Almost a year ago, we started a profoundly personal conversation about the sorry state of dying in America.

The discussion, inspired by my frail 88-year-old father’s expensive hospital death, has taught me that too much drama and desperation consume our final days, lending them too little dignity.

Today, I want to build on our conversation and prescribe a cure — a new way of considering end-of-life medicine — in the final installment of our yearlong examination of the emotional and financial Cost of Dying.

It is not a drug or a device, a test or therapy. It is a different way of organizing our ending — so that we live our last days better and pass more gently.

Powerful lessons have emerged from the stories of suffering and triumph we have shared — not only through the reporting but from dozens and sometimes hundreds of emails and phone calls from readers. Together, we’ve met Bay Area people like Ray Brown, who showed how agonizing it can be when a loved one’s end-of-life wishes are unknown. And doctors like Jessica Zitter, who insists it’s the doctor’s job to help families decide whether it’s time to quit. We admired the resolve of Bill Newman, who wears his end-of-life wishes on a homemade “Do Not Resuscitate” badge, and marveled at caregivers like Susan Meyers who sacrificed her own well-being to allow her beloved husband, John, to die at home.

And we were privileged to share Gayla Caliva’s own goodbye, as the retired hospice nurse from San Jose chose to enjoy stargazing and spicy foods with friends instead of exhausting and painful dialysis.

The real miracle? Places as different as a community in Wisconsin and Oakland’s Highland Hospital are showing the way to a death that is kinder and less expensive. Medicare has become the single biggest contributor to the country’s long-term budget deficit, according to the Congressional Budget Office. And a quarter or more of Medicare costs are incurred in the last year of life.

“Everyone says they don’t want to die in a hospital, with tubes in every orifice,” said U.S. Rep. Jackie Speier, D-San Mateo. She saw the two paths of medicine when her parents died. She lost her 92-year-old mother after an angioplasty meant to improve her life instead led to intensive care and nine months of decline. Her father, in contrast, died after five days in hospice, his pain controlled.

If we want to improve end-of-life care, “there are ways to do it — but we have to commit to it,” she said. (…) Read Full Publication Here

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