Our family has seen a lot of death. My father when I was 16, two of my sisters before age 40, multiple aunts, uncles, cousins, Mom’s second husband, and several pets. For years, Mom and I talked about what she wanted at end of life. I was her Power of Attorney for both health care and business matters. She was very clear about how it needed to be. And her desire included Hospice.

Just slightly over 2 weeks ago, it was clear to me that it was time. In the weeks leading up to this, she had made several statements to the staff at the assisted living facility that she was tired. Though she spoke of having Mincemeat Pie for Thanksgiving desert, her future talk went no further.

She was losing weight and her desire to live when she suffered what appeared to be her 2nd compression fracture (she wanted to xrays, no hospitals). Clearly she was in a lot of pain and had resisted using what she called “dope”. When I suggested it was time to call Hospice, her only concern is that she would have to leave her apartment (which she did not have to).

Hospice arrived the next day and felt that Mom probably had a few more week. However, Mom had other plans and less than 24 hours later, she slipped away very peacefully and comfortably.

What happened? Calling in hospice, as we had previously talked about, gave her the permission to let go when she was ready. I’m not sure what she was holding on for, but I believe even the idea that I would call Hospice let her know, that I “knew” and it would be okay.

If you have not talked with her family members about end of life issues do so now. It’s the best gift a family can give one another…the assurance that you will be able to follow through with end of life wishes.

This is a complaint I literally hear on a daily basis. While sometimes there is something structurally wrong in the back, often times there is little to offer someone outside of exercise, massage, acupuncture, physical therapy and medication. While most people get better, there is a significant portion of people who go on to develope chronic back pain. In my practice, it’s one of the most frustrating ailments to treat.

But…I have hope again. I stumbled across a new book (to me anyway) that offers guidance on treating the back. Esther Gokhale an acupuncturists and former victim of back pain, found a way to address the issue to reduce and/or remove back pain. She focuses on posture and decompression of the spine in order to achieve this. She outlines this information in her book 8 Steps to a Pain Free Back.

The reviews are excellent. I’m already recommending this to by patients.

I read this article and thought I’d share it with you. While it makes sense (we do know that social connectedness has lots to do with ones well being and longevity), the fact that these researchers excluded non-married partners (regardless of sexual orientation) is a huge flaw in this study. My opinion is that “marriage” has nothing to do with it…it is having family and social support and connections (regardless of their legal status) that is important. What do you think?

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Never-Married Penalty: Early Death?
Daniel DeNoon

People who have never married are more likely to die — at all ages — than people who are married and live together, U.S. data show.

It’s the “never-married penalty,” suggest University of California researchers Robert M. Kaplan, PhD, and Richard G. Kronick, PhD, in the August issue of the Journal of Epidemiology and Community Health.

Kaplan and Kronick extracted data from two sources: a 1989 national health interview survey, and the 1997 U.S. national death index. They had sufficient data to analyze information on more than 80,000 Americans.

Their main findings:

* Never being married has a greater risk of “poor health outcome” than being divorced or widowed.
* For men, the never-married penalty is stronger early in life.
* The never-married penalty affects both men and women.

“The risks of being never married … rival the risks of having increased blood pressure or high cholesterol,” Kaplan and Kronick conclude.

The researchers found that never-married people, compared with their married peers, are:

* 5 times more likely to die of infectious disease
* Twice as likely to die in accidents, homicides, or suicides
* 38% more likely to die of heart disease

Social Isolation to Blame?

What’s going on? Kaplan and Kronick suggest that people who never marry are isolated from other people. People who are divorced or widowed, they say, are more likely than the never-married to have children or other family relationships that offer social support.

“Accumulated evidence suggests that social isolation increases the risk of premature death,” they note. “Marriage is a rough proxy for social connectedness.”

The data strongly argue against other explanations. For example, it wasn’t true that people with poorer health tended to be unmarried. In fact, the never-married penalty was strongest among people who said they were in excellent health. Moreover, never-married people reported better health habits than married people.

There are some drawbacks to the study. The researchers excluded people who were unmarried but living together. And the survey questions did not ascertain a person’s sexual preference. Given the study period — 1989 to 1997 — a disproportionate number of deaths due to AIDS may have affected young men in the never-married group.

SOURCES: Kaplan, R.M. and Kronick, R.G. Journal of Epidemiology and Community Health, August 2006; vol 60: pp 760-765., WEbMDHealth

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