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End Of Life

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OPINION
November 29, 2010
Americans have a near obsessive interest in death and dying. Today's most popular television series is about violent crime investigators. The biggest movie of the year is likely to be " Harry Potter and the Deathly Hallows Part 1. " The bestseller list is packed with crime novels. And the latest hit video game revolves around Cold War assassins. And yet, Americans also are notoriously reluctant to confront the realities of death itself. In particular, how is it that so few people have taken steps to ensure that their wishes will be respected if they're too sick or injured to speak for themselves?
ARTICLES BY DATE
OPINION
November 9, 2013
Most of the mail that crosses my desk deals with politics, policy and other largely impersonal subjects. Occasionally, readers will tell their own deeply personal stories as a way to inform a discussion. Several did just that in response to Steve Lopez's column Wednesday about the prosecution of a Philadelphia nurse accused of helping her ill 93-year-old father end his life. We heard from doctors, but most poignant were the letters from spouses of terminally ill patients who were confronted with grave end-of-life decisions.
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HEALTH
January 22, 2010 | By Lisa Zamosky
Every year, billions of dollars are spent in the United States to treat terminally ill patients during their final year of life. Tests, procedures and hospitalizations do little to prolong or improve the quality of that life, research suggests, and in fact may make the final days of terminal illness more emotionally upsetting for patients and their families. The Centers for Medicare and Medicaid Services estimate that 5% of the beneficiaries who die each year take up 30% of the $446-billion annual Medicare budget.
CALIFORNIA | LOCAL
June 12, 2013 | By Anna Gorman
Sixty percent more money was spent in the Los Angeles area on chronically ill patients in their final years than the national average, according to new data on Medicare patients released Wednesday. Spending in the last two years of life was about $112,000 per patient in Los Angeles, compared to about $70,000 on average across the country,  the report by the Dartmouth Atlas Project showed.  From 2007 to 2010, Medicare spending on end-of-life care rose by 15% nationwide. The jump occurred despite more patients enrolling in hospice care, fewer patients dying at the hospital and patients spending fewer days in the hospital in the last six months of life.
HEALTH
January 25, 2010 | By Jill U. Adams
Most doctors don't talk about end-of-life issues with their cancer patients when those patients are feeling well, a new survey has found. Nor do they talk about them until treatments have been exhausted. Those delays mean patients might not be able to make truly informed choices early in their treatment. The study, published online Jan. 11 in the journal Cancer, surveyed 4,188 physicians about how they would talk to a hypothetical cancer patient with four to six months to live. A majority of respondents (65%)
CALIFORNIA | LOCAL
December 28, 2011 | Steve Lopez
Last week, my dad was taken on a practice run from his Northern California nursing home back to his house. He'd had recent hip surgery, and the idea was that if he could master the challenge of getting in and out of the car and the wheelchair, he could leave the facility and begin hospice care in his own home. But first he had to get there. You go down by the high school, my dad told his driver, an aide from the nursing center. The school, which my dad attended 65 years ago, was in precisely the wrong direction.
OPINION
June 17, 2010 | Stella Fitzgibbons
As a hospital-based doctor, I am one of the people responsible for the country's ever-escalating cost of healthcare. And I can tell you that the new healthcare plan will do nothing to restrain me. There is enormous pressure on healthcare providers to continue practicing the most expensive medicine in the world. To resist that pressure, we need some help from policymakers. Consider the case of a man I'll call Mr. A. At the age of 80, he is admitted to intensive care after a huge stroke.
NATIONAL
May 20, 2013 | By Michael Muskal
With the strokes from three gubernatorial pens, Vermont on Monday became the fourth state in the country to allow doctors to prescribe lethal medication to terminally ill patients. Gov. Peter Shumlin signed the measure in a state House ceremony in Montpelier, capping a decade-long effort on the issue in Vermont. Vermont is the first state to pass such a law through the legislative process. Oregon and Washington enacted their laws by referendum; in Montana, it was legalized by the courts.
CALIFORNIA | LOCAL
December 19, 2012
A video of 97-year-old California doctor E.T. Rulison discussing his end-of life plans is available online, along with previous Steve Lopez columns.
NEWS
February 14, 2012 | By Shari Roan, Los Angeles Times / For the Booster Shots blog
More palliative care services are available in California compared with five years ago, according to a new survey from the California HealthCare Foundation. The exception, however, is in Los Angeles. Palliative care is focused on providing pain relief and comfort at the end of life with an emphasis on following the patient's wishes. The data, released Tuesday, examine trends in palliative care from 2007 through 2011. The study indicated that adult palliative-care services increased statewide by 24%, while pediatric palliative care increased by 128%.
