Saturday, October 13, 2018

How to Write a Condolence Note

The New York Public Library is presenting our beloved Amy Cunningham to discuss how to write a condolence note.

Join funeral director and Green-Wood Cemetery educator, Amy Cunningham, for this workshop on how to write a condolence letter.

With death ever-present, condolence letters were mainstays of 19th-century life, missives of comfort written straight from the heart. Amy and participants will read copies of letters by Charles Dickens, Emily Dickinson, Mark Twain, Abraham Lincoln, and Queen Victoria herself with comparisons to modern letter writing. Participants will then review the principles of a good condolence letter. Amy Cunningham is a Brooklyn funeral director who helps families with green burials, cremation services in Green-Wood Cemetery crematory chapels, home vigils, and other sorts of memorials.

Dying Patients Forced in Twice as Much "Rehab" in For-Profit Facilities

The New York Times reports on a study showing that residents of for-profit assisted living facilities are given twice as much "rehab" as those who are not, even when they are close to death, suggesting that the services are more about revenues than the patient:

Nursing home residents on the verge of death are increasingly receiving intense levels of rehabilitation therapy in their final weeks and days, raising questions about whether such services are helpful or simply a lucrative source of revenue.

That is the heart of a new study published in the Journal of the American Medical Directors Association, which found that the practice was twice as prevalent at for-profit nursing homes as at nonprofit ones.

More broadly, the study’s findings suggest that some dying residents may not be steered to hospice care, where the focus is on their comfort.

Although the research is based on a relatively small number of patients in one state, it echoes what federal regulators have found in recent years.

It’s also a fresh reminder that families should keep a close watch on, and ask questions about, the kind of care their relatives are getting in nursing homes.

“Some of these services are being provided in the last week and sometimes on the day of their death,” said Dr. Thomas Caprio, one of the study’s authors. Dr. Caprio, who specializes in geriatric medicine, hospice and palliative care, is an associate professor at the University of Rochester Medical Center.

Rehabilitation services — physical, occupational and speech therapy — are “a potential revenue source for these facilities,” he added. “And when the plan of care shifts to hospice care and palliative care, that revenue stream disappears.”

Thursday, October 11, 2018

An Obit with a Twist

This obituary for Rick Stein has a surprise twist at the end that is very touching.

Wilmington - Rick Stein, 71, of Wilmington was reported missing and presumed dead on September 27, 2018 when investigators say the single-engine plane he was piloting, The Northrop, suddenly lost communication with air traffic control and disappeared over the Atlantic Ocean off the coast of Rehoboth Beach. Philadelphia police confirm Stein had been a patient at Thomas Jefferson University Hospital where he was being treated for a rare form of cancer. Hospital spokesman Walter Heisenberg says doctors from Stein's surgical team went to visit him on rounds when they discovered his room was empty. Security footage shows Stein leaving the building at approximately 3:30 Thursday afternoon, but then the video feed mysteriously cuts off. Authorities say they believe Stein took an Uber to the Philadelphia airport where they assume he somehow gained access to the aircraft.

"The sea was angry that day," said NTSB lead investigator Greg Fields in a press conference. "We have no idea where Mr. Stein may be, but any hope for a rescue is unlikely."

Stein's location isn't the only mystery. It seems no one in his life knew his exact occupation.

Tuesday, October 9, 2018

Holding an Illegal Shiva for My Mom

Mark Effron's rabbi told him that he could not hold a shiva for his mother because it was Sukkoth. He did it anyway.

Back at our house, we held a non-shiva shiva. Mirrors stayed uncovered, family and friends and colleagues descended upon our house and we talked about my mother well into the night. There was plenty of food, plenty to drink.

That’s when I realized that, though I might have felt thrown out of sync at first by the unexpected scheduling, it really was all for the good. My mother got a grand send-off, filled with at turns poignant and hilarious paeans to her warmth and sense of humor. And she would have loved the non-shiva shiva. It wasn’t interrupted by a minyan and solemnity. It was just a damn good party.

As my mother told us as we were planning her 90th birthday party in Florida three years ago:

”All I care about is that we’re all together….and the hall is nice…and the food is delicious.”

John Pavlovitz: Do Not Say This to People Who Are Grieving

John Pavlovitz writes about how kindly meant comments can be painful to hear:

They saw my total, alarming devastation, and in their urgency to alleviate some of it, did what good people do when other people they care for are grieving: they said things.

And often the things they said, as birthed from a beautiful place as they were—really hurt. What they so desired to be healing, actually poked the already massive wound in my heart, and made it worse.

It does not help to say: "God needed another angel," "He's in a better place," "Everything happens for a reason," "I know how you feel."

Just say: "I care about you." "I loved him/her." "I will cherish my memories of him/her." "I am sorry."

And do not ask if you can do anything. Just do something.

Friday, October 5, 2018

Is Assisted Death "Rebranding Euthenasia?"

A widow writes about her opposition to assisted death:

Hope inspired us to try standard and experimental treatments to combat J.J.’s cancer. Those treatments extended his life beyond the initial four-month prognosis to three and a half years. If we had relied on the initial prognosis, given in to the depression and given up on hope, we would have missed out on so very much. Our oldest son, James, would never have gotten to know his father; our youngest son, Lucas, would never have been born.

Getting through his darkest moments and the temptation to despair made J.J. realize that assisted suicide presents a very real risk for terminally ill patients like him. J.J. and I resolved to fight efforts to legalize assisted suicide, laws that prey on terminally ill patients when they are most vulnerable. Assisted suicide is legal in seven states and Washington, D.C. This is a tragedy, and one we can prevent.

J.J. served as president of the Patients Rights Action Fund, an organization that works on behalf of patients to oppose legalizing assisted suicide. We dedicated the last years of J.J.’s life to this because we recognized the "death with dignity" movement for what it is: a well-funded rebranding of euthanasia offering nothing but a message of hopelessness.

If our experience taught us anything, it is to hold on to hope for yourself and for others around you, especially in the face of life-threatening illness. You could be improving their lives, as well as your own.

Letter-writers responses (excerpts):

It’s a blessing to have that possibility for terminal patients, especially those who have immense pain. It galls me when people want to take that option away from others, just because they find it wrong. What works for others may not be feasible for you. We can make up our own minds.

Death with dignity isn’t for everyone. In fact, a very small percentage of terminally ill patients choose to use it. Often, the angels of hospice can keep dying patients comfortable until a disease runs its course. But death with dignity should remain a choice for those who wish to use it. The Hansons should not be allowed to limit the choices of others.

Wednesday, October 3, 2018

Palliative care Lengthens Live as Well as Improving It

A new study shows that "Patients with advanced cancer randomized to receive outpatient specialty palliative care lived longer and had better quality of life."