How do you wish to die?
Although it’s not ordinarily a topic of conversation, Debra Oliver asks the question nearly every day.
The warm, smiling associate professor in MU’s Family and Community Medicine works with dying patients.
She helps them stay comfortable and dignified through her research in developing better communication networks for hospices, the caregivers of terminal patients.
“We’re all going to die,” Oliver said. “We don’t like to think about it. We don’t like to talk about it. We pay other people to take care of it.
Although Oliver’s research pertains to death and dying, she still calls the topic complex, partly because Western society’s tendency to hush voices whenever death is mentioned.
“Regardless, the bottom line is that it happens to all of us.”
Nearly 93 percent of terminally ill patients in Missouri die at home or in nursing homes, according to the Missouri Hospice and Palliative Care Association.
In Boone County, 26 percent of all deaths are the result of a cardiovascular issue, such as stroke, hypertension and heart disease, reports the Missouri Department of Health and Senior Services.
Missouri ranks 10th in the nation in heart attack deaths and 13th in stroke mortality rates, according to the National Heart, Lung and Blood Institute.
Risk factors for cardiovascular diseases include high blood pressure, high cholesterol, diabetes, family history of such problems and smoking, said William Fay, director of cardiology at MU’s health center.
“Although we’re seeing improvements in trends, it’s very possible that they’ll go the other way, for reasons like diabetes,” Fay said.
Public awareness of lifestyle changes has improved overall health, he said, and he is a proponent of preventative measures before problems arise.
“From a good ole visit from the doctor, you can assess your risk from cardiovascular disease and the risk from dying from them,” he said. A few simple tests, such as blood pressure and cholesterol screenings, are needed to assess cardiovascular health.
John Best, also a physician, is equally concerned about the trends he has seen in patients during his 25 years in cardiology.
“I see patients coming in earlier, younger and with more complicated — worse — disease,” Best said.
He identified diabetes and smoking as culprits because both increase the strain and damage on the body’s organs to function properly.
Oliver expressed similar sentiments about awareness and consistent dialogue.
“All the big, controversial cases about dying weren’t about an older person with heart disease,” she said. “They were over young people and their families having to choose whether they should live or die.”