• Begin thinking about quality of life by considering a fate worse than death. “I won’t live like this” is reason enough to choose wisely when making medical decisions.

    A recent study listed four predicaments as being fates worse than death

    • Lacking control over the situation
    • Living in a constant state of confusion
    • Losing control of bladder and bowels 
    • Being placed on a breathing machine or requiring a feeding tube

    These fates reflect chronic illness like cancer and dementia that become unmanageable and often insufferable. “Just let me die” are not words that family members or personal physicians tend to oblige. The only recourse for patients is strategic aging, an advance care plan that engages self-determination before accepting standard medical care.

    Quality of life, no matter at what age, requires mindfulness and discipline. By knowing what to think, do and achieve, you’ll maintain control over the choices being made for you as the chronic illness likely becomes worse.  

    Strategic aging is knowing how to experience wellness despite the challenges of becoming older or living with chronic illness. Finding comfort in the state of feeling uncomfortable is necessary to make medical decisions that will positively impact your physical health and spiritual well-being.

    The following three-part plan describes the benefits of strategic aging:

    • Prioritize Quality of Life

    Your state of independence (physical, financial and competency) determines quality of life. Fear, obligation and guilt often sabotage personal freedom. Sacrificing personal freedom becomes a living hell.  As you age and become wiser, you might ask, “Am I living for myself or someone else?” Self-determination means caring for yourself. Successful stress reduction requires discipline. Quality of life is based on “less is more” rather than “more is better.”

    Tips that support quality of life:

    • Well-being (belief in your spiritual nature) instills confidence in making tough decisions
    • Accentuating the positive allows for leaving well enough alone
    • A strong-willed support system combats the high-strung medical system
    • Self-determination (saying “no”) keeps you in control
    • Be willing, able and ready to overcome fear to achieve personal goals
    • Manage Chronic Illness

    Using a spiritual approach like the 12-step program for alcoholism creates a different type of treatment plan for chronic illness. As people become older and contend with more illness, they depend more on physicians. Physicians often practice defensive medicine, ordering more tests and finding more medical conditions to treat.

    Steps to living with chronic illness:

    • Admit you have a chronic illness with no cure
    • Believe that a higher power can restore sanity
    • Decide to accept the will of God or nature to take its course
    • Make a list of do’s and don’ts that will promote serenity
    • Reduce stress through participating in activities that lift your heart
    • Appreciate Palliative Care

    Patients with chronic illness often claim, “I can’t live like this anymore.” These patients prefer to remain at home. Palliative care provides patients peace of mind through effectively managing symptoms at home. Palliative care is not the end of the road, it’s an integral part of treating chronic illness. (Hospice relates to terminal illness)

    Tips to better appreciate palliative care:

    • Palliative care stands apart from hospice and “shelters” patients from advanced medical care
    • It aligns with compassionate, conservative, person-centered home-based care (not end-of-life care)
    • It deploys common sense nursing skills over the medical knowledge of highly-trained specialists
    • Instead of practicing defensive medicine, it treats patients’ symptoms
    • Palliative care nurses advocate listening to their patients’ goals and personal values

    The best defense against a fate worse than death is strategic aging. Having the ability to say “no” to medical care and “yes” to palliative care allows patients to leave well enough alone and continue to focus on quality of life. Ending life on your own terms is not a medical conquest, it’s a spiritual undertaking. If you prefer to die at home, listen more to your own heart than physician recommendations.

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    Article by: Kevin Haselhorst

    Emergency physician, Kevin Haselhorst, MD, an expert on advance care planning, speaks to patients, family members and healthcare providers about advance directives, palliative care and dying with dignity. He’s the author of “Wishes To Die For”, “Is Palliative Care Right for YOU?”, and the forthcoming “The 4 Seasons to Caregiving.” Dr. H practices at Abrazo Arrowhead Campus. He is a contributing writer for the Arizona Republic’s Ask the Expert Column, publishes Dr. H’s Clipboard: twice-a-month e-tips for advance care planning. He moderates DrH4Caregivers: Support groups on Facebook and LinkedIn where caregivers and healthcare professionals share concerns, post articles and offer support.

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