As she nears dying at age 92, former first woman Barbara Bush’s announcement that she is in search of “comfort care” is shining a lightweight — and stirring debate — on what it means to cease attempting to struggle terminal sickness.
Bush, the spouse of former President George H.W. Bush, has been affected by congestive coronary heart failure and chronic obstructive pulmonary disease, based on household spokesman Jim McGrath.
In a public assertion Sunday, the household announced she has determined “not to seek additional medical treatment and will focus on comfort care.”
The announcement comes amid a nationwide effort to outline and doc sufferers’ needs, and think about options, earlier than they’re positioned on what has been described as a “conveyor belt” of pricey medical interventions aimed toward prolonging life.
Ellen Goodman, co-founder of the Conversation Project, which inspires households to debate and doc their end-of-life preferences, applauded the Bush household announcement.
“It sounds like this forthright, outspoken woman has made her wishes known and the family is standing by her,” Goodman mentioned.
“It makes perfectly good sense at her age, with her failing health, that she would say at some point, ‘Life’s been good, and while you always want more, it’s enough,’” mentioned Dr. Joanne Lynn, director of this system to enhance elder care at Altarum Institute.
Lynn labored with Barbara Bush years in the past, when she was a congressional partner volunteering on the Washington Home for chronically in poor health sufferers. Bush helped with the founding of the hospice program there.
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“We have so few examples in visible leadership positions” of public figures selling palliative care, she mentioned.
“It’s a personal decision that she didn’t have to share, but hopefully it will encourage others to think about their choices, talk about their choices, document their choices and have those choices honored,” mentioned Nathan Kottkamp, founder and chair of National Healthcare Decisions Day.
Thousands have been anticipated to concentrate on their end-of-life preferences Monday, which has been designated as National Health Care Decisions Day since 2008.
Dr. Haider Warraich, a fellow in cardiovascular drugs at Duke University Medical Center and writer of the e book “Modern Death,” additionally applauded the Bush household for placing the phrase “comfort care” into the general public sphere in order that different individuals can think about it “a viable option at the end of life.”
But he mentioned the household assertion additionally creates confusion concerning the which means of “comfort care,” by suggesting that it entails stopping medical therapy. On twitter, palliative care specialists vigorously refuted that mischaracterization.
“Comfort care” normally refers to palliative care, which focuses on managing sufferers’ signs to maintain them snug and retain their dignity, Warraich mentioned.
“One of the common myths about palliative care is that they are being denied medical help,” Warraich mentioned.
For coronary heart failure sufferers, he mentioned, “comfort care” normally means opting to not use a respiratory machine or CPR. But sufferers do proceed to obtain medical therapy, together with morphine to ease shortness of breath, and diuretics to take away extra fluid from their lungs, he mentioned.
Heart failure sufferers, he mentioned, typically obtain “escalating medical treatments until days before the end of life.” Their transition to consolation care will be abrupt, “like falling off a cliff,” he mentioned.
“By bringing this into the sphere of discussion,” Warraich mentioned, “we can start thinking about comfort and palliation long before they are in the clutches of death.”
KHN’s protection of end-of-life and severe sickness points is supported partially by the Gordon and Betty Moore Foundation.
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