When Enough is Enough

“When are we going to get to the business of understanding when our interventions make a meaningful change in the outcome of humans and when they won’t? When are we going to finally decide that enough is enough?”

Dr. Greg Henry, past president of the American College of Emergency Physicians, and a leader in the specialty, writes about the lack of information given to families about end-of-life care and how to handle the inevitable functional and physiologic decline that aging brings with it.

Dr. Henry points out that emergency physicians routinely spend about one third of their time in the ED dealing with chronic illnesses that they cannot fix. Acute problems, such as falling out of bed and breaking a wrist or hip can be treated. Reversing the “ravages of time,” as Henry puts it, is another matter.

One common situation is what will happen starting next week and going through the holiday season. Families will come from far away to visit their elderly relatives. They may not have seen their relative for six months to a year and the difference is startling. Grandmother is just not the same as she was last year. Something must be done! And to the Emergency Department they will go with Grandmother in tow, of course, expecting a sure and swift reversal of Grandmother’s condition.

Unless Grandmother has an acute medical problem, an infection or electrolyte abnormality for example, there’s not that much to do. This is an opportunity, however, for compassion and caring, and a chance to educate the family about their loved one’s inevitable decline, even if it is in a crowded emergency room in the middle of Thanksgiving night.

Read Dr. Henry’s forthright article here.