In this issue of Right at Home

• Home Care Helps Seniors Manage Painful Conditions
• New Book Examines Issues of Caregiver Siblings
• Drowsiness, Staring and Other Mental Lapses May Signal Alzheimer's Disease
• When Measuring Medicines, Not All Spoons are Created Equal
• On the Horizon: New Technologies to Keep Seniors Safer, Healthier

The death of euthanasia

It is time to discard the word euthanasia because it mixes ideas and values that confuses the debate about dying, states an editorial in the Canadian Medical Association Journal.

The term, euthanasia, is from the Greek and was coined in 1646. It was intended to mean a gentle and easy death. A nuance was introduced, by 1742, referring to the means of bringing about such a death and, in 1859, to the action of inducing such a death. Modern dictionaries have a variety of definitions, but they all imply the same meaning, an intentional action to bring about death in someone who is suffering.

"Euthanasia's broad meaning has inadvertently enveloped a set of actions that also involve the relief of symptoms in dying people," write the authors. "For example giving enough narcotic to relieve pain in cancer patients and adding enough sedation to enable comfort and minimize agitation is appropriate and compassionate care, even when the amounts required increase the probability of death. It can be argued that, in such circumstances, death becomes an acceptable side-effect of effective palliation. But, in our view, it is not euthanasia."

Physicians can help by not using "euthanasia" to refer to actions taken to assist dying patients and instead, can clearly name and define each action as well as its possible repercussions. PhysOrg

What Role Can Family Members Play in Long-Distance Caregiving?

Join Shelly Beach as she identifies some tangible ways that long-distance family members can offer support to the main caregivers. Video and transcript

More surprises in Dutch euthanasia of infants

For people outside the Netherlands, the most surprising thing about legally tolerated non-voluntary euthanasia of infants is that it happens at all. But for Dutch doctors, the surprise is that reports of it are far lower than the quota.

It was expected that 15–20 cases would be reported. To date, however, only one case has surfaced. There appear to be several reasons. First of all, the authorities may have over-estimated the number of infant deaths based on deficient data from previous years. Some abortions had also been wrongly reported as infant euthanasia. Improved ultrasound technology now allows doctors to abort defective babies before birth, making euthanasia unnecessary. There has been an increase in the use of “terminal sedation,” which is not regarded as euthanasia, even if it causes the death of the patient. “It is likely that at least some cases of active ending of life occurred during the past years,” the authors admit. So why have the doctors kept it quiet? BioEdge, study abstract

March 31 Marks Fifth Annual 'Terri’s Day'

Friends of Terri Schiavo are calling on the pro-life community to commemorate her murder by dehydration and starvation on March 31, the anniversary of her death, by learning more about Terri's story and praying for other vulnerable individuals at risk of a similar fate. LifeSiteNews

Here's one thing you can do to mark the day: Fill out, and make others aware of, National Right to Life's Will to Live. See also BFL's Protective Medical Decisions Declaration.

New Federal Subsidies for Drug Purchases

For about one million low-income Medicare recipients, some good news: it’s just gotten easier to qualify for the federal Extra Help program, which provides more generous prescription drug benefits. NY Times

Stressful but Vital: Picking a Nursing Home

Finding a good nursing home takes research and perseverance. You want a safe, engaging and pleasant environment with caring staff and solid medical practices. “You can actually get all of that in a nursing home — if you know what to look for and how to search,” said Larry Minnix, chief executive of the American Association of Homes and Services for the Aging. NY Times

See also: Deciding on Care for Elderly Parents in Declining Health

A New Long-Term Care Insurance Program

Most families pay scant attention to how they’re going to pay for long-term care for their elders — whether they will need help with bathing and dressing or meal preparation and medication reminders, whether they will need help at home or in a facility — until they’re face to face with the problem. Many times, surveys show, families mistakenly believe that Medicare will foot the bill. When they realize that virtually any nonmedical help beyond their own uncompensated efforts must come from their parents’ pockets, or their own, they’re prone to panic. NY Times

