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May 25, 2024 9 mins
WHEN APPROACHING THE END OF LIFE, MANY PEOPLE SEEK THE COMFORT AND DIGNITY OF PASSING AWAY AT HOME; AND A COMPREHENSIVE GUIDE FOR THOSE CARING FOR A LOVED ONE AT THAT STAGE OF LIFE HAS JUST RELEASED IT’S THIRD EDITION. WE SPEAK WITH DR. ANDREA SANKAR, PROFESSOR OF MEDICAL ANTHROPOLOGY AT WAYNE STATE UNIVERSITY AND CO-AUTHOR OF: “DYING AT HOME: A FAMILY GUIDE FOR CAREGIVING.” 
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(00:00):
Welcome to American Medicine Today, presentedby the Benati Spine Institute, featuring internationally
acclaimed inventor of the Benati spine procedures, Alfred Benatti, MDI here your host,
Kimberly Bermel Benati and co host EthanYucker. Welcome to American Medicine Today.
I'm Kimberly Benatti alongside Ethan Yucker andworld renowned orthopedic surgeon, doctor Alfred

(00:21):
Benatti. When approaching the end oflife, many people seek the comfort and
dignity of passing away at home,and a comprehensive guide for those caring for
a loved one at that stage oflife has just released its third edition.
Joining us to discuss as Doctor AndreaSanker, Professor of Medical Anthropology at Wayne

(00:41):
State University and co author of Dyingat Home, a Family Guide for Caregiving,
Thank you for joining us, doctorSanker, thank you for having us.
Certainly, Well, it's a topicthat no one really wants to talk
about, but it's something that weall have to think about. So what
made you want to co author abook on such a sensitive matter. Well,

(01:02):
several years ago, my sisters andI took care of my mother,
well, she was dying and atthat time my family had there were two
social workers, a physician, abiowethicist, a former aid at a nursing
home. We all took care ofher together and it was so difficult that
we decided My sisters urged me towrite a book about how our experiences and

(01:25):
other people's experiences, so that wecould help other people through this challenge but
also extremely rewarding period in life.Well, and as far as caregiving goes,
what are some of those stressors?I mean, it's there's the obvious
matter at hand that you all lovedone is approaching the end of end of
the road, really, but whatare some of the other stressors that caregivers

(01:47):
can expect to experience. Well,this may seem obvious, but people who
are dying are extremely sick. Thekind of care they need is pretty daunting
in many cases, and most familycaregivers are not prepared for that. So
if you are participating in hospice,you get help from hospice. But basically

(02:07):
the care is the responsibility of thefamily, So there's a heavy responsibility of
care that has to be met.Then any tensions that have been around in
the family, from childhood, anythinglike that tense. When people are under
such stress as they are when you'recaring for somebody who's dying at home,
those tensions tend to come out too. And then, of course, because

(02:30):
it's a twenty four to seven kindof commitment, may have jobs, you
may have other responsibilities, maybe littlechildren, maybe other people are depending on
you for care, so there's thatkind of stress. So it's it is
a highly stressful situation, although deeplyrewarding. Is there any other help available
for those that are caring for lovedones at home outside of hospice. If

(02:53):
you're outside of hospice, you don'thave the kind of care. You don't
reimburse care when hospice is reimbursed byMedicare, Medicaid and most private insurance companies.
If you're not using hospice, youhave access to home care, which
is much more limited in the kindsof support it provides. And then of
course, if you have independent means, you can hire people to help you,

(03:16):
or you may have a very largefamily or a support network that can
help do it. But the levelof care that's required you need professional input
into it. So it's not somethingthat people could easily do on their own.
I've watched people go through hospice,and I guess something that comes to
mind is if you start the processthat far in advance, I think people's

(03:38):
fear is that they're going to beput on opiates and all sort of medications
to kind of drug them up andalmost progress death faster. Yep, that's
a very common fear, absolutely,but the research shows that that in fact
does not happen that people who areon hospice because the quality of care,
in particular pain and symptomat management,is so so good in most hospices that

(04:03):
it's possible people actually live longer.But what you've identified is a common concern
about it, but in fact,the research shows that that's not the case.
And furthermore, many people don't wantto have opiates. They don't pay
meds, they don't have that's notrequired to be on hospice. You do
not have to take that kind ofmedication. It's available if you need it,

(04:25):
and it's really good to have somebodywho knows how to administer it,
which is one of the reasons whyhospice care is so effective is because they
do know how to manage the medicationand they manage it, and then they
teach the caregiver how to manage it. I have a bad experience with it,
and that thing doesn't mean that happenswith everybody. But I have a
brother who practically had a very simpleproblem but affect him every day because he

(04:54):
had that type of aerathmia that hefelt heart every day that dropped him to
a situation for depression. I thinkhis wife is a very dedicated person who
took care. Her parents took mybrother also, and the situation that I

(05:18):
envision was to me very devastating.My brother looks extremely young, incredible beautiful
that night, his body looks healthy. I think his mind was not.
And what I'm going to say isnot something that is nice, because every

(05:41):
one of us is going to die, But I think you have a time
to die. I don't think hereally had the time. I think he
was pushed to a drugs and Isaw increase of medication as a physician.
And you know very well that despitethis, my brother, I don't have

(06:04):
any rights over the decision seemed tobe. The decision was made between him
and his wife, and after Isaw him, he died that night,
and to me. I believe thatwas assisted suicide, and I'm telling you

(06:26):
something that is unfair. It istotally not what probably happened. But I
am a doctor and I can seea body and I can see the reactions.
I think he was extremely depressed,and I think he asked to terminate

(06:50):
his life. I was practically puton the side because he said he doesn't
want anybody on the family to bethere, and his wife let us know
that he was terminal and that weshould be there. I appreciate that,

(07:15):
but I don't really I don't reallyknow exactly what happened, and you don't
have a way to inquire that either. So just terminate a life with assistance
is very much a situation that happensin Holland. And when I see people

(07:38):
that they terminate their life, becauseI had a clinic in Holland in the
past and I had patience that theycome. I saw people thirty years old
that they request terminate their life.And I'm telling you that that situation confused
me. I don't know about assistantsuicide. I don't know anything about terminating

(08:05):
life. I love life very verymuch, but I never will have clear
in my life. I think theway that my brother went. I was
not sure that was correct. Ithink was a bad depression, poorly treated.
I understand my husband's point of viewbecause he's a doctor and the first

(08:31):
thing to do is to kind ofstep in and try to help ensure that
a patient lives. When you areterminal, I think it's a very personal
choice that you want to make whetherto stay in a hospital and be treated
or undergo hospice care. But thankyou so much for being on the program
and sharing how caregivers can get help, doctor Andrea sink Or, thank you

(08:54):
for being on the program. Thankyou for having me, Thank you.
Make sure you stay too, andwe'll have more after the break. You're
listening to American Medicine Today.
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