Time to adddress the need to improve end-of-life care

<p>For a few decades now, I’ve been steeped in work dedicated to improving care for people living with serious life-limiting illness that ends in death. This work grew out of concern for the impacts of high-tech medicine on elderly people who really needed “high touch” care instead.</p><p>I’m delighted to see health care reforms in progress aimed at providing more appropriate care and assistance for older adults, the frail elderly and dying.</p><p>My end-of-life care work with the Community Network Journey Project is rooted in personal experiences with old folks close to me, including neighbors, family and friends. In this way, I experienced what it was like to be old and frail, traveling the journey through life’s end.</p><p>Routinely, I helped people learn about choices and find their way despite tremendous pressure to pursue aggressive medical interventions they didn’t want. That’s what helped to alleviate needless trauma and suffering most of all. </p><p>What made the difference was just plain common sense. It was simply taking the time to learn of the elder’s hopes and fears, their values and wishes. It was about being a good listener and offering help in the smallest of ways, nothing out of the ordinary, really. </p><p>They all knew they were dying and chose to live out their remaining life on their own terms. After all, that was how they had found their way through lives spanning most of the 20th century. They weren’t willing to risk dying in an Intensive Care Unit plugged into machines and they accepted dying in old age as a natural part of living.</p><p>In the health care arena, things have improved somewhat these past few years, but there is much more to be done. Important changes concerning end-of-life care are now under review in Congress. Changes proposed are essential given the fact that nowadays most elders die as a result of multiple life-limiting illnesses spanning several years. It is rare for an elder to benefit from aggressive treatment when already dependent upon others to get through activities of daily life. </p><p>New benefits proposed for seniors include the right (not the obligation) to have timely, meaningful conversations with health providers about advance health care planning.</p><p>Palliative care, a life-affirming supportive way of caring for people living with serious illness and frailty, would be covered as any other medical program. Models of care — the bedrock for reforms proposed — are time-tested and well proven. Health outcomes are better, patient/family satisfaction is top notch, burnout is less for family caregivers and health care workers, and cost-savings are remarkable. </p><p>Leaders at our local, regional, state and national levels clearly understand how this all works. They know how critically important proposed reforms are to community health and well-being.</p><p>Here in Sonoma County, a coalition of health and human service leaders is working with the Community Network to nurture development of palliative (comfort) care and values-based advance health care planning across the health care system.</p><p>This work complements the County of Sonoma Health Action effort dedicated to improving health and health care for all residents. Changes now under way and on the horizon are badly needed and essential for community health and well-being.</p>