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Missoulians learning about death throughout life
Missoula, Mont., long known for its trout streams and mountains, is developing a new reputation as a beautiful place to die.
The city's 80,000 residents are part of the Missoula Demonstration Project, a study geared toward exploring and improving the quality of end-of- life care.
"We wanted to take the study of end-of-life issues to the next level," said Ira Byock,M.D., a family and palliative care physician and the principal investigator of the Missoula Demonstration Project. "We're trying to show how a community can more consciously support people during the end of their lives."
The first phase of the project included setting up workshops and focus groups and organized task forces and studies, with the express purpose of getting the people of Missoula to talk about death and dying. More than 2,000 residents have participated. Some work with the life-stories task force, encouraging people to share their life adventures. Others bring their specially trained dogs to dying patients so they can feel the unconditional love that some pets provide. Last year, local children celebrated Halloween with an enormous "Day of the Dead" festival, complete with a parade.
Missoula residents are being encouraged to think about how they want to be treated at the end of their lives. They're learning how to complete advance directives, do-not-resuscitate orders, durable powers of attorney and living wills.
"In this first phase, we're developing an enormous database looking at every aspect of how we die in Missoula and how families and friends have experienced grief," Byock said. "We're taking a high-definition, data-driven snapshot of the quality of life's end and the quality of care at life's end circa 1997-98."
Byock said project participation includes representatives from every health care institution and agency in the city. And they've teamed up with teachers, clergy, activists, politicians, business leaders, cultural representatives -- everyone in town with an interest toward improving end-of-life care.
"The collaboration has been quite remarkable. I couldn't have imagined it was going to grow so fast, or that we would get such a positive response," he said. "I'm astounded by the degree to which the community is interested and engaged."
Byock said this information will be used over the next 10 to 15 years to help the community improve the quality of care and the quality of life at the end of life.
"We're offering ourselves up as a laboratory of experience for the nation and seeing what works and what doesn't work in improving the quality of life's end," he said.
FP Report is published by the AAFP News Department. Copyright © 1998 by American Academy of Family Physicians.