The Gerontologist 43:285 (2003)
© 2003 The Gerontological Society of America
END-OF-LIFE DECISIONS, PART II
Robert E. Yahnke
The two videos reviewed in this column approach end-of-life decisions from complementary viewpoints—those of patients and their families on the one hand, and physicians and other health care professionals on the other hand. Taken together with the video Caring at the End of Life (reviewed in The Gerontologist, Vol. 42, No. 6, 2002), the two videos reviewed below offer a number of perspectives on the ways in which living with dying and yet having to make decisions about end-of-life care are a complex dynamic, characterized by ambivalence, ambiguity, and—too often—poor communication or miscommunication. Obviously, care and compassion should be the basis of the relationship between health care professionals and their patients when it comes to end-of-life care; but even as health care providers try to acknowledge the individuality of the patients they serve, there are no easy answers to the interactions between the interested parties. Sometimes the dilemma of end-of-life care relates to health care professionals leaving unspoken what needs to be spoken; at the same time patients and family members may not be able to hear what is plainly spoken.
The first video reviewed below, More than a Failing Heart, illustrates the shortcomings of end-of-life care when health care professionals fail to clearly and adequately communicate with patients and families. Prof. Karen Feldt comments on the way the video effectively weaves together scenes of families interacting with each other as well as interview segments where family members articulately recount their painful stories. The interviews with family members represent the core of this video. Prof. Feldt appropriately comments on the lack of any perspectives on the part of nurses and physicians that might have balanced the perspectives of family members.
Although The Way We Die: Listening to the Terminally Ill was reviewed in a former Audiovisual Review column of The Gerontologist (Vol. 36, No. 4, 1996), I felt compelled to solicit another review of this video because I thought it deserved a more sustained and in-depth analysis. When I previewed the video a few months ago, I was struck by the quality of the production—the technical qualities that revealed characters through a glance or gesture, the innovative way graphics introduced each of four cases, and finally the compelling testimony of patients, family members, and the doctor who guides us through the insights she has gained from being "broken open by my patients." The Way We Die deserves a wider audience, and I was gratified to see the review that Dr. Guy Micco submitted below. I think he offers a fully developed and insightful "second look" at this video. He grapples with the complexity of the communications between patients, family members, and physicians; and he offers some intriguing analyses of the failures in communication.
I hope readers will let me know their thoughts on the quality and content of future issues, share their ideas for future themes, inform me of their media productions, and share their thoughts on new developments in film, television, and other media as they relate to gerontology. Readers may contact me via E-mail at the following address: yahnk001@umn.edu
