"Am I Dying Doctor?": How End-Of-Life Care is Portrayed in Television Medical Dramas | Open Access | OMICS International

This is a fascinating academic study of the portrayal of EOL care on television.

"A total of 68 episodes (in total 48 hours) of television medical dramas were reviewed. We viewed 22 episodes of ER (15 hours), 22 episodes of House (16 hours), and 24 episodes of Grey’s Anatomy (17 hours). End-of-life communication We observed 99 events of end-of-life communication between a healthcare professional and patient or loved one (27.3% in ER, 41.4% in Grey’s Anatomy and 31.3% in House) shown in Table 1. Most patients were male adults. In 45.5% of the events a physician initiated a discussion about end-of-life care. The words “death” and “dying” were used in 16.2% and 47.5% of the events, respectively. Chi square tests revealed no significant differences in the use of the words “death” and “dying” between patients, loved ones and healthcare professionals (p>0.05). Other words used when talking about end-of-life care were for example “fatal”, “the heart will stop”, and “nothing we can do”. The most frequently addressed topics were: talking about the possibility of dying, treatment options, and life-sustaining treatments. Patients’ feelings about getting sicker were not discussed at all. In 12.1 % other topics were discussed such as talking about sedation, talking about the fact that the patient has already died, talking about the death of a loved one, talking about a death wish or preferred place of death. Death During the 68 episodes, 27 patients died (59.3% in ER, 33.3% in Grey’s Anatomy and 7.4% in House) Table 3. In general, death was unexpected and patients were surrounded by a physician, loved one and/or nurse. Life-sustaining treatments were shown for 81.5% of the patients who eventually died and mechanical ventilation was discontinued in a minority before death. In only 11.1% of the situations in which patients died there was a reference to an advance directive. Discussion Key findings The present study shows that in television medical dramas healthcare professionals and patients or loved ones talked regularly about end-of-life care. Also CPR and death were frequently portrayed. Discussions about end-of-life care in television medical dramas were mostly initiated by physicians in the presence of patients and loved ones. The most frequently addressed topics were: talking about the possibility of dying, treatment options, and life-sustaining treatments. The immediate success rate of CPR was 51.1%. Death was often unexpected. Usually, a life-prolonging treatment was performed before death. Finally, advance directives were uncommon. "

"Am I Dying Doctor?": How End-Of-Life Care is Portrayed in Television Medical Dramas | Open Access | OMICS International:

What's your grief? The Pain of "Secondary Losses"

I always remember my cousin talking about the weeks following her mother's death: "Just when you are devastated and have every right to expect that the world will give you a break on everything but mourning, you have to deal with so much stuff."

"When we experience a death the grief associated with the loss itself is excruciating.  There are the obvious things we “expect” (though it is hard to describe anything with grief as expected).  In the immediate, the pain of the loss can be all consuming.  But in the weeks and months that follow there can be a sense that we are losing even more than just that person.  The world turns upside down and suddenly it feels like everything is changing or disappearing. This snowball effect stems from the fact that a death does not just create a single hole in one’s life.  Instead the loss can impact many areas of one’s life, creating multiple losses from that “primary loss”.  Though it is easy to think that our grief is solely the grief of losing the person we cared for so deeply, our grief is also the pain of the other losses that were a result of the death.  You will hear these losses referred to as “secondary losses”, not in the sense that their impact is secondary, but rather that they are a secondary result of the primary loss."

What's your grief?

NHS Trust encourages terminally ill patients to leave final wish list | Daily Mail Online

When we feel least in control, opportunities like this provide great comfort for terminally ill people and their families.

"Terminally ill patients are to be encouraged by an NHS Trust to write their own ‘end-of-life plan’ instructing doctors, nurses and family about their wishes for their final months, days and hours. The document is based on birth plans that pregnant women commonly draw up with their midwives, and takes the form of a single-page grid detailing the personal wishes of the patient about every aspect of their care. Subsections include: ‘What will be important to me...’, ‘How to support me and those I love...’, ‘What MUST happen...’, and ‘What MUST NOT happen...’ when the patient has months, weeks, and then just days to live, at the time of their death, and then afterwards."

NHS Trust encourages terminally ill patients to leave final wish list | Daily Mail Online

Not Just a Death, a System Failure - The New York Times

"My mother’s brutal death exposes so many flaws in American medicine: our lack of palliative care, our unwillingness to face end-of-life decisions, our inability to stop the procedures and just let go. Her death was a system failure, and as a doctor I don’t know how I alone can fix the system. I know only that I will try."

Not Just a Death, a System Failure - The New York Times:

End-Of-Life Care For Cancer Patients Can Help Bring More Value To Life

Death is an important part of the conversation when it comes to cancer, which is why specialists have become focused on ensuring patients know their options when it comes to palliative care. For Dr. James Downar, a critical care and palliative care staff physician at Toronto General Hospital, he's seen an increased recognition in the value of palliative care, and better adoption of it earlier on in the disease course. "Palliative care is often thought of as speciality of medicine that is only given to people at the very end, and that’s not true anymore," he explains to The Huffington Post Canada. "Our intention is to help with symptoms and decision making, and that's often relevant much earlier than people realize."

End-Of-Life Care For Cancer Patients Can Help Bring More Value To Life

Words of Comfort

A friend writes words that comforted her: "May his spirit safely depart to join the spirit that unites us all."

How to Transform Our Discomfort Around Death and Loss - Sonima

 "Death unavoidably touches and changes us. Although we often deem death a negative force, the transformation it instigates can be positive. Caitlin Doughty, a mortician and death acceptance advocate, says, “Death is the engine that keeps us running, giving us the motivation to achieve, learn, love, and create.” Whether it motivates us to live more fully or calls us to examine our beliefs, death—our own or that of those we love—will affect us. Exactly how death and loss affects us is determined by our perspective and how we engage with the process. Because fear of death and dying is common in contemporary Western culture, many of us do not hold an accepting attitude towards, nor do we actively participate in, the process. And yet, death is a primary source of what nourishes life. By engaging in a loved one’s dying process and staying present in the aftermath of their death, we can explore and ferment our values, evaluate and prioritize other relationships, and examine how we care for others and ourselves. And by intentionally cultivating a relationship with our own death—regardless of our age or degree of health—we might just be able to dispel our fears, sidestep unnecessary suffering, and enhance our quality of life."

How to Transform Our Discomfort Around Death and Loss - Sonima