>> welcome to al jazeera america. i'm richelle carey in new york. here are your headlines at this hour. we're now in day 2 of the partial government shutdown. the house offered measures to reopen national parks and some parts of the department of veteran affairs but the efforts were defeated. cherry picking parts of government that they like. open enrollment for the affordable care act has begun. six months to sign up for coverage before being penalized. a number of glitches have been reported including overwhelmed sites and long waits to log on.

jacksonville airport was shut down, investigators say devices had a destructive component, the airport has reopened. iraq has seen its worst spike of violence in five years. car bombings in iraq have become a nearly daily occurrence. victims killed by al qaeda linked groups. thanks for watching al jazeera america. you can get the latest on our website, aljazeera.com.

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>> joie: the government shutdown, the budget battle, all of this ties back to the bitter bicker over the president's program to bring affordable healthcare to americans. there is another struggle over american healthcare in homes across the nation. a personal fight faced by many families over the end of life. we know that most americans want to die at home. but most of us made our end in hospitals or nursing homes how that could change might begin with a tough talk on how w how we want to die. >> my name is joe nyre.

i am 40 years old. i was diagnosed with stage four brain cancer. it's the most dangerous brain cancer there is. the medium is 1 14 months from diagnosis. the standard protocol is to be on chemo for life. 14 days on and five days off. i did five days on and it took me 13 of the 14 days to get off the couch and do what i love. for me it's more about quality of life than quantity. i opted not to continue the chemo protocol at all. it was too much time of feeling horrible. and very, very slim gain. >> joe spoke to his family making it clear how he wanted to be cared for and how he wanted

to die. >> if i got pneumonia or something like that i would go to the hospital, if it's a treatable condition. if it's related to brain cancer i want to stay home. if it goes that route, i know the end is coming, i don't want to be away from here. i can see and feel people going, gosh why isn't he doing everything he can? i am doing everything i can. i am doing what i think is best for everyone involved, myself and the family. >> family. i knew for me an joe i and joe e way to go. >> the kind of death joe envisions is rare. the study showing that most americans would prefer to die at home. more than two-thirds die in a hospital or in a nursing home. many after stays in an intensive care unit like this one. >> he is a o of 56-year-old decreased

respiratory drive. a probable bacterial meningitis and a lot more lab abnormalities. temperature is 103. her daughter is here. her husband does not understand she is doing very badly. >> it's very serious. >> today the doctor and her team are treating a 60-year-old woman with multiple organ failure. >> this is the patient who just came in last night who became very ill very quickly. we don't know which way it's going to go. i think it's important that it's clear to the family that the patient is almost as sick as she can be. do you have any questions right now? i know it's overwhelming. we don' don't know if she will survive this. we have pushed the limits as far a sedation. we have to talk about what the patient would want. in terms of remaining on life fort fo

support for a prolonged period. >> the nurse has worked here for 14 years. patients get severely ill and nobody is disgusted. families are not ready to go. and they will stay to the staff, of course mom would want everything done and other members would be like, no she wouldn't want that done. and the way i help and a lot of us do, is to say to the family members if your mom were listening to us, what would she be telling us to do. or what was important to her in her life? i think if decisions were made by patients prior to their admins their family, then a lot of the suffering that goes on right now would be a be avoided. >> that is the goal of the conservation project. we want people to go to the kitchen table with the people

they love and have a conversation about what it is they want. my interest in this subject really grew out of the end of my mother's life. i was faced with a cascading number of decisions for her healthcare. and i wasn't always certain what she would have wanted. i often wished i could have said, mom, is this what you want me to do. >> is this whado? is this what you want to have happen to you. the project website has tools to help families think about and talk about what kind of death they want. >> when you ask people how they want to die, 70% of them say they want to die at home, for example. home is not a geographic place, necessarily, but it's an idea. it's away you want to die peacefully, not in pain. surrounded by people you love. not in the icu.

people are not dying in the way they would choose. that is a big motive for the conservation project. >> that is how jay felt about his father's death. he and his wife decided to have their conversation with their daughters, starting with 22-year-old kaitlyn. what did you feel went wrong with gran grand pa'spa's passin. >> when he got sick at the end i don't know if he knew who should pack the decisions. >> some family members thought grand glpa should go to the intensive care unit and some felt he should stay home. >> if something happened to me today i would not want to be kept alive by medicine if i didn't have a chance to recover or if i didn't know you. >> if there is something going on with me, you don't know how things would turn out, say is

mom actually going to get better, or is she going to live or never talk to us again. >> okay ncht. >> for me what the important thing is it's not the best medical out there and everything that can possibly be done. it's di dignity for me and -- >> comfort. >> they are using the project tools as a guide. >> it gave an outline which was helpful and important. all i could do is look back at my father-in-law or somebody i had lost and say, what would i have done in that circumstance. >> we changed the way we give birth in america. women had their feet in stir uppings and theupups an and knocked out. it was women in general who

said, wait let's have this experience the way it should be. this is that. not only a medical experience, it's a life experience. i think if we changed the way we gave birth in america, we can change the way we die in america. >> there are lots of hospitals where healthcare providers are eager to respect wishes. but it's been really hard to feel comfortable doing that. so they need is for the culture around them to change. how are you? >> dr. lore ra laura rock agree. she says when patient's wishes are not clear doctors often feel forced to give more treatment than necessary. >> we need to have a culture shift. it's rare we have a family that comes in that has had conversations about the type of care they would choose or their

loved one would choose at the end of life. it's rare. when they have had those conversations they weren't burdened with guilt in making decisions that they think is leading to the death of someone they love. >> that is what joe nyre has tried to do with his family, by talking to him about how he wants to die. >> it's not going to be easy for the kids or laurie but it's going to be easier if you talk it through. you know death is not going to go away but the fear and anxiety is going to go away if you are clear and you communicate with each other. it's huge. >> joie: and america tonight so many money stories sound complicated. but don't worry, i'm here to take the fear out of finance. every night on my show i break down confusing financial speak and make it real.

