured if they are not taken care of properly, thus are seen as unfit to live on their own. On the other hand, however, others argue that the elderly should be allowed to live on their own as long as they maintain a healthy lifestyle. Atul Gawande, one of this view’s main proponents, urges us to realize that no one is immortal
...nd institutions are made today. The book made me change my outlook on placing people into this homes for many different reasons. Even though I feel like nursing homes are not as bad as ILLC, I do know that they place a discrimination and place ableism on these people. Overall, this book has opened my eyes to many different things and has shown me that even though we think the world is good, there are “bad kings” out there too.
The Dying of the Light is an article by Dr. Craig Bowron that captures the controversy surrounding the role of medication in prolonging life. The author describes that many medical advancements have become a burden to particularly elderly patients who in most instances are ready to embrace the reality of death. Dr. Bowron believes that dying in these modern times has become a tiring and unnatural process. “Everyone wants to grow old and die in his or her sleep, but the truth is most of us will die in pieces,” Bowron notes (Bowron). The article does not advocate for euthanasia or the management of health care costs due to terminal or chronic illness. Bowron faults humanity for not embracing life and death with dignity as it was in the past. He blames the emergence of modern medical advances and democracy as the sole reason why everyone is pursuing immortality or prolonging of life rather than embracing the natural course of things. The article is very articulate and comes out rather persuasive to its target audience that happens to be health-conscious. Craig Bowron uses effective rhetorical strategies such as logos, ethos, and pathos to pass on his message. The article’s credibility is impeccable due to the author’s authority in health matters as he is a hospital-based internist. A better placed individual to dissect this issue by analyzing his experiences in the healthcare profession. The article incorporates a passionate delivery that appeals to the readers’ hopes, opinions, and imagination.
The thought of death is a scary one. However the scarier thought is “living” a life in pain and suffering from an incurable and terminal disease such as cancer or Alzheimer’s. Imagine your grandparent has recently been diagnosed with Stage 4 Lung cancer. Now the doctor will list off all the possible treatments and in your heart you want your grandparent to try everything to fight for their life. After hearing the doctor give the terrible news, your grandparent ask the doctor about some options but also mentions assisted death. Your mind floods with memories and arguments against it. Your grandparent explains how they have lived a full life, doesn’t want to put the family in debt from the medical bills along with the inevitable cost of a funeral and have
The story of Miss. Julianne took me to my childhood. When I was 13-14 years, my Nana was also suffering from dementia at that point. I was too young at that point to understand his situation, now in nursing I am learning about different diseases and how patients react to those particular situations, I can relate more to his pain and understand from what he was going through. As in the story Miss Julianne forgets things, as she said, “Where are my dentures?” (Lenar, K., 2016,), and she blames others, “and
End-of-life care in the United States is often fraught with difficult decisions and borne with great expense. Americans are often uncomfortable discussing death and
...ter care home somewhere in southern California. Her present condition is debated. One individual hired an investigator in 2000 and supposedly found her to be happy. Another person, this time a psychiatrist, who visited her found her to be silent, depressed, and chronically institutionalized. After watching this documentary, I truly was appreciative to the family care and environment I was born into. The importance of human contact became very evident through the heartbreaking discussion of Genie. I was able to develop successfully though Erikson’s stages as I had a basic trust, a will to do things myself, an initiative to create plans, and a sense of competence. Genie on the other hand has been deprived of happiness, a sense of safety, love needs, human contact, opportunities to learn, and many other factors that makes a healthy, normal, happy human in society.
...overtaken her body and the family know how much care Deana will need. By placing Deana in a nursing home where she can get the care she needed, I could only imagine that the decisions from the family were very challenging. Caring for Deana probably was a lot on some or most of the family member. So being honest about the care she needed, the decision made about placement in the nursing home was the best decision they made and in her best interest.
Anyone can be diagnosed with a terminal illness. It doesn’t matter how healthy you are, who you are, or what you do. Some terminal illnesses you can prevent by avoiding unhealthy habits, eating healthily, exercising regularly and keeping up with vaccinations. However some terminally ill people cannot be helped, their diseases cannot be cured and the only thing possible to help them, besides providing pain relieving medication, is to make them as comfortable as possible while enduring their condition. Many times the pharmaceuticals do not provide the desired pain escape, and cause patients to seek immediate relief in methods such as euthanasia. Euthanasia is the practice of deliberately ending a life in order to alleviate pain and suffering, but is deemed controversial because many various religions believe that their creators are the only ones that should decide when their life’s journey should reach its end. Euthanasia is performed by medical doctors or physicians and is the administration of a fatal dose of a suitable drug to the patient on his or her express request. Although the majority of American states oppose euthanasia, the practice would result in more good as opposed to harm. The patient who is receiving the euthanizing medication would be able to proactively choose their pursuit of happiness, alleviate themselves from all of the built up pain and suffering, relieve the burden they may feel they are upon their family, and die with dignity, which is the most ethical option for vegetative state and terminally ill patients. Euthanasia should remain an alternative to living a slow and painful life for those who are terminally ill, in a vegetative state or would like to end their life with dignity. In addition, t...
The care of patients at the end of their live should be as humane and respectful to help them cope with the accompanying prognosis of the end of their lives. The reality of this situation is that all too often, the care a patient receives at the end of their life is quite different and generally not performed well. The healthcare system of the United States does not perform well within the scope of providing the patient with by all means a distress and pain free palliative or hospice care plan. To often patients do not have a specific plan implemented on how they wish to have their end of life care carried out for them. End of life decisions are frequently left to the decision of family member's or physicians who may not know what the patient needs are beforehand or is not acting in the patient's best wishes. This places the unenviable task of choosing care for the patient instead of the patient having a carefully written out plan on how to carry out their final days. A strategy that can improve the rate of care that patients receive and improve the healthcare system in general would be to have the patient create a end of life care plan with their primary care physician one to two years prior to when the physician feels that the patient is near the end of their life. This would put the decision making power on the patient and it would improve the quality of care the patient receives when they are at the end of their life. By developing a specific care plan, the patient would be in control of their wishes on how they would like their care to be handled when the time of death nears. We can identify strengths and weakness with this strategy and implement changes to the strategy to improve the overall system of care with...
A ‘good death’ is something that can help us to evaluate how to formulate improved end-of-life care, free from discrimination regardless of a person’s social level with no stereotyping. Learning to respect difference and diversity and to ensure that everyone is treated as equals with their end-of-life care. Diversity is a concept that forms acceptance and respect of individual differences. Whereas, difference gives us variations within the connection of control leading to
Change is Possible at Any Age It is always possible to be better; your best performance can be improved upon, no matter what you level of expertise is. In the article Personal Best, Atul Gawande (2011), a surgeon who specialized in endocrinology, talks about how he thought he was at the peak of his career, he had “hit a plateau” and “the only direction things could go from here was the wrong one” (p.1 & 2). He comes to find that with the help of a coach, there is room for growth and greater achievement. Gawande talks about how he came up with the idea of hiring a coach to watch him perform surgery after an experience he had playing tennis.
The subject of death and dying is a common occurrence in the health care field. There are many factors involved in the care of a dying patient and various phases the patient, loved ones and even the healthcare professional may go through. There are many controversies in health care related to death, however much of it roots from peoples’ attitudes towards it. Everyone handles death differently; each person has a right to their own opinions and coping mechanisms. Health care professionals are very important during death related situations; as they are a great source of support for a patient and their loved ones. It is essential that health care professionals give ethical, legal and honest care to their patients, regardless of the situation.