Littleton Citizen Forum Shows Broad Consensus Around End of LifeIssues
Littleton, NH – Littleton residents believe health care in the United States is in crisis, that it is more important to control pain and maintain dignity near the end of life than it is to have life-saving treatments to prolong life, and that tax incentives and other measures should be in place to ease the burden on family caregivers.
These were some of the results from a Thursday night forum on Reclaiming the End of Life, an event designed to let New Hampshire residents voice their opinions about what issues of end of life care are most important to them. The first of eight such forums to be held around the state this spring and summer, the Littleton event covered questions ranging from how and where people would like to die, to what training doctors and nurses should have, and what standards should be set on nursing homes and other long-term care facilities.
65 percent of participants said they would most prefer to die at home over a hospital, nursing home, hospice facility or other location. Not being a burden to one’s family was a shared concern, with 92 percent saying it was “extremely important,” “very important,” or “important.” Similarly, 86 percent said not losing the family’s savings ranked high among their concerns, as did not “leaving my family in debt,” which fully 100 percent of the attendees ranked in one of the three most important categories.
Polling was done on a real-time basis, using touch-pad technology that allowed those present to instantly enter their votes on each of the dozens of questions asked. The evening was led by Ira Byock, MD, Director of the Reclaiming the End of Life Initiative. Byock told the group that the problems of frail elders, dying people of any age, and family caregivers constitute a crisis that will only get worse and baby boomers age. “And yet,” he said, “nationally, publicly, no one is talking about it. Our families facing these situations are too exhausted, too weak, too overwhelmed to be heard. It’s up to us to lift our voices high and speak for those who cannot speak for themselves.”
Byock said the results of the eight forums will be compiled and put in front of presidential candidates and the media to “shine a spotlight on this crisis that’s been hiding in plain sight.”
“The next president of the United States will have no choice but to deal with the tidal wave of aging Americans and the inadequate systems we have in place to deal with them,” he said. “Here in New Hampshire, we have a unique opportunity to talk one on one with the next president. We’re going to present him or her with the voices of this state’s voters and compel candidates to address these issues.”
Questions for the evening were broken into categories: Common concerns and fears, questions about care, policy, cultural diversity, the special challenges of rural care, medical and nursing education, nursing homes and long-term care, hospice and palliative care, pain management, and family caregiving. Most of the questions were based on years of research and recommendations by groups including the Institute of Medicine, the National Association of Attorneys General, and the congressionally-appointed Citizens Health Care Working Group.
Among the results of the polling:
Asked whether “physician assisted suicide” was important, 52 percent said it was important, while 47 percent said it was “a little” or “not at all” important. Similarly, access to euthanasia was considered important by 55 percent; 36 percent said it was “a little” or “not at all important.”
91 percent said continuity of care between appointments and among health care providers was very important to them. There was laughter when the question of whether health care billing should be “clear and simple” came up – 95 percent gave a resounding yes.
On the question of whether the U.S. should provide “affordable health care for all Americans,” 71 percent said yes, while only 25 percent disagreed or strongly disagreed. 81 percent said they would be willing to pay a percentage of their income across their working life to be guaranteed “appropriate, timely, comprehensive care from conception to death.”
Full results of the Littleton Forum, along with results from subsequent forums around the state, will be posted on the web site: www.ReclaimTheEnd.org. The next forum will be held April 24th in Laconia, with a Manchester event following on May 3rd. Other forums will be held in Concord, Keene, Hanover-Lebanon, Nashua, and Portsmouth-Exeter.
