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Who wants to talk about death and dying? No one seems to want to talk about the process of dying with family members, let alone doctors.

But we must.

We must in order to get what we want – and let others know that we are getting what we want.

A study of 249 legally incapacitated, critically ill adults over a three year period, more than half of whom were expected to die in the hospital, found that silence prevails – likely meaning that these people did not have whatever they themselves envisioned as a good death.

Even when doctors met with family members this was true over ¼ of the time: no consideration was given to what might be the patient’s values and preferences.

Fortunately, information was exchanged almost 70% of the time – but applied to decision making less than half. Where it was applied, important end-of-life considerations, physical and spiritual, were taken into account much of the time, but not always.

In fact, only 8.2% of the time was the mode of treatment based on the patient’s values and preferences.¹

No wonder 61% of Americans die in pain.

¹ Clinician-Family Communication About Patients’ Values and Preferences in ICUs, Leslie P. Schuenenaan, Natalie C. Ernecoff, Praewapnnaria Buddadheenaruk, JAMA Internal Medicine 2019: 179(5): 6676-684 doi:10,1004 jamainternmed 2019.0027


Elder law attorney, Terry Garrett, is a member of the National Academy of Elder Law Attorneys and is an Approved Guardianship Attorney. She assists people in elder law, estate and special needs planning, guardianship and settling estates. She graduated with honors from Cornell University. She was on the Dean’s List at Wharton Business School. She earned her J.D. at Columbia Law School, receiving the Parker Award and a Mellon Fellowship.


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