One in five Americans still die while using emergency services. One in seven of these emergency room deaths occur among patients 85 years and older. Although death is our only exit strategy in life, few of us are preparing for it. Ask any person how they want to die and they will have a definitive response, “quick and painless.” Yet despite this authoritative choice, we remain shy when planning to achieve such an exit--which is why many of us will end up in an emergency room to die.
A classic study conducted in Oregon—which has a state law for physician assisted suicide—found that twice the number of terminally ill hospice patients choose to speed their deaths by refusing food and drink rather than by physician assisted suicide. Their nurses reported that these patients, who typically died within two weeks, died more serenely than those who chose other methods.
Planning for death might involve a number of formal decisions, such as advance directives, living wills, powers of attorney, and Do Not Resuscitate orders, and hospice. However these options remain underutilized. An analysis of a random sample of all U.S. deaths in 1986 found that about 10% of decedents had living wills. In addition, when they were completed, it is not uncommon to find that the attending clinical staff ignored them.
In addition, although hospice is an increasingly-accepted choice, often considered to be the "gold standard" of optimal end-of-life care, less than half of eligible patients utilize these services, and when they do, most start hospice too late. Hospice care is not just for the dying patient, but also for the family. Caregivers of the dying are twice as likely to have depressive symptoms as the dying themselves. This is why the hospice setting is more likely to be at home than at a hospital, and involves the family.
Communication is especially important. One of the ways to initiate an end of life discussion is to start with “Five Wishes.” This document meets the legal requirements for an advance directive in California and in 41 other states. Answers to the following questions will start the discussion of how you can die with dignity:
The Person I Want to Make Care Decisions for Me When I Can't;
The Kind of Medical Treatment I Want or Don't Want;
How Comfortable I Want to Be;
How I Want People to Treat Me;
What I Want My Loved Ones to Know.
Dying quickly and painlessly means that we are willing to discuss these final details with those around us. This level of dignity implores us to communicate about our eventual death and to design a course of action that reflects our wishes and desires. This is a difficult and uncomfortable topic. But no one said that aging is easy.
Mario Garrett PhD is a professor of gerontology at San Diego State University can be reached mariusgarrett@yahoo.com
© Mario Garrett 2010
About Me
- Mario Garrett
- Mario D. Garrett, Ph.D., is a professor of gerontology at San Diego State University, California. Garrett was nominated in 2022 and 2023 as "...the most popular gerontology instructor in the nation,” according to authority.org. He has worked and lectured at the London School of Economics/Surrey University, Bristol University, Bath University, University of North Texas, University of British Colombia, Tokyo University, University of Costa Rica, Bogazici University, and at the University of New Mexico. As the team leader of a United Nations Population Fund, with the United Nations International Institute on Aging, he coordinated a five-year project looking at support for the elderly in the People’s Republic of China. Garrett founded the international aging magazine ‘BOLD’, now the “International Journal on Ageing in Developing Countries.” His 2013 talk on University of California San Diego TV had just under 2 million views. Garrett has over 50 academic publications, hundreds of blogs, and ten non-fiction books. You can find his work at www.mariogarrett.com
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THE SAN DIEGO UNION-TRIBUNE
Dance as journey of discovery - The San Diego Union-Tribune
www.sandiegouniontribune.com/sdut-dance-as-journey-of-discovery-2012jan07-html...
Jan 7, 2012 - Directed by SDSU professor Mario Garrett, the festival's purpose is to offer positive images of aging. All films are free of charge and screen at ...Jing debunked - The San Diego Union-Tribune
www.sandiegouniontribune.com/.../sdut-jing-debunked-sexual-activity-shown-to-aid-l...
Mario Garrett. Sometimes we joke about how other civilizations or other ages looked upon old age. Since we have “medicalized” aging and death, we have ...Older adults are the backbone of volunteerism - The San Diego Union ...
www.sandiegouniontribune.com/sdut-older-adults-are-the-backbone-of-volunteerism-...
Mario Garrett. Volunteerism has long been one of America's traditions. Since Benjamin Franklin's founding of Philadelphia's first volunteer firefighter company in ...Life span is a moving target - The San Diego Union-Tribune
www.sandiegouniontribune.com/.../sdut-life-span-is-a-moving-target-2011nov01-stor...
Life span is a moving target. Mario Garrett. Not all immortal beings are the creation of Hollywood. In the same league as Peter Pan, Dracula and the Highlander, ...Feeling of well-being among older adults is on the decline - The San ...
www.signonsandiego.com/news/.../feeling-of-well-being-among-older-adults-is-on/
Mario Garrett. The state of well-being among older adults does not seem to be improving. A recent AARP report compared sex and well-being in 1999, 2004, ...[PDF]Increase in aging population means challenges to transportation system
ftp://gis.sanbag.ca.gov/.../2011-9-7%20-%20Aging%20Population%20Challenges%2...
Sep 6, 2011 - By Mario Garrett ... Copyright 2011 The San Diego Union-Tribune LLC. ... Mario Garrett, Ph.D., is a professor of gerontology at San Diego StateHemlock Society of San Diego -- articles related to End of Life Issue
www.hemlocksocietysandiego.org/articles.htm
Letter to the San Diego Union-Tribune about "Suicide Kits" -- by Faye Girsh ... the Living - by Dr. Mario Garrett in the San Diego Union Tribune -- July 12, 2011Word of Mouth: Good News And Bad
https://murfink9wordofmouth.blogspot.com/2013/03/this-is-not-good-news.html
"New Insights in Aging" by Mario Garrett This is a book, taken from a series of 500 ... from September, 2010 to November, 2011, in the San Diego Union Tribune.Plastic Surgery Replaces the Movie 'Cocoon' as Seniors' Preferred ...
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San Diego State University gerontology professor Mario Garrett writes more surprising facts in the San Diego Union Tribune: Americans 55 and older had 3.3[PDF]Happy Holidays - Peisch Custom Software
www.peisch.com/tutti/2010-2011/Tutti-2011-04.pdf
Apr 25, 2011 - The San Diego Union-Tribune, March 13, 2011. ―Florist proves irresistible in La Jolla ... to emotion and, perhaps, longevity‖. By Mario Garrett.[PDF]Behavioral Health Services Beyond the Talk: A Resource Toolkit to ...
https://www.sandiegocounty.gov/.../sdc/.../CCMH_XVIII_Resource_Toolkit_2012.pdf
State becoming equal parts Hispanic and white. San Diego Union Tribune. Retrieved from .... Angelica Garcia. B5. Diversity in Dementia. Mario Garrett, PhD.
braintainment.at/.../brain-fitness-the-social-aspect-of-dementia-mild-cognitive-impair...
Join us for the next public lecture as we welcome Mario Garrett, PhD, professor of ... The San Diego Union-Tribune · ETC: Spy Camp, Brain Fitness, Songwriters' ...
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