Assisted suicide laws cited in 95 deaths in Washington, Oregon

Ninety-five terminally ill patients died in 2009 after taking lethal doses of medications prescribed by their physicians under death-with-dignity laws in Washington and Oregon, according to health department reports released in March. aMedNews

New York’s Family Health Care Decisions: A Chaplain’s View Act

Of all states, New York has long had the most difficult legal standard for determining whether to withdraw or withhold treatment for dying patients who cannot decide for themselves. That changed on March 16, with the passage of the Family Health Care Decisions Act, which gives surrogates the power to make such decisions in the absence of an advance directive. Bioethics Forum

Starvation 'within patient's rights'

Medical ethics experts have stood by a terminally ill patient's wish to starve herself to death, saying a doctor's task is to prevent suffering and not death.
Margaret Page has not eaten for 11 days and has drunk only a small amount of water. She has said she no longer wants to live, and three psychiatric assessments have found her capable of making her own decisions. The facility is respecting her decision as her right.

Mrs Page's husband, Barry Page, separated for 12 years, said the facility she lives in was not doing enough. He said his wife was starving herself to death in a "hunger strike" because the facility would not help walk her to the toilet and would not get her a wheelchair with a seat that did not hurt her. She also wanted "technology" in her room to stave off boredom. She was on a waiting list for these things and still several months away from getting them, he said. NZ Herald

Webcast: Looking Forward on the 5th Anniversary of Terri's Death

Days before the 5th anniversary of Terri Schiavo's death, Family Research Council will host a panel at its headquarters in Washington, DC, to discuss the circumstances and policy implications of the court ordered decision to slowly starve her to death. The event may be viewed via webcast on March 31, the anniversary of her death. Register at www.frc.org.

Elderly Irish Encouraged to ‘Plan Now for Suicide’

Speaking in Dublin, euthanasia campaigner Dr. Philip Nitschke encouraged his audience to confirm their plans to commit suicide before they become too infirm. “Don’t wait until it’s too late, plan ahead and put in place an end-of-life strategy."

A major focus of his appearance was to help overturn Ireland’s blasphemy laws that make it “almost impossible” to talk about assisted suicide for fear of opposition from religious groups. “As an atheist I am often asked to debate the ethical issues involved in providing a person with information that will allow them to end their life peacefully and reliably at a time of their choosing. I am constantly up against this idea that somehow life belongs to God. I disagree strongly with that assertion.” LifeSiteNews

"The Family Guy" Mocks Terri Schiavo

Near the fifth anniversary of the death of Terri Schiavo, the disabled woman whose husband won a court order to take her life, the Fox program "The Family Guy" featured a satire about her. Terri's family expressed shock and sadness that Fox would allow such insensitive programming during prime time. During the program, a segment titled "Terri Schiavo: The Musical," aired. In it, Terri is mocked and her suffering ridiculed. She was portrayed as someone on a number of mechanical life support systems and referred to as a vegetable. The segment ends with characters calling for pulling the plug. LifeNews

Numerous factors weighed when patients cannot make their own decisions

Living wills and surrogate decision makers account for only a portion of the many factors weighed by physicians when making medical decisions for hospitalized patients lacking the capability to make their own decisions, according to a recently published study. When asked to identify the single most important factor in making decisions for their patient, physicians most commonly reported "what was best for the patient overall" (33 percent), "what the patient would have wanted you to do" (29 percent), "the patient's pain and suffering" (13 percent), and "the patient's prognosis" (12 percent). EurekaAlert

Mum wanted to die

. . . but convincing her to live gave us both a gift beyond measure. Daily Mail

Editor: Watch out for objectionable images on the page

Ethics at the end of life

A recent study of dying children in Boston suggests doctors ended their lives with morphine, sometimes at the urging of parents. Bioethicist Jeffrey Kahn talks about the dilemmas faced by doctors who are in a position to assist a suicide or hasten death. MPR

Aid & Attendance Pension Benefits—Important Facts Older Veterans Need to Know

Aid & Attendance (A & A) is an underutilized benefit available to any United States Military veteran (or surviving spouse) who meets the service, financial, and physical criteria. This benefit is an addition to a veteran’s monthly VA pension. Of the 7 million Michigan veterans, over 500,000 are eligible for the Aid & Attendance benefits. However, only 20,000(4%) are receiving this deserved benefit! The bottom line—due to government cutbacks the VA DOES NOT advertise this program.

