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If you or a close friend or
relative has recently been diagnosed with cancer or heart failure or
Alzheimer’s disease or a similarly worrisome condition, it’s likely you are
feeling a little confused and vulnerable. Suddenly you are on a difficult
journey that you didn’t choose to make. It’s understandable to feel as if you
were lost in a strange land.
These days, decisions about
treatment are often complex. America’s healthcare system is well-oiled to treat
disease but falls down when it comes to communicating, preventing problems, or
guiding people through predictably difficult times. People frequently feel uncertain
that they are doing the right things.
It’s important to be prepared and to advocate for yourself and your family. Here are some things I commonly suggest in order to avoid problems and get the best care possible for yourself and those you love.
First, it’s important to find
doctors in your area who are experts in your condition – and then to work closely
and effectively with your doctor and other members of your healthcare team. Although
we wish that every physician had a great “bedside manner,” it is not necessary
for each doctor to have a warm personality. What IS important is for you to be
able to have confidence in your doctor and feel that he or she genuinely cares
about your wellbeing. If that is not true, look for a different doctor. Feeling
comfortable with your doctor is essential to your care.
Second, there are a few basic
tips that can help you work effectively with your healthcare team. Here are
some of my favorites:
When faced with a dangerous
diagnosis, second opinions can be important in getting the best treatments. We
are talking about serious illness that threatens to shorten one’s life. Don’t
feel awkward about gathering second – or third or fourth! – opinions from the
best healthcare centers and teams you can find. Use the internet, local experts,
and word of mouth to determine which doctors or centers are best for you.
I strongly advise that one of
the medical opinions you seek is with a palliative care specialist physician or
Because palliative care grew out of hospice, many people assume that receiving palliative care means giving up. Not true. These days, through programs like Iyashi Care, palliative care is provided together with treatments for cancer, heart, lung, liver, kidney and neurological conditions.
Having a specialized clinical
team working to treat pain and other physical discomforts, as well as
optimizing a person’s appetite, digestion, and (all important) bowels, allows
people to sleep better, be more active, and at ease. They simply do better both
physical and emotionally.
It’s not surprising that
people with cancer or other serious conditions who receive palliative care
along with disease treatments tend to feel better – and sometimes live longer!
The extension of palliative
care into one’s own home when a person is nearing the end of life is called hospice.
Hospice is essential in managing medical matters and supporting families to
care well for people through the end of life. Hospice nurses, social workers, and
physicians are competent, proactive, and responsive.
Remember, at the end of the
day, what matters most is getting the best care possible for you and the people
About the Author
Ira Byock, MD
is Founder & Chief Medical Officer, Institute for Human Caring of Providence
Health and Services. He is an active emeritus professor at Dartmouth’s Geisel
School of Medicine and author of Dying
Well (1997), The Four Things That
Matter Most (2003), and The Best Care
Possible (2012). More information at
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