Quality of life is something that we often talk about. It’s important, as it’s the standard of health, happiness and comfort that we set for ourselves as we make important life decisions. However, when it comes to quality of death, this is a topic that we often avoid. This makes sense, as talking about the end of life isn’t comfortable, and the idea of death itself can be quite scary. We often push these conversations under the rug for as long as possible. However, this sometimes means that we can reach a point where it’s too late to take meaningful steps. Through knowledge, we can recognize how important this topic is in easing the transition from life to death.
What is Quality of Death
What do we mean when we talk about quality of death? These are the elements that make up our preferences about how care is managed and how our life is lived when death is near. While there are certain preferences that individuals express, most people share remarkably similar ideas about what quality of death means. When polled about their preferences for the end stage of life, most indicate that a “good death” would include the following:
- Freedom from pain and discomfort
- Spending last moments at home
- Remaining lucid for as long as possible
- Having family, friends or other loved ones present
- Ending life knowing they had the opportunity to find closure, say goodbye and make final amends
- Having access to appropriate spiritual and emotional support
- Feeling confident that final wishes have been expressed clearly and will be honored after passing
Though none of these things remove the sadness or heartache that the death of a loved one brings, when we can fulfill these basic and practically universal wishes for a dying loved one, their quality of death is typically ranked higher. The experience, thus, has a greater potential to feel peaceful. Family members are left feeling less regret, and the dying individual feels honored, dignified and valued.
A Physician’s Role
Discussing quality of death without considering ways in which to improve it is viewed by many palliative care and hospice care professionals as remiss. Physicians play an important role here. A reluctance by medical professionals to discuss end of life care decisions can lead to care that is too little, too late or a prolonged use of invasive treatments that are not effective or desired by your loved one.
A physician who is open to introducing palliative care conversations in the months or even years leading up to the end of life (rather than only in the final days) improves both quality of life and quality of death by empowering his patients to find pain relief and the support that they need throughout this critical period. If your loved one’s doctor does not broach this important topic soon after diagnosing a serious medical condition, take it upon yourself to ask questions and gather information.
While it isn’t always easy for a physician to determine when it’s appropriate to bring up palliative and hospice care, it is almost always better to err on bringing it up too soon. Even if your loved one ultimately makes the decision not to seek care immediately, you’re armed with information that better prepares you for the future and can help to improve quality of life and quality of death when the time comes.
The Reluctance to Discuss Palliative and Hospice Care
One of the reasons why physicians are sometimes slow to bring up palliative and hospice care has to do with society’s perceptions about death and dying. While death is a natural part of life, many view it as taboo. That has led to death becoming medicalized and curative across our country. While there is certainly value in medical innovations that help to prolong life and effectively treat many health diagnoses, there sometimes comes a time when such measures are uncomfortable, painful or even ineffective.
While the benefits of palliative care and hospice care are well-proven, some in society view such paths as “giving up” rather than recognizing the value that they bring. Through education, we can change our perceptions about these programs, remove stigmas and better understand their value with regard to quality of death. These shifts in perception take time and aren’t easy. However, they do help to ensure that hospice and palliative care are more widely discussed with patients and made available in the medical community.
Death truly is part of life. That is why, when we have discussions about quality of life, it’s also important to consider quality of death. In our medical community, patients benefit when doctors are open to discussing palliative and hospice care even very soon after a diagnosis. This empowers patients by helping them to clearly understand that they have options. Salus of Los Angeles continues to advocate for such conversations in our medical community. As part of our community outreach, we provide important information to doctors that assists them in providing the highest level of care to all patients, at every stage in life. We’re also available to answer your questions about palliative and hospice care. Reach out if you ever need us.