Veterans seeking appeals for information on benefits used to be able to go to local service centers with paid workers to provide them with help. However, elimination of these local centers and workers due to state budget cuts have forced veterans to go through this process alone, or through the backlogged Ann Arbor facility. It takes an average of 8-12 months for a filer’s application to be processed and to receive a determination letter. Due to the current backlog of claims to be processed, this time frame can be much longer.

Thankfully, the VA now allows certified attorneys to represent veterans before its review boards. It is recommend that people looking to file for this important benefit take advantage of the assistance of those experienced with the bureaucracy of the VA since it can greatly reduce the time it takes to receive benefits. Plachta, Murphy & Associates, P.C., located in Grand Rapids, is proud to be one of the few firms in West Michigan certified to represent our beloved veterans and their families.For more information and eligibility requirements please visit http://pmalawpc.com/va.html or contact Government Benefits Specialist Rick Cross at (616) 458-3994 or by email.

Remembering Terri on the Fifth Anniversary of Her Death

March 18, 2005, was Day 1 of Judge George W. Greer's court ordered slow death by starvation and dehydration of Terri Schindler Schiavo. Please visit www.terrisfight.org the next two weeks where they'll post stories of the events that occurred on each of the 13 horrific days that Terri went without food or water.

Grace before dying

Louisiana has some of the toughest prison laws in the nation, where one of every 55 residents is behind bars -- many of them for life. At the Louisiana State Penitentiary, a maximum-security facility in Angola, some 85 percent of the 5,100 inmates are expected to die in incarceration. Until recently, that was a lonely process: prisoners were buried in shabby boxes in numbered graves. But in 1998, Angola prison created a hospice program that officials say has been transformative. Newsweek

Music by Prucence

Prudence Mahbena had the bad luck to be born with arthrogryposis—a genetic condition that warps the joints in utero, causing them to form improperly—and the worse luck to be born in Zimbabwe, where disabled children are apparently thought to be cursed by witchcraft. According to the film Music by Prudence’s Web site, “in their culture, you have to dispose of the ‘weakest link.’ What do you do with disabled children? You kill them. You boil them sometimes. Or you starve them.” Newsweek

Assisted suicide's new face

Final Exit Network is one of the most radical right-to-die organizations in the country. While most such groups advocate assisted suicide only for terminally ill patients, FEN's bar is lower. Newsweek

Dr Death arrives in UK for suicide DIY workshops

An Australian euthanasia activist was temporarily detained while attempting to enter the UK, but officials allowed him to enter on a ten-day visa. Dr Philip Nitschke and his organisation Exit International, will conduct workshops in which he will detail different ways to commit suicide.

Baroness Finlay of Llandaff, chair of the pro-life Dying Well Group, said: “I hope that he will be closely observed because I find the kind of suicide message that he’s pedalling extremely worrying. The vast majority of deaths in this country are now much, much more peaceful, much better than they used to be because of all of the advances that we’ve made within the medical care of people that are dying.” Christian Institute

Baby Isaiah Dies with Family on Parents' Terms

Baby Isaiah James May died yesterday afternoon in the arms of his parents. After enduring a legal fight to keep doctors from forcing death upon their child, the May family bade farewell to their son on their own terms after becoming convinced that there was no chance of his recovery. According to Alex Schadenberg of the Euthanasia Prevention Coalition, the tragic case “has probably turned out the best it possibly could have turned out.”

"All along it was our hope that Isaiah's condition would brighten and improve. It has not,” his parents stated. “The decision that has now been made may be incomprehensible. But it has been made knowing that we did everything possible to find meaningful answers to our questions and that all reasonable alternatives were fully explored and carefully considered. We very much believe that life is a gift from God and that our son's inherent value and worth as a human being is not diminished by the number of days recorded in this world. Isaiah has reminded all of us once again that life is very precious and fragile.”

