A Graceful Exit: Taking Charge at the End of Life

[littlemissmartypants]

A Graceful Exit: Taking Charge at the End of Life
How can we break the silence about what happens when we’re dying?

http://www.yesmagazine.org/issues/its-your-body/graceful-exit/

/image
Wherever you come down on end-of-life decisions, the question is one of control—and who is going to have it over our bodies at the last moments.

Photo by Andrew Alderson

Claudia Rowe posted May 21, 2019
This article from the YES! Media archives was originally published in the Fall 2012 issue of YES! Magazine.

I was standing in my cubicle, a 24-year-old fact-checker envisioning a publishing career of glamor and greatness, suddenly shaking as I read the document my mother had mailed. It detailed her wish that I promise never to keep her or my father alive with artificial respirators, IV-drip nourishment, or anything else she deemed “extreme.”

I was horrified, and slightly angry. My mom was a 54-year-old literature professor who’d spent the 1970s eating whole grains and downing vitamins. She was healthier than anyone I knew. Why get so dramatic now? It seemed ghoulish, not to mention premature. But I scrawled my signature at the bottom of the page and shoved it into an envelope, my mother’s voice in my head, prodding me along.

As with the whole wheat and vitamins, my mother—back in 1990—was onto something long before it became conventional wisdom. But these days, Americans’ approach to aging and death is rapidly evolving, pushed both by the numbers and the grim reality behind them: In 40 years, 19 million Americans will be over 85, all at high risk of losing the ability to care for themselves or dwindling away because of organ failure, dementia, or chronic illness. (The days of a sudden fatal heart attack are fading; by 2008, the death rate from coronary heart disease was down 72 percent from what it was in 1950.)

So while many seniors now live vigorous lives well into their 80s, no one gets a free pass. Eating right and exercising may merely forestall an inevitable and ruinously expensive decline. By 2050, the cost of dementia care alone is projected to total more than $1 trillion.

My mom’s decision to face her end came not from any of these facts, but from the nightmare of watching her own mother’s angry decline in a New York nursing home. “You’re all a bunch of rotten apples,” Grandma growled at visitors, the words erupting from her otherwise mute lips. And there she sat for three years, waiting to die. “Why can’t you just get me some pills so I can go?” she would sometimes wail.

Snip...

More at the link.

[safeinOhio]

1. As someone who has watched many

peaceful end of life out comes of animals, please take me to the vets office.

[Duppers]

5. Wish this country would make that an option.

Canada does.

Sigh.

[3Hotdogs]

2. Two "end of life" shit shows this month.

Both people, kidney failure. One was a long time friend and the other is a housemate for 20 years.

One went to hospital when his neighbor found him on the floor. That was the day after Memorial Day. A day later, he coded. From that day, until July 9, he was in bed with iv, respirator intubation and in restraints.

He signed a healthcare power of attorney, but without specific instructions.

Time passed on, with tests, procedures, more tests and bed sores.

A week before he died, his p.o.a. sent a block text asking if we felt hospice was in order. I felt badly for the P.O.A. as that is a heavy decision.

Hospice was agreed to.



Housemate depends on a daughter to make decisions as she is now delirious. Same scenario --- tube, I.V.s and restraints. Daughter is in denial that the end is near and authorizes everything. It will be over in a day or two but we are watching her suffer.

My medical will with D.N.R. was filled out yesterday.

[bronxiteforever]

3. Kick and recommend. Thanks for posting.

A well written, thoughtful and righteous piece.

[babylonsister]

4. Planning now makes all the difference later.

My dad passed last month but had his ducks in a row. He had a POA, a living will, a will, and DNR directives. He even hand wrote a note indicating he did not want an obit but a party and wanted to be cremated as soon as legally possible.

He made our decisions much easier which has been so helpful in our time of grief, and the party is in September!

[marble falls]

6. I'm still at least a few years away from it, but my surgeon asked me about ...

a medication that could used that would give me three more months.

Three months is not enough. And too much if that's all there is. If I am in pain I want to go quickly. I want to go with grace. I do not want my family on emotional pins and needles waiting for at most delays with no quality of life.

[ColesCountyDem]

7. My dad was a physician and understood all too well how monstrous end-of-life care could be.

I was very fortunate to be raised in a home where death and end-of-life care were not only not taboo subjects, but were openly discussed...

Dad understood what manner of end-of-life care could be given as the 'default choice', in the absence of truly informed decision making about that care. Our periodic discussions were not at all morbid, but took place in a context of 'what you truly need to understand about how people die'. The types of care likely to be offered were detailed and the pros and cons discussed. The quality of life was emphasized, and death was not presented as an enemy to be fought at all costs. The bottom line regarding whether or not certain types of dramatic medical intervention was warranted was tested against a very straightforward question: was whatever medical intervention being offered likely to lead to recovery and a quality of life that was reasonably enjoyable?

Both of my parents signed advance directives and gave me power of attorney for health care. They each made it very clear what they wanted done and under what circumstances. When the time came for each of them, my mind was at ease with the decisions I made, and that was a wonderful gift to me. Like anyone who loves their parents, I felt grief, but I was not burdened by guilt.

Although we're getting better about it, we still avoid talking about this subject, even though we should do so. Have the conversation with your loved ones, while you still can, rather than have life-or-death decisions forced upon them for which they are unprepared.