Prognosis

“Life is a sexually transmitted terminal condition.” Having said that most Americans live well into their 70’s or beyond. Those with disease will likely die sooner. How much sooner? How do we know? (pro-forward, gnosis-knowing)

Have you asked your doctor? It is an Art - and even the best doctors are often inaccurate or unwilling to give you hard and fast numbers. Having less than 6 months to live is a criteria for Hospice. (See Texas Hospice Criteria). How can you get an honest estimate?

UCSF has eprognosis tools that are evidence based, if focused.

Ways we Die

Most doctors, for themselves - given a choice want a rapid decline over a few months - maintaining mental capacity - after we have lived a full life. Few want to live into Dementia or Major Disability. Some of us die of sudden cardiac events, others languish for years. How can planning help? How can you get the truth about a disease course without the sales pitch and eternal “Hope, Dope and Cope”. Stephen Jenkinson in Die Wise does a masterful job discussing the topic

Where we die

Most Americans die in Hospitals, despite their overwhelming wishes to die at home. Some of this is financial (the system bills for more if you are in a hospital and we are “doing things” to you). Some of this is fear based, “can we really support Grandma at home?” Can you have agency and choice in this? What would need to be in place for you to remain at home? How can you advocate for this?