Schadenberg emphasized that there is “nothing morally wrong” with the parents' decision to remove the child's respirator. “There was nothing done to this child to cause [his] death. [He] died a natural death, and that's exactly what we look for.” LifeSiteNews

Bath safety

Of all the accidents that occur in homes each year, 70% occur in the bathroom. Falls in the bathroom are the second leading cause of accidental death and disability after automobile accidents in the US today. Ezine

A patient's death prompts a doctor to assess 'Do Not Resuscitate' orders

My version of DNR is "Do Not Resign." Don't give up on me if I can still think, communicate, create and enjoy life. When taking care of me, take care of yourself as well, to make sure you don't burn out by the time I need your optimism the most. My DNI? It means "Do Not Ignore" . . . my needs for companionship, stimulation and purpose, as these, too, make life worth living. . . . It's so easy to let someone die, but it takes effort, determination and stamina to help someone stay and feel alive. Washington Post

Dignitas death for wife who tried to murder her husband

Vicki Wood, who attempted to smother her seriously ill husband to death, despite his objections, has ended her life in a Swiss suicide clinic. The couple, who were married for 20 years, were both members of a euthanasia society. Describing the attempt on her husband's life, Mrs Wood said: “I told him I loved him and everything would be all right. He went on struggling but I told him I loved him and I was doing it for him.” The murder attempt failed when her husband, Tim Wood, began to struggle, complaining that he couldn’t breathe, and fell out of bed. Christian Institute

Nitsche euthanasia lecture canceled

It was recently announced that Philip "Dr. Death" Nitschke was to hold a ‘DIT Euthanasia workshop’ in Dublin on 19 March next. Thanks to the objections of many UK organizations, the so-called ‘workshop’ will not now be held at the planned venue. The situation, however, will be closely monitored. European Life Network

Analysis: Washington’s suicide report mirrors Oregon’s

Washington mirrored Oregon in the low number of people who were referred for psychiatric evaluation. “So, Washington looks like Oregon, redux,” bioethics commentator Wesley Smith wrote on his weblog March 6. “And that’s too bad. Terminally ill patients deserve better than to have their worst fears verified by doctors issuing lethal prescriptions instead of vowing to stay with the patient to the end caring for their pain, validating their dignity and supporting the importance of their lives. ERLC

Hospice Study Finds Racial Disparities

Among patients with advanced heart failure, blacks and Hispanics are less likely to receive hospice care than whites, researchers found. The data are consistent with previous examinations of hospice use, and the findings "counter speculation that overall increases in the availability of hospice services in the 1990s may have erased racial and ethnic differences in hospice use." More research is needed to determine the underlying cause of the disparities. Medical News

Dutch group endorses right to suicide for elderly

A campaign to give elderly people in the Netherlands the right to assisted suicide said it has gathered more than 100,000 signatures, hoping to push the boundaries another notch in the country that first legalized euthanasia. The "Of Free Will" campaign said the group had hoped for 40,000 signatures. The group proposes training non-doctors to administer a lethal potion to people over the age of 70 who "consider their lives complete" and want to die. Atlanta Journal-Constitution

Bunny's Last Days: When Living Will Isn't Enough

Palliative care specialists, relatively new players on the health care scene, offer comfort, support, pain control and, if requested, spiritual counsel, helping them sort through often confusing and ambiguous medical options. Unlike hospice care, which requires patients to forgo aggressive medical care, palliative care allows patients to continue any level of medical care they desire. They help people make tough decisions that are less about dying than about how they want to live at the end of their lives. Kaiser Health News

Pro-life critique of WA's assisted suicide report

Alex Schadenberg of the Euthanasia Prevention Coalition had these concerns about the new report: "The majority were 65 years old or older, and educated. Nearly half had private insurance. These factors are consistent with their being individuals with money. Older people with money are prime targets of abuse. Washington's act is, regardless, coercive: An heir who will benefit from the death, is allowed to help the person sign up for the lethal dose; there is no requirement of consent at the time of death." According to the report, 23 percent of the Washington residents who killed themselves via assisted suicide did so due to a concern about becoming a "burden" to their families.

