Gradual Dying and End-of-Life Care, Part 1

The Bible says in John 11:25-26: "Jesus said unto her, I am the resurrection, and the life: he that believeth in me, though he were dead, yet shall he live: And whosoever liveth and believeth in me shall never die. Believest thou this?"

The featured quote for this episode is from Anaïs Nin. She said, "People living deeply have no fear of death."

Our topic for today is titled "Gradual Dying and End-of-Life Care (Part 1)" from the book, "The Art of Dying: Living Fully into the Life to Come" by Rob Moll. And, I want to remind you to take advantage of our special offer. If you enjoy this podcast, please feel free to purchase a copy of this book -- "The Art of Dying" by Rob Moll. It is available on our website for just $20. 

While 20th-century medicine drastically changed how we die, it has also had a more subtle — but no less profound — effect. Because of modern medicine, dying often takes a long time. One study found that most elderly are diagnosed as having a disease three years before it will eventually end their lives. On top of that a Rand study found that “Americans will usually spend two or more of their final years disabled enough to need someone else to help with routine activities of daily living because of chronic illness.” Long before we are visiting loved ones on their deathbed, we may be helping them cook, clean and use the bathroom. 

While the period may average three years, many people — particularly women — will spend more than a decade caring for older parents and in-laws. In the coming years, “family care giving —[for so] long the backbone of long-term care — will be heavily burdened,” the Rand study predicted. Today’s family structures— smaller, often spread across the country and more independent— make it even more difficult to care for the elderly and dying. “Longer durations of illness and greater numbers of women working outside the home also place greater burdens on the pool of potential caregivers.” 

While the first half of the twentieth century saw the major causes of death change from quick-killing infectious diseases to quick-killing heart diseases or cancer, the end of the century saw those diseases replaced by chronic ones that killed gradually. In 1976 the leading cause of death was heart disease, which typically manifested itself as a heart attack. Strokes were another instant killer. Today, a life-ending heart attack happens at a rate 61 percent below that of thirty years ago. Stephen Kiernan writes that even the death rate from accidents, either on the road or elsewhere, has dropped 36 percent. Rapid response teams are so proficient that they have been able to significantly reduce the number of deaths that occur from such emergencies as car accidents and heart attacks. 

Having largely succeeded in treating these, our leading causes of death now advance slowly. Kiernan writes, "In a recent fifteen-year span, deaths from chronic respiratory disease increased 77 percent. Fatalities from Alzheimer’s disease have doubled since 1980... People now succumb to congestive heart failure, lung disease, diabetes that leads to kidney failure, ALS (or Lou Gehrig’s disease), Parkinson’s, [and] osteoporosis."