When my father was 93, riddled with cancer, chronically nauseated, and living on opioids he suffered a major heart attack. In the hospital, doctors determined his death was imminent but didn’t tell him. Dad denied his condition was serious. He was furious to be given a room on the heart ward instead of the ICU.

Dad had signed a DNR (do not resuscitate) and disclaimed extraordinary measures. But he changed his mind when push came to shove. He raged for two days until, at my request, a female resident physician sat beside Dad’s bed and gently told him the truth. Then he agreed to accept palliative (comfort) care. He needed to hear his time was short and he could control how it was spent.

Palliative care (with or without Hospice) can be received in a hospital, a nursing home, or the patient’s own home. Medical interventions are out; comfort and pain relief are in. Surprisingly, comfort care often extends the patient’s life beyond expectations, perhaps because it allows him to set his own priorities as the end approaches. He might continue to attend church, meet a new grandchild, participate in a daughter’s wedding, or celebrate a family holiday. [Read more…]