NBC Primetime Gives CHF and End of Life Center Stage

On January 29th 2015,  NBC’s Parenthood gave the world a candid, graceful view into some very important issues often overlooked not just by millions of people all over the country, but by the entertainment industry as well: Heart Failure, end of life processing, and end of life choices. As a former Heart Failure/Heart Transplant Nurse I watched each of the last few episodes with bittersweet recollection as I reflected upon so many faces and families… the times we as healthcare providers got it “right,” and the moments we all knew we missed the mark.

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What I loved about the last few episodes of Parenthood: For once, the main character wasn’t dying of Breast or lung Cancer and viewers were introduced to—for the first time on primetime television— the reality of what Heart Failure patients and families live with daily. We were able to get a peek into the deterioration of a loved one’s physical abilities, the struggles of various family members as they tried to cope with anticipatory grief while supporting the choices of a parent and spouse to forego further treatments… and the life review many patients and families embark upon as a means of making things right, tying up loose ends,  and arriving ( ideally) at a peaceful acceptance of an impending life transition.

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Parenthood presented a more than optimal picture of the death and dying process, beginning with the crucial conversation between Mr. and Mrs. Braverman in the hospital as he resolved that they would make the important decision together and then talk to their children individually. The last few episodes were delicate and touching as we all watched the Braverman adult children have their own private moments with their father, each being given the chance to say things they needed to say, to tell their father something he needed to hear, to include him in on important life events before time ran out. We followed the gradual decline of Mr. Braverman as he needed to sit and rest more frequently, struggled with his limited ability to physically and emotionally cope with the family arguments at the dinner table, and lastly—his painfully difficult attempts to take a simple walk with his wife. He had opted not to have heart surgery in favor of living out the remainder of his life the way he felt it was supposed to be…passing away peacefully at home while napping in a chair that faced a window towards the sunlight.

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We should all be so lucky. Our parents and loved ones should all….be so lucky– and blessed– to have this healthy, robust, ideal, end of life experience. There really is health in death and dying, although that is a difficult concept for most people to comprehend.

Obviously these are my  opinions, based on my own experiences as a nurse. But I felt that Parenthood beautifully illustrated the things I always wanted for the families I cared for to have toward the end of life:  a therapeutic life review, support, love, laughter, hope, no conflict or opposition to a loved one’s choices, family members circling around a loved one in a show of warmth and continuance of life while in the setting of a life transition. Time after time, it’s what patients have told me they wanted the most: to see that there will be a continuation of life. That life will be okay for all those left behind. That there will be happiness when they go on to the next place, wherever it is they believed that will be.

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Mr. Braverman was able to quietly let go, having been assured all of these things. He shared in the birth of a great grandchild, walked his eldest daughter down the aisle at her wedding, and was relieved by the reunion of another daughter with her husband after a lengthy separation. He knew that all was as it should be, and that all would be well—but much more importantly—he knew it was okay to go, that he had his family’s permission and blessing.

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Parenthood-finale-3There are a plethora of medical related shows saturating nighttime television, and yet very few really hit the reality of what its like to care for people as a nurse, the things we experience with them and help them process.  Although these last few episodes weren’t medical in nature, they gave a very real, moving depiction of what it’s like to be a Heart Failure and Heart Transplant Nurse—what we see, hear, and feel while walking alongside patients and families in the various stages of Congestive Heart Failure. It goes far beyond giving medications and taking vital signs, and I hope that there is more attention given to Congestive Heart Failure by the entertainment industry in the future.

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Incidentally, Cardiovascular disease gets very little in the way of research dollars when compared to Cancer’s mammoth like  allotment of research funding and yet it is the number one cause of all deaths in the United States. Heart Failure alone affects five million of all adults in the US, 50% of whom will not survive to the fifth year after the diagnosis is initially made. It is projected that by 2030 greater than eight million adult Americans will be living with it. (Heart Rate Matters)

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Heart Failure care is expensive. In 2012, 21 billion dollars was spent on Heart Failure related care and that number is expected to skyrocket to 53 billion by 2030. (The cost of Heart Failure related care also drives up the overall cost of healthcare in the US) Fifty percent of those costs are due to hospitalizations. Congestive Heart Failure is also one of the leading causes of hospital readmissions: “25% of patients are readmitted to the hospital within 30 days of discharge, while 50% of patients are readmitted to the hospital within six months of discharge.” (Heart Rate Matters)

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KUDOS to NBC for taking the road less traveled. For giving Heart Disease a nod. For showing viewers everywhere that death and dying isn’t this dark ugly thing to be feared and avoided at all costs. For reminding us that the end of life process is a natural inevitable experience every single one of us will face at one time or another, and for focusing on the importance of supporting the end of life choices of those we love.

It’s time that the public and the entertainment industry wake up: RED is the new PINK.

Let’s do something about it.

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Comments

  1. As an OR nurse that did Open Heart surgery, I have witnessed more than one patient being coerced by family and surgeon alike, into a procedure they did not want. It always felt like abuse of a corpse to me. In America we have the right to decide our health care; however, all too often, family and health care professionals are not equipped with the knowledge or skills to advocate for the patient’s wishes. Kudos to NBC and you for having the courage to tackle this difficult subject.

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