Sunday, June 26, 2016

Five Sunday Questions


Mom has been in the hospital this week.  At 89 she is nearing the end of nearly a decade of illness and decline, Parkinson's, dementia, and an inability to walk or transfer are leading to a laundry list of complications. I called for a briefing on her health, and it read like a check-list of the top ten things you are likely to die from at 89, with a few too many boxes checked.  And yet overnight she stabilized and plans were made to send her home. She wants to go home.  

What care we want or don't want at the end of life is a highly personal question, one we all need to think about and assure that our loved ones know what our wishes are.  So here are five questions about the inevitable end of life. 

1: If given the choice of tube feeding only and living an extra 2 months, or eating what you want when you want and maybe dying 2 months earlier, which would you want?  Eating is a sensual pleasure, I'd sooner die sooner and enjoy every bite along the way. 

2: Who do you most trust to make your health care decisions, when you are not able to do so?  My sweet husband, and he better not needlessly prolong my suffering or I will haunt him. 

3: If you had late stage dementia, you were unable to communicate your thoughts, and needed assistance with basic activities of daily living, and you needed open heart surgery, would you want the surgery or not?   When my mind goes, or my ability to communicate my  mind (the research is inconsistent on what works and what does not work inside the mind of a person with dementia,)  don't do anything that delays the death of my body.  As an adult I have the right to decline health care, and under those conditions I would decline, please do so on my behalf.  

4: If you are in serious pain, without pain medication you are aware of who you are, where you are and what you are doing, but with pain medication you are not aware of who, where and what; would you take the pain medication or not?   One of my biggest arguments with the nursing staff last year, was on over medicating me.  There is no reason for pain to keep me awake when I need to sleep, or to make me unable to connect with my environment, beyond that, I will take the pain so I can experience the world.  (It has been over a year since my last pain pill, it only hurts when I breath.)

5: If given the choice between care at home that barely met your care needs and care in a skilled nursing facility that catered to your every need, which would you choose?  I couldn't wait to get home, to get back my freedom and privacy. 

Now go talk to your most trusted family and friends and let them know what you want or don't want when you are unable to speak for yourself, and the end is near. DO IT TODAY!  

6 comments:

  1. I agree completely with your thoughts on this. The medics have a hard job, balancing risk of litigation for not doing or suggesting every treatment available, against common sense and compassion. But the patient's and their family's wishes should always override.
    Bon courage during what can be a very difficult time.

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  2. 1: eat whatever I want!

    2: spouse; no drawn-out dramatics for me. I cheated death once; it will not let me do THAT again

    3: nope, no surgery; see #2 (heh heh heh, #2)

    4: depends on the pain, but I would rawther (to use a spo expression) be in my right mind to decide

    5: HOME! one heals better in familiar surroundings

    hope you and your dad and siblings make the best care decisions for your mom.

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  3. I feel for what you are going thru I really do. Thank goodness she has you.
    As for 1-5? I always avoid questions asking whether I'd like to be boiled or fried!
    JP

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  4. I would rather take my own life than go through any of these

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  5. 1.no tube feeding
    2. I have several siblings who are physicians. My partner would consult them.
    3. no surgery
    4. i would probably take the medication.
    5. the later.

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  6. I agree with you on all five points. And if I knew I had a terminal illness and was facing months ( or years)of prolonged pain and dependency on others, then I would make my move to California and arrange for a physician assisted suicide. I'll be 75 this year and have had a good run. I'm on "Gravy Time" now and have no regrets that I missed out on much.
    Ron

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