Paula Span

Short on Staff, Some Hospices Ask New Patients To Wait

October 8, 2021 by Paula Span

Anne Cotton had enjoyed her years at an assisted living facility in Corvallis, Ore. But at 89, her health problems began to mount: heart failure, weakness from post-polio syndrome, a 30-pound weight loss in a year.

“I’m in a wheelchair,” she said. “I’m getting weaker. I’m having trouble breathing.” On Sept. 30, Dr. Helen Kao, her palliative care doctor and a medical director at Lumina Hospice & Palliative Care, determined that she qualified for hospice services — in which a team of nurses, aides, social workers, a doctor and a chaplain help patients through their final weeks and months, usually at home.

Ms. Cotton, a retired accountant and real estate broker, embraced the idea. “I’ve lived a very full life,” she said. “I’m hoping I’m near the end. I need the help hospice gives.” Her sister died in Lumina’s care; she wants the same support. For older patients, Medicare pays the cost.

‘I Need to Know I Tried’

August 11, 2021 by Paula Span

In 2019, Dr. Richard Leiter, a palliative care specialist, met a patient and the man’s wife in the intensive care unit at Brigham and Women’s Hospital in Boston. The patient, in his 70s, had heart disease and kidney problems. But he had been living at home and doing reasonably well until sepsis, a life-threatening bloodstream infection, sent him to an emergency room.

He had already spent several days on a ventilator, requiring drugs to keep his blood pressure from plummeting. Now, “his kidneys were no longer working and he wasn’t waking up at all,” Dr. Leiter recalled, adding, “We were very worried that he wasn’t going to survive.”

When the kidney palliative care team — including a nurse-practitioner and a social worker, as well as a consulting nephrologist — met with the man’s wife to discuss treatment, it proposed what is known as a time-limited trial, in which life-sustaining treatment continues for an agreed-on period to see how the patient responds.

Family Caregivers Feel the Pandemic’s Weight

August 10, 2021 by Paula Span

Mary Ann Boor could see her husband’s Alzheimer’s disease progressing, and her responsibilities as his caregiver intensifying.

For years, David Boor had carefully taken diabetes medications. But as he grew forgetful, Ms. Boor had to start monitoring the doses and timing. She took over the driving and then the finances; she had to begin helping him bathe and dress.

The Boors, retired high school teachers who moved to a lakefront retirement home in Huron, Ohio, were managing on their own. “Then, about the time I thought maybe I should look into home health aides, the pandemic struck and I was leery of people coming into the house,” Ms. Boor, 71, recalled.

Should Youth Come First in Coronavirus Care?

January 5, 2021 by Paula Span

In April, as the coronavirus was rampaging through the Northeast, Larry Churchill considered what he would do if the pandemic caused medical shortages. Should he, a 75-year-old, direct care to younger people before him if he got sick?

He was in a good position to raise the question. A bioethicist retired from Vanderbilt University, he published an essay on the Hastings Center’s bioethics forum saying that he intended to avoid hospitals if they became overwhelmed and forgo a ventilator if equipment grew scarce. When a vaccine became available, he would move to the end of the line.

Fortunately, Dr. Churchill has not had to face such decisions. He remains healthy, writing and teaching, and hiking in the Blue Ridge Mountains. And enough ventilators were produced to meet demand.

For This Diner Waitress, It’s a Long Day’s Journey into Lunch

January 4, 2021 by Paula Span

3:45 AM: Amal “Molly” Kaydouh gets up in the dark. Padding around her North Arlington apartment on this Tuesday morning, she reaches for one of her five identical red shirts appliqued with the Nevada Diner’s logo, along with a black apron, leggings and, crucially, non-skid shoes. She brightens the ensemble with sparkly earrings and painstakingly applies makeup, because appearance counts.

Driving to the diner in Bloomfield, she stops at a Dunkin’ Donuts for an espresso and smokes a single Salem menthol in her car. By 6 am she’s on the job, cleaning every surface in the back room—tables, booths, saltshakers. She makes pots of coffee and restocks bins of ketchup packets and plastic Cream-O-Land containers.

And then she waits.

My gym is closed because of Covid-19. I’m doing bicep curls with jars of gefilte fish.

January 2, 2021 by Paula Span

The exercise studio I’ve patronized for 30 years had to shut down, of course. So I switched to 40-minute walks through my suburban neighborhood and around the perimeter of the nearby park, since the park itself was also now off-limits.

That would provide the necessary cardiovascular workout, but what about keeping my core firm, my finicky back unclenched, my flexibility intact? I unrolled a yoga mat on the bedroom floor and added a daily 20-minute hodgepodge of crunches, knee bends, asanas, balance poses and, um, improvisations.