End-of-Life Choice, Palliative Care and Counseling

Personal Decisions Matter at End Of Lifeby Sonja

Back

The