How long is too long to hang on when the end of life calls? Abraham Verghese, MD, Stanford physician and best-selling author, discusses the emotional and financial costs of extended end-of-life care in a New York Times book review of Katy Butler’s “Knocking on Heaven’s Door.” In the book, Butler details the drawn-out descent of her father after a stroke and sheds light on the unseen hardships of caring for the slowly dying, both for families of the ill and hired home workers.
From the review:
Butler finds that the health care system — and society — seem quite unprepared for a patient like her father. Had he received a diagnosis of a terminal illness, the family would have been supported by a Medicare-funded hospice team.
“But there is no public ceremony to commemorate a stroke that blasts your brain utterly, and no common word to describe the ambiguous state of a wife who has lost her husband and become his nurse.”
The review compares the sometimes six-figure cost of an end-of-life ICU stay to a home health-care worker’s salary, which Butler describes as typically “immorally low.”
My hope is that this book might goad the public into pressuring their elected representatives to further transform health care from its present crisis-driven, reimbursement-driven model, to one that truly cares for the patient and the family.
Previously: A conversation guide for doctors to help facilitate discussions about end-of-life care, How a Stanford physician became a leading advocate for palliative care, Honoring an exploration of the “cost of dying”, Exploring the psychological trauma facing some caregivers and Is $618,616 too much to (try to) save a life?