Dr. Patricia O’Halloran, the vice president of Physicians for Compassionate Care Education Foundation, pointed out other problems. Only three patients were referred for psychiatric evaluation — despite the fact that the primary reason people attempt and die from suicide is underlying depression. Also, the physician who wrote for the fatal overdose was present at the time it was ingested in only 3 of the 36 cases. "Who are these witnesses to death? Are they advocates of assisted suicide? In the remaining 45% of cases, we have no information as to whether anyone was present with the patient when they died. Did they die alone? . . . Without an unbiased, disinterested witness at death, there is no way to know if the patient was of sound mind and making an informed choice when the actual ingestion took place, or even if the patient ingested it voluntarily." LifeNews

Dr Death set to visit the UK and Ireland

Dr Philip Nitschke, nicknamed Dr. Death, has attempted to justify his visit to Dublin by saying that he has had “significant interest” from older people in Ireland who want more information about their ‘end-of-life choices.’ Dr. Nitschke, founder of right-to-die group Exit International, has targeted his workshops at areas with a vulnerable elderly audience before. Christian Institute

Report Finds 36 Died Under WA Assisted Suicide Law

At least 36 terminally ill people died last year after taking lethal medication prescribed by doctors under Washington State’s new physician-assisted suicide law, according to a state report released Thursday, the first since the law went into effect a year ago. A total of 63 people filled prescriptions for lethal medication, but not everyone took it. All those who did take it died. Some people who did not take it died from other causes. NY Times

Related: Noon protest Friday at state capitol marking anniversary of Washington's Death With Dignity Act.

The Suicide Tourist

Directed by Academy Award-winning filmmaker John Zaritsky, The Suicide Tourist is a portrait of Ewert's final days as the Chicago native pursues a physician-assisted suicide in the one place where it's legal for foreigners to come to end their lives: Switzerland. With unique access to Dignitas, the Swiss nonprofit that has helped more than 1,000 people die since 1998, The Suicide Tourist follows Ewert as he debates the morality -- and confronts the reality -- of choosing to die before his disease further ravages his body, and he loses the option to die without unbearable suffering. Watch here.

Then there's this from the Washington Post showing society's schizophrenia on suicide ("suicide is bad, but assisted suicide is okay"): Pulling loved ones out of the lure of suicide

On Both Sides of the Atlantic, a Debate Over Quality of Life

Two legal cases dealing with the rights of family members to decide life or death for a critically injured loved one have touched off a storm of controversy on both sides of the Atlantic, landing one mother in prison for life, and locking a young couple in battle with the very doctors charged with keeping their infant alive. FoxNews

The disappearing disabled

The thinking behind eugenics isn’t very difficult to understand. People are different in many ways. Some of these differences are socially and medically acceptable, others are not. We need more people with socially acceptable traits, fewer people with undesirable traits. There are two ways to do this. One, we passively encourage people with undesirable traits not to reproduce, but this takes a long time to reduce the undesirable population. Two, we actively take steps to eliminate those with undesirable traits by whatever means we can. Historically, that has meant sterilization, abortion, laws banning people with undesirable traits from marrying or reproducing, and the killing of so-called defectives. MercatorNet

Cerebral Palsy Stem Cell Trial Begins

U.S. scientists say they are starting a clinical trial to determine whether stem cells from umbilical cord blood can help children with cerebral palsy.
Medical College of Georgia researchers said their study represents the first such U.S. Food and Drug Administration-approved clinical trial. The study will include 40 children age 2-12 whose parents have stored cord blood at the Cord Blood Registry in Tucson, AZ. OfficialWire

Hundreds hoarding death drugs, claims Aussie Dr. Death

According to Exit International founder and euthanasia advocate Dr Philip Nitschke, hundreds Australians are hoarding lethal doses of an illegal euthanasia drug as an insurance policy, so they can control the time and manner of their own death. news.com.au

