HOST INTRODUCTION:
How do you want to be cared for when your life is ending? We have a tendency to think there’s plenty of time. And to put off difficult conversations about end of life.

But life is uncertain. More than 80,000 New Yorkers lost their lives due to COVID since 2020. While research suggests that most people in the US want to die at home less than 35 percent actually do. People die at hospitals, surrounded by doctors,and machines, getting life prolonging treatments they potentially didn’t want.

And hospice care, that prioritizes comfort and quality tend to be underutilized. In fact, in New York, the rate of hospice utilization is only 25 percent. The lowest in the country.

Subeksha Poudel [paw-o͞o-dell] reports.

SUBEKSHA POUDEL: It was Sajay Deshpande’s first day at Harvard. He’d come all the way from India to his dream college. Right when he finished unpacking his luggage in the dorm, he recalls freezing and falling down, hitting his head hard on the floor. He woke up 48 hours later, at a hospital, to the news that he had brain cancer.

SANJAY DESHPANDE: I was being wheeled into the operation theater for my surgery. And the doctor did not know how I would emerge at the end of the surgery. Imagine being a 29 year old person thinking about ok so what’s going to happen once I die.

SUBEKSHA POUDEL: Some of us die suddenly, with no time to think of our end of life. And some of us die slowly. Either way it can be really hard to contemplate our own end of life care.

MANDY ZUCKER: Some of the things we want to think about is what matters to us, as far as our values go. Would you want to live as long as possible, even if that means you’re in pain, or would you want to live less if it meant that you would not be in pain?

SUBEKSHA POUDEL: Mandy Zucker. Executive Director of End of Life Choices New York. She says there are no right or wrong answers. It’s our preferences that ensure our lives are as good as possible until the end.

MANDY ZUCKER: This not only helps by the way the patients but it helps the family. Because when you die on a table getting aggressive treatments and family members are left to wonder is that what they wanted and are they in pain and that’s an awful feeling for the people who are left to grieve.

SUBEKSHA POUDEL: Zucker says New Yorkers are far behind in using end of life services.

MANDY ZUCKER: So NY has one of the lowest rates of hospice utilization at about 25 percent. And if you compare that to like Nevada, they have the highest rate of hospice utilization at about 60 percent. So there’s a huge gap.

SUBEKSHA POUDEL: She attributes the low uptake to people not knowing about their options and doctors who are trained to save lives not discussing hospice options. Zucker recommends making an end of life care plan early on, without having an emotionally charged reason to do it.


When Sanjay Deshpande went into his surgery, he says he mustered all his courage to share his wishes.

SANJAY DESHPANDE: I basically told my father, that in the middle of the surgery, if they come out and say, ok here’s the problem, we can get the whole tumor out but in the process, he might lose his ability to do X, Y, Z and hence it might affect his quality of life. And I told my father very clearly, that I'm willing to take my chances at chemo and radiation aa but I would want better quality of life. Rather than like you know focusing on like you know longer life span.

SUBEKSHA POUDEL: Deshpande’s cancer is in remission. Right now, he’s where he wants to be - back studying Learning Design, Innovation and Technology at Harvard. But he also knows where he wants to be EVERY five years - revisiting his end of life care plan.

Subeksha Poudel, Columbia Radio News

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