“And how we deal with death is at least as important as how we deal with life, wouldn’t you say?” – James T. Kirk, Star Trek II: The Wrath of Khan

The Knight discusses his future with Death

The Knight discusses his future with Death

Like Captain Kirk, many Americans think they can cheat death and avoid dealing with it – though most are happy to deal with life and many seek to live it as long as possible. And I daresay that most are hoping to live life to its fullest with passion and good health (just check out last week’s blog by Tony DiNuzzo –  http://wp.me/pH3Dx-fl).  Unfortunately, that is not the case for everyone and even if life is lived well – there is always an end. How do you want your life to end? Are you as passionate about how you want to die as you are about how you want to live?

Americans have the opportunity to declare how they would like to be cared for when they are dying or have a catastrophic illness that renders them incapable of making decisions. However, research studies have found the use of advance directives ranged from less than 50 percent of severely ill patients (AHRQ, 2003) to 67% in those over age 60 (NEJM, 2010). Studies do show that when an advance directive is available, patients generally receive the care they requested (NEJM, 2010). Advance directives come in a variety of formats – living wills, durable powers of attorney for health care, and ordinary written instructions.

I know I would rather make it clear to my spouse, my children, and my primary care provider what is important to me to continue life , what kind of life sustaining measures are acceptable, and when it’s OK to say “good-bye”. But this is frequently a difficult discussion – nobody wants to talk about dying. One method I found that gets the discussion started is an online resource called “The Conversation Project” (http://theconversationproject.org/ ). It contains “starter kits” that help people identify their values and their wishes for the end of life and helps start the conversation with family and health care providers.

So, deal with death in a way that is at least as important as how you deal with life and help yourself, your family, or your patients make their wishes clear.


And… thanks to my doctoral student, Carrie Simmons, for her research on advance directives.

Our Guest Blogger this week is Linda R. Rounds, PhD, RN, FNP, Professor, UTMB School of Nursing.

Join us for a real-time discussion about questions raised by this essay on Tuesday at from 12:00 p.m. to 12:45 p.m. See Discussion and SL tabs above for details. Link to the virtual meeting room: http://tinyurl.com/cjfx9ag.

Image source: The Seventh Seal. Allan Ekelund (Producer), Svensk Filmindustri, 1957  (http://www.imdb.com/title/tt0050976)