The terminal phase of any life-threatening illness is the time between diagnosis and the final decline when no cure or extension of life is in the offing. The individual confronts progressive decline and deterioration. Death is imminent. The care manager has a role.
The focus of doctors and patients now changes from attempting to cure the illness or prolong life to trying to provide relief from pain and to comfort the sufferer. Religious concerns such as what happens after someone passes away or how to handle the suffering at the end of life or how to give comfort to family members are the focus during this time as well as trying to tie up any loose ends.
But what happens, when in the terminal phase the client asks you, the geriatric care manager, about the right to die in your state. In California where In June 2016, our state became the fourth in the nation to allow medical aid in dying for patients suffering from terminal illness, they do have a right to discuss this with their physician. Four other states have passed this law including Oregon, 20 years ago.
In an article in yesterday’s New York Times a physician in Oakland, Ca discussed the ethical dilemma that physicians face. She called for more, guidance and training for physicians in solving this dilemma themselves but also said the law was working well.
For geriatric care managers.
This speaks to more directions for care managers who face this request and it’s ensuing dilemma. We cannot make any of these decisions but this adds another step for us if the clients ask us to help them with physician assisted suicide. So we need protocols and training as well.
I am adding new protocols ,about requests for physician assisted suicide, to the product Care managers Working With Death and Dying in My Geriatric Care Management Operations Manual, for those who want to add a death and dying service or End of Life to their Menu of Services
