Talk about end-of-life issues

With the discussion on health care reform, emotional terms such as "death panels" and "health care rationing" are making the news. Though no one is advocating sending Grandma off on an ice floe, perhaps this discussion is forcing us to think seriously about such questions as: What is good medical care at the end of life? Is there a time when we do need to pull back on costly, high-tech, aggressive therapies? Do we sometimes make the treatment worse than the disease?

Studies repeatedly have shown that Americans consume staggering amounts of medical resources (as well as human resources) near the end of life, often on treatments that realistically do not extend quality of life very much.

November is National Hospice Month. Simply stated, the hospice philosophy is about "quality of life" rather than "quantity." Hospice is now involved with 40 percent of all deaths in this country and recognizes that all individuals have their own goals in life that give meaning and purpose.

We cannot be very thoughtful individuals if we don't ask ourselves the sobering question of what gives meaning to our own lives. What is it that, without those things or abilities, ceases to give life meaning or purpose for us?

It is necessary that we extend this question beyond ourselves, to our close friends, parents and other loved ones. Admittedly, it is a hard discussion to have. However, starting the conversation may be as easy as asking your aging mother for that special recipe that you have never bothered to write down — and then moving on to: "You know, there are a lot of things I would like to know about you." Eventually, the conversation, if directed, can move into end-of-life wishes. Ironically, older people are much more comfortable than their children with this type of discussion.

As families come together during the holidays, it is my plea that we will approach some of these discussions. I guarantee that we will be glad we did.

JERRY OLD

Chief medical officer Hospice Care of Kansas/Midwest

Arkansas City