Disabled people need assistance to live, not die

There is a saying among disabled people that goes: "If it hurts, we know we're alive." Like most humans our natural instinct is not merely to survive but to flourish. For this we need assistance to live, not die. Disabled people suffer so much neglect, isolation, exclusion and discrimination that some volunteer for euthanasia. But this is not the only way to address suffering. What about assistance to live? The Independent

Emotional testimony at Mass. House hearing on right-to-die bill

Called the “death with dignity act,” the bill would require that a patient requesting physician-assisted suicide initially ask for approval in writing, go through psychological screening and then verbally request the medication. Massachusetts Citizens for Life opposes the proposed bill, saying it would make it possible for patients who are mentally competent with terminal illnesses to elect to end their lives through physician-assisted suicide.The bill must be approved by the Judiciary Committee before it can go before the full House or Senate for debate and a vote. Milford Daily News

The Schindlers Were Right to Insist on Tests for Terri

The family begged Judge Greer to permit sophisticated brain scanning that had never been used on her before. It couldn’t have hurt her, and it might have shown something. But stubbornly, he refused. I will go to my grave believing the judge knew what he didn’t want to know. Secondhand Smoke

13-Year-Old Pro-Life Superstar Tackles Euthanasia

13-year-old Lia Mills, who wowed judges and garnered widespread international attention last year for her bold speech on abortion (a video of which has been viewed hundreds of thousands of times), has taken on euthanasia this year. In another powerful and articulate address, the young Toronto native explores the devastating consequences Canada would face if it welcomed euthanasia, and implores Canadians to find ways of caring for suffering patients rather than killing them. LifeSiteNews, YouTube

What makes a 'good death'?

In Leo Tolstoy's famous novella The Death of Ivan Ilyich, the title character is suddenly struck down by a terminal illness. In his dying days, he screams in agony and rails against his misfortune, blind to the fact that he has lived a selfish life, putting his career before his wife and children. In his last hours he finally gives in to his fate and becomes reconciled to his family.

The story is cited in a recent paper by the Lancet which addresses the controversial issue of pain control in terminally-ill patients. The article says there is such a thing as a “good death” and the desire, especially among relatives to control pain whatever the cost, can have unintended consequences. Chief among these is that many dying patients do not get a chance to make their farewells at the end of life because they are too sedated. Irish Times

Study explores child end-of-life scenarios

A small study published yesterday in the Archives of Pediatrics & Adolescent Medicine reports that more than one in eight parents surveyed considered hastening the death of a child with terminal cancer, with the child’s suffering increasing the likelihood of such thoughts. Five parents said they actually asked a caregiver to speed up their child’s death. Boston Globe

A Different Dream for My Child - Meditations for Parents of Critically or Chronically Ill Children

In A Different Dream for My Child, Jolene Philo shares frank, heartfelt meditations to build your faith and hope. You won't find trite, easy words. You will find rare understanding, refreshing honesty, and a wise spiritual companion to walk with you through the highs and lows that only the parents of chronically ill children can know. Discovery House

Someone's there

Men and women in extremis often find themselves facing the question of life's meaning. Not all of us at the end of our life-journeys will experience epiphanies, but all of us have the potential to be so blessed. And many of us, even if immobile, physically unresponsive and without reasonable hope of recovery, might still engage most important matters — things like forgiveness, repentance, acceptance, commitment, love, God — perhaps the most momentous matters we will ever have considered over the course of our lives. Are such vital encounters worth less than running and jumping? Is ending a life of pure contemplation less objectionable that ending one that includes physical activity? JWR

UK publishes new rules for assisted suicide

New guidelines published Thursday offer people in England and Wales broad hints about how to help a gravely ill loved one end their life with minimal fear of prosecution. Assisted suicide remains illegal, but six factors would make it less likely that prosecutors would bring criminal charges in individual cases. Prosecutors will still evaluate each case for possible prosecution. One key indicator: Whether the suspect was acting wholly out of compassion, or had a darker motive. Washington Post