Top 50 Nursing Assistant Blogs

Much thanks to NurseAssistant.org for including The Good Death in its listing of the Top 50 Nursing Assistant Blogs.

I am happy to be in such great company. If you scroll down the list to Hospice Care Blogs, you will see us listed amongst some of the best palliative-care focused blogs out there.

Thanks for the shout out!

Hospital Type and Likelihood of Feeding Tube Use

A new study published in the Journal of the American Medical Association suggests that nursing home residents with advance dementia have starkly different odds of being given feeding tubes depending on which hospital they are sent to.

According to the study, some hospitals used feeding tubes in as many as 1 in ever 3 patients, while other hospitals used feeding tubes in as few as 1 in ever 100 patients.

Not surprisingly, hospitals that were more aggressive about providing end-of-life care were more likely to insert feeding tubes. Also, likely to use them were large hospitals and for-profit hospitals.

The sad implication of this study is that it suggests hospital protocols become more important in deciding end-of-life behaviors than family and patient wishes.

Here's a link to the JAMA abstract.

End-of-Life Planning

Carla from Compassion and Choices raised an excellent point in the comments of another post. End-of-Life planning is rarely straightforward, and it's important to fully understand all sides of an issue before you make important decisions.

There are some potential flaws in the simplicity of the Five Wishes format (a form I previously blogged about). Barbara Coombs Lee has written a nice piece about it. While its clever branding makes it memorable, and the positive framing of "wishes" is a nice language to cast death planning within, the form does have bent toward prolonging life that will not work for everyone.

The form does not allow doctors to withhold any treatment with the intent of taking your life. And it could be argued that many such behaviors than would be spelled out in a living will or advance directive could be cast as taking a life.

I'm a firm believer that any planning is better than no planning because, at the very least, you're giving your loved ones some indication of your wishes, fully understanding the implications of the forms you are working with is important to having the kind of death you would like.

Palliative Care Grand Rounds

Hi all!

Another edition of Palliative Care Grand Rounds is up at Alive Hospice Blog. It's a great overview of what has been going on in the world of palliative-care-related blogs.

Check it out!