A focus on end-of-life care emphasizes social and spiritual elements over aggressive medical intervention.

The New York Times reports on the phenomenon by examining end-of-life care at an upstate New York convent: “A convent is a world apart, unduplicable. But the Sisters of St. Joseph, a congregation in this Rochester suburb, animate many factors that studies say contribute to successful aging and a gentle death – none of which require this special setting. These include a large social network, intellectual stimulation, continued engagement in life and spiritual beliefs, as well as health care guided by the less-is-more principles of palliative and hospice care – trends that are moving from the fringes to the mainstream.”

The Times notes: “For the elderly and infirm Roman Catholic sisters here, all of this takes place in a Mother House designed like a secular retirement community for a congregation that is literally dying off, like so many religious orders. On average, one sister dies each month, right here, not in the hospital, because few choose aggressive medical intervention at the end of life, although they are welcome to it if they want. … Few sisters opt for major surgery, high-tech diagnostic tests or life-sustaining machinery. And nobody can remember the last time anyone died in a hospital.”

The paper notes the absence of anxiety and fear among the nuns as well as less pain, depression and use of narcotics to manage symptoms. The Times also contrasts the peaceful convent experience to hospitals’ intensive-care units that can be impersonal and wastefully expensive. The nuns suffer from different ailments: none have chronic obstructive pulmonary disease and few have diabetes. It notes: “Laura L. Carstensen, the director of the Center on Longevity at Stanford University, says the convent setting calms the tendency for public policy discussion about end-of-life treatment ‘to devolve into a debate about euthanasia or rationing health care based on age”.