Using the Morbidity and Mortality Conference Model to Explore and Improve Community-Based Oncology Care (Video Program)End-of-life planning for patients with mCRC
3:29 minutes.
TRANSCRIPTION:
DR CHEN: At that point she started on hospice care. DR LOVE: And of course she then passed away. But you said she was on hospice for 3 months? DR CHEN: She was. DR LOVE: That was one thing. It’s interesting. DR CHEN: Yes. DR LOVE: We’ve done these kinds of surveys before, and a lot of these patients are on hospice for less than a week. DR HECHT: Which is not good. DR LOVE: But a lot of these patients in this survey, I mean, 3 months. This woman was on hospice for 3 months. What was going on? What were some of the palliative issues that were being dealt with at that point? DR CHEN: Yes. One of the things was the pain control, because of the liver involvement and also the abdominal involvement. So it was treating her abdominal pain. Other things included treating her nausea. I think hospice was excellent for her in terms of providing this care. She had a great family support. For a lot of my patients, we’ve needed to have them see our psychologists. But in her case, it was the family members that were excellent. DR LOVE: So you took care of her then the entire time? DR CHEN: I took care of her the entire time. DR LOVE: For more than 5 years? DR CHEN: I did. DR LOVE: Wow! DR CHEN: I did. Yes. DR LOVE: And we asked for each one of these cases, how attached did you feel to this particular patient, emotionally? And you checked off for her, “very attached.” What was it like to take care of her? DR CHEN: It was very satisfying, taking care of her. She always had a very positive attitude. And so she would tell me a lot about what’s going on in her family, the birth of her grandchildren, the family events that she went to. And I was very attached to her and was very much bonded to her. DR LOVE: Did you feel a sense of sadness when she deteriorated and died? DR CHEN: Absolutely. But also, knowing that she had a fairly good quality of life throughout her treatment and she was able to participate in the things that she wanted to do, traveled quite a bit, and I think those things were satisfying. DR LOVE: Any comment, Maggie, on the issue of attachment to patients, burnout, taking care of yourself? DR DEUTSCH: Well, I think there’re naturally patients that you become bonded to or attracted to, especially perhaps younger ones, people who are in difficult situations, social situations, who are just kind of struggling day to day, and then they get a bad illness. But I always think that there’s a certain distance you have to put in there. You can be bonded to someone and be empathetic, but you have to have a certain distance. And to me, it’s like on my drive home, there’s a box, and you have to close the lid of the box. And when you get home, it’s got to be gone because you can’t have that 24/7, otherwise you will burn out. So that’s how I handle it. I have a long drive home. That’s my time to decompress and just know that once I walk in the door at home, I’m not the doctor. I’m the home person. |