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The 4 vital end-of-life lessons from 40 years in Palliative Care

After decades working with dying patients, Dr. Edward Creagan has cumulated many tidbits of hard-won wisdom, which he shares in his new book Farewell: Vital End-of-Life Questions with Candid Answers from a Leading Palliative and Hospice Physician. Dr. Creagan joined me on the Peaceful Exit podcast to dive into some of these end-of-life difficulties and provide clarity on how to approach it with compassion. Here are some of my top takeaways from our conversation:


1. Know the difference between hospice and palliative care 


Hospice specifically supports patients expected to live 6 months or less. The focus is 100% on comfort, not treatment. Palliative care has similarities but can start at any stage of illness, while patients still receive treatment. Understanding the distinction empowers patients to access these services sooner to improve quality of life. 


2. Ask for a palliative care consult 


If your medical team doesn’t suggest a palliative care consult proactively, you can ask to see someone from palliative care. That doctor will look at your diagnosis, circumstances and desires in a wholistic way and help ensure comfort and dignity are preserved. There’s even data that supports Dr. Creagan’s insights that people with palliative care often live a bit longer and more comfortably without it. 


3. Address emotional needs as well as physical 


Connecting with patients about their pets, families, worries or goals gives meaning when time is short. Providers who compassionately listen retain more information to provide personalized care. Tend to the whole person - relationships, purpose, dignity, not just the body. 


4. Plan ahead to reduce bereavement stress 


No one is ever fully prepared for loss, even medical professionals like Creagan. However, legal/financial planning and candid conversations with family enable the bereaved to grieve instead of managing logistics. Update documents every few years as health/life circumstances change. 


While emotionally difficult, end-of-life can be navigated with greater compassion and empowerment by applying Cragen’s decades of expertise. His guidance equips patients and providers alike to have these vital conversations. By planning ahead, listening deeply, tending to relationships, and retaining autonomy in choices, we can work towards more peaceful exits. 

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