>> joie: and finally tonight we look south of the border to a turnabout that few would have predicted . not so long ago a trip to

tijuana would mean trinkets and tequila. but now it's a very different destination. >> you are looking at one of the hottest new art scenes south of the border. it's a small passage way in downtown tijuana, mexico. the creative energy is flowing here as sculptors are showing off the twisted metal they tranltransform. and painters transform abandoned shops into art galleries. >> even the man dressed as a corpse has an elec electric vib. ♪ until recently this scene in this playing would have been unimaginable. swept up in a brutal drug war, many residents fled tijuana, tourism the city's life blood dried up.

now they are experiencing a rebirth. led by artists. what was the atmosphere like when you were able to open mple. >> it was a place where a lot of hood hoodlums would hang out. and a lot of shops were closed. they abandoned business. >> how dihow did you think of transforming tijuana. >> we didn't think of transforming tijuana. it was the idea of low rent. tijuana transform itself again. >> this latest reinvention was a unlikely one. when the tourism and partygoers left it turned into a transformed place. >> people wanted to turn it into another place especially with tourism.

it all went away. >> roberto is one. most famous musicians in mexico. his former group is known around the world. mendoza is a life long resident of tijuana. >> what has changed over the last few years when it comes to the art scene. >> tijuana is happening at the moment. but especially with local people. it's really interesting you don't see a lot of tourists but you see a lot of locals everywhere from the clubs, bars to the restaurants. you see all of these new faces and new generations growing up and people just really enjoying the city. that is the biggest difference between now a and before. >> it looked like some of the tour istourism had gone away. at first it looked like a detriment or a bad thing. but you are saying now there is more community. >> yeah. i don't know how to say, but exactly. it's like that.

>> the danger hit pretty close to your home? >> oh, yeah. this this

have died, and what the struggles were around the people and the people that went through there. the coyotes. it's very sad. that is why we want to turn it into something more positive. >> it's an incredible metaphor. as artists we love me metaphors. >> every place in the world there is good and bad. a lot of bad from tijuana has been magnified out of pro proportion. this is a cultural hub for the community. this night the music

is afro cuban. a regular feature that attracts people from both sides of the border. >> when i first moved here in '92 it felt like the harlem renaissance. i was completely amazed at the quantity and quality of art. and the level of art. and the level that people were educated about art. and enter the drug wars and it was tragic to see. >> the youth really stood up, it's coming back. the kids and the youth have taken over. they have taken over with art and culture and that is the way it should be. it's not the border that it used to be. totally different than the americans coming and getting drunk. no, that is the same old tijuana. it's totally different. >> i'm a merchant. i have been here for many years on this same street. maybe 30 years ago. >> not everyone is convinced

that tijuana is back. mr. g gomez owns this stop on a tijuana street. americans were his best customers and without them he struggles. with the art scene he sees a ray of hope. >> we welcome people to come and make away of life. maybe the american tourists they see and they can come again. >> i was here and there was shootings all the time sirens and police and ambulances. every day it was like a war zone. >> it's not just the souvenir shops that depend on free spending tourists. javier is one of mexico's acclaimed chefs. he is playing a big part in the renaissance. we met him in his newest restaurant. >> we decided to open this restaurant when tijuana was going through harsh times.

>> i probably heard and saw shootings three and four times a week. >> he and his family own several high end restaurants in tijuana. a few years ago garage gangsters tried to kidnap his blower. brother. back then anyone with money was a target. >> we left tijuana my whole family, brothers and sisters and father and everybody. my father has been in business for 36 years and he told us i have never seen or experienced anything like this. people started to ask is the restaurant? what is happening? i was thinking to myself, i felt sort of like a coward for leaving. i wanted to come back and do something about it because i was reading in the newspaper and seeing how this bad people were taking over our city. >> now they are not just getting

rave reviews from local customers, but from far flung publications lik like the "new york times." he says it's a start. >> i feel very proud of what we did. and i feel very lucky to be living at this time. and how the future looks. i feel very excited. >> how does the future look? >> very, very, very bright. i love this city and i couldn't be happier. >> joie: and that was america tonight's laura jane gliha. >> that is it for america tonight. we would love to hear from you log on to www.aljazeeraamericatonight. and

... senior members of a far right party in greece are released on bail. the leader is due in court, charged with organizing a criminal group. hello. welcome to access live from doha. italy's government confronts a challenge from berlusconi holding a vote of confidence. we will be live in rome. u.s. weapons inspectors arrive in damascus. adel are people are being st