Most avoid discussing a 'good death'

BUFFALO, N.Y., July 31 (UPI) -- There is an avoidance of death in U.S. society that often sidesteps important issues until it is too late for critically ill patients, a professor suggests.

Professor Deborah P. Waldrop of the University at Buffalo School of Social Work says, when asked, the majority of people say they want to die at home surrounded by their family. However, 60 percent of chronically ill people die in hospitals and 20 percent die in nursing homes, so these wishes are often unfulfilled, Waldrop says.

"Too often, their lives have ended in pain and despair, spending their final days in an alienating institutional environment, just another patient in an impersonal progression that leads to 'reciprocal suffering" for families who also watch their loved ones die," Waldrop says in a statement.

Waldrop says there is a growing emphasis on factors that contribute to a "good death" -- a transition to a home that has sustained them for many years, surrounded by the people who have given their lives meaning with "comfort" can be the defining goal of a death without pain and suffering.

"We're not addressing what people want. When you don't really talk about it, things like unwanted aggressive treatment or another emergency room visit happen by default," Waldrop says.

The loss of functional abilities that requires more care-giving from families can be one of the trigger points for patients and families to ask for palliative care -- treatment that concentrates on reducing the severity of disease symptoms, rather than striving to halt, delay, or reverse progression of the disease itself or provide a cure.