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b'Hanno Kirk on End of Life Care. Mental Help Net (www.mentalhelp.net) presents the Wise Counsel Podcast (wisecounsel.mentalhelp.net), hosted by David Van Nuys, Ph.D. Hanno Kirk, LICSW, Ph.D. had a successful Army and political policy career before deciding to retrain as a social worker and focus his career on end-of-life care. In the United States, the dying process has become highly medicalized such that some 80% of people die in hospitals (contrasted to 80% of people dying at home 50 years ago). Death has become more hidden and taboo than in the past, and younger people have little experience with it. Several consequences of this shift in how people die are that people put off planning for their own dying process, failing to set up advanced directives, and that dying people are offered more interventions designed to prolong their lives, often without careful thought as to how these interventions will affect the quality of life remaining. Life extension is a fine goal for otherwise healthy people, but when body systems approach becoming irreversibly damaged, especially during the terminal drop phase of dying, such efforts are counter-indicated as they will cause more harm than good. Efforts to promote advanced directives, provision of realistic end-of-life education and education regarding hospice services end up producing dramatic health care savings, as people then willingly avoid costly life extension efforts as an affront to their dignity. Dr. Kirk suggests that end of life should be a spiritual and sacred time during which families can share, reconcile and grieve, rather than a series of stressful crisis interventions.'