I read an article recently that discussed the fact that the U.S. is now number 42 on the world ratings list for life expectancy.  The big reasons believed to be behind this are the number of Americans who are obese and lead sedentary lifestyles.  As a nurse, I have another idea of what’s behind this.

I think that the medical community, doctors and nurses, are doing a better job of educating our patients about quality of life issues.  We’re helping patients and their families look at what kind of quality they would have as opposed to just blindly focusing on prolonging their lives and forget what the quality of that life may be like.

That isn’t meant to sound cold and heartless.  It’s just a fact that there sometimes comes a time when it’s time to look at what the treatments we’re putting the patients through are costing them.  Take for instance, chemotherapy.  Being an oncology nurse, this is an example I see frequently.  Take, for example, an older patient who has been fighting cancer for years and their body is frail and tired.  They’re tired of fighting, both physically and emotionally.  The side effects of the treatment for their cancer is making them miserable and unable to function and do anything they want to.  There comes a time to discuss with them the option of stopping treatment and making them comfortable, allowing them some better quality time when we know that their time is limited.  We can offer some pain free time without the miserable side effects of the chemo. 

That’s not to say we ever suggest to a patient that they give up.  It’s only when it’s really obvious that the treatment is only prolonging death and not going to offer a cure and equally obvious that the cost of that treatment is outweighing the benefit of it that we would discuss stopping aggressive treatment as an option.

I think it’s getting more common to discuss quality of life as a concept than in previous years.  And that may lead to some patients dying just a bit sooner than they might otherwise with more aggressive treatment.  So this could be skewing the life expectancy figures a bit.  Or I could be wrong and the the difference could be so short as to not effect life expectancy figures at all.  It’s just a thought.

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