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Informal
Caregiving
- Death
& Dying
Assure A Better Life Through A Dignified Death
Recently a close friend’s mother had a massive stroke.
Suddenly, a once independent and social 75-year-old became
physically incapacitated, confused, and unable to communicate.
After being rushed to the emergency room, the family faced
long delays, confusing doctor jargon, and some potentially
huge decisions. The family was frantic, had little time to
react and did not know what to do. One expert recommended
that she be intubated, placed on an artificial breathing machine,
and rushed to surgery. She would then be monitored in an intensive
care unit. The family agreed. Just then, a physician who was
a family friend arrived and began to ask some pointed questions.
“Would the surgery help her?” “What are her
chances of survival?” Well, on further questioning it
seemed that her chances of being helped were non-existent,
and if surgery were performed she would most likely remain
on a respirator for the rest of her life. Furthermore, her
stroke was so severe that recovery was essentially impossible.
With assisted breathing and food delivered artificially, either
through a vein or into her stomach, she could remain alive
for many months or even years. But she would spend her last
years in a coma and never recognize her family.
Fortunately, the patient had made her wishes known to her
family. She did not want to be placed on a respirator or be
fed artificially. Therefore, the decision was made to place
her on comfort care. She stabilized and two days later hospice
care was contacted to help her die with dignity outside of
the hospital.
Most people hope to die quietly, peacefully, and with dignity.
Unfortunately, this does not always happen. Eighty percent
of a person’s life-time health care costs are often expended
in the last few weeks of life. The goal of our health care
system is to prolong life at all costs; death is considered
a failure, and health care providers have little understanding
or training in the ethical and loving care of the terminally
ill. There is also concern that by not doing everything possible
healthcare providers will open themselves up for criticism
and even litigation. Families often view their loved one’s
terminal illness as an absolute nightmare.
Death is inevitable and a natural part of the cycle of life.
However, the fear often associated with death and its unpredictable
situations leave people hoping for “short and sweet”
- pain free and dignified. “Please let it be quick”
is a common refrain. Unfortunately for many, death comes more
slowly. Palliative and hospice care can be of great value
for patients with no hope of recovery. Every person should
have a living will, which implicitly describes his or her
wishes. Making family members aware of what you want done
alleviates the stress of last-minute decision-making. Already
I have told my family that if I have an incurable condition
and cannot make decisions for myself, I do not want to be
placed on machines, I do not want to be artificially fed,
and, if my heart stops, I do not want to be resuscitated.
I would prefer to be in my own home and if I have only a few
months to live, I wish to enter a hospice program. To assist
in the decision making process I have given my wife durable
power of attorney, which allows her to make decisions if I
am no longer able to make them for myself.
Hospice helps patients die a good death and provides much
needed support for the grieving family. Care involves paying
attention to the medical, social, and spiritual needs of the
entire family. Understanding the dying process provides invaluable
assurance for the patient and family and facilitates an ability
to cope with the ordeal. Hospice care is very proactive aiming
at assuring comfort. It is possible to be pain free, to be
at peace, and not to suffer. Families can stay close to and
connect to their dying loved one. Those last few days or months
can be very precious. Entering a hospice usually means acceptance
that death is imminent and admissions to the hospital are
limited exclusively to treat conditions that may cause unnecessary
suffering. Remember a good death means a better life.
Websites:
www.pbs.org/wnet/onourownterms
www.partnershipforcaring.org
www.adec.org/links/index.html
www.caregiver.org/factsheets/end_of_lifeC.html
www.hospicecares.org
www.hospice.net
www.hospicefoundation.org
dying.about.com
www.death-dying.com
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