NATIONAL
May 20, 2013 | By Michael Muskal
With the strokes from three gubernatorial pens, Vermont on Monday became the fourth state in the country to allow doctors to prescribe lethal medication to terminally ill patients. Gov. Peter Shumlin signed the measure in a state House ceremony in Montpelier, capping a decade-long effort on the issue in Vermont. Vermont is the first state to pass such a law through the legislative process. Oregon and Washington enacted their laws by referendum; in Montana, it was legalized by the courts.
NEWS
March 20, 2013 | By Mary MacVean
Finding out what dying patients want and treating them accordingly leads to happier patients who are in less pain and who use fewer healthcare dollars, UCLA researchers said Tuesday. “You can improve care while reducing costs by making sure that everything you do is centered on what the patients want, what his or her specific goals are and tailor a treatment plan to ensure we provide the specific care he or she wants,” Dr. Jonathan Bergman, a Robert Wood Johnson clinical scholar at UCLA, said in a statement.
CALIFORNIA | LOCAL
December 19, 2012
A video of 97-year-old California doctor E.T. Rulison discussing his end-of life plans is available online, along with previous Steve Lopez columns.
NEWS
November 13, 2012 | By Jon Bardin
Terminal cancer patients who receive information early about end-of-life care receive less medical care during their last days and are more likely to enter hospice, according to a study in the Journal of Clinical Oncology . The findings suggest that early discussion about the likely outcome of a terminal illness can dramatically change a patient's end-of-life decision-making. According to the study, which was carried out by a team led by Dr. Jennifer Mack of the Dana-Farber Cancer Institute in Boston, national guidelines suggest that doctors begin discussions about end-of-life care shortly after diagnosing a terminal illness.
CALIFORNIA | LOCAL
July 21, 2012 | Steve Lopez
On the evening of July 2, Bill Bentinck, 87, was led from his Palm Springs home in handcuffs, in mourning and in shock. The body of his wife of 25 years, Lynda, was still in the house, but there was no time to grieve. After telling police that his terminally ill wife had chosen to disconnect her oxygen supply and put an end to her suffering from emphysema, he was arrested on suspicion of murder. Bentinck, a straight-talking man in the Jimmy Stewart mold, felt that he had made a difficult but compassionate choice in honoring his wife's last wish and not reconnecting the oxygen.
OPINION
June 17, 2012 | By Sue Horton
It was a talk we needed to have, but I didn't know that until my father's cardiologist insisted. Here's how it happened. In 2002, I took my 83-year-old father to his doctor to discuss the results of some heart tests. My dad's memory had been failing for several years. Now he was slowing down physically as well. The doctor seated us in his office and then broke the bad news. My father had a failing heart, and without valve replacement surgery, he wasn't likely to live more than a year.
OPINION
November 9, 2013
Most of the mail that crosses my desk deals with politics, policy and other largely impersonal subjects. Occasionally, readers will tell their own deeply personal stories as a way to inform a discussion. Several did just that in response to Steve Lopez's column Wednesday about the prosecution of a Philadelphia nurse accused of helping her ill 93-year-old father end his life. We heard from doctors, but most poignant were the letters from spouses of terminally ill patients who were confronted with grave end-of-life decisions.
HEALTH
July 26, 2010 | By Jessica Pauline Ogilvie, Special to the Los Angeles Times
Leaning forward in his chair, Bob Patterson, 64, addresses a small group of his peers seated around a conference table. "You want to fill each day with something that's relevant," he says. "Live like it's the last day of your life, whether you have a disease or not." His audience nods in agreement. Patterson's philosophy resonates, and not without reason; like him, many of the other 17 participants were recently diagnosed with Alzheimer's disease. The rest are caregivers, often spouses or other family members.
CALIFORNIA | LOCAL
February 19, 2012 | By Elaine Woo, Los Angeles Times
"I'm not sick; I'm only dying," a friend told Dr. William Lamers Jr. The man had inoperable cancer and wanted to go home to die, but his doctor wouldn't let him out of the hospital. It was the early 1970s, when most people with incurable illnesses died in a hospital, in a lonely room, attended by doctors and nurses with no specialized knowledge of the dying patient's emotional and physical needs. There was no system for caring for the dying at home. The experience opened Lamers' eyes to a major failing of the healthcare system.
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