Among hospice staff, it is called “getting it.” One says, “He doesn’t get it,” “I think she gets it,” or, “They definitely get it.” It is a little hard to define, but as with pornography, you know it when you see it. Nonetheless, given the importance of “getting” good end-of-life care, let us take a moment to try and explain.
The 92-year-old patient is bleeding into her head, but has blood clots in her lungs. She suffers from advanced heart disease and has been on both a respirator and dialysis for three weeks. She is failing as, like flimsy rowed dominos, vital systems collapse. Her chance of surviving the hospitalization is less than one in a hundred.
Despite death lurking, just another complication away, this nonagenarian is treated with maximal, aggressive, unrestrained care. She is not only full code (when her body stops they will pound on her chest and pour joules of electricity into her broken heart), but she is receiving over 30 different medications, a list which grows as medical complications breed new catastrophes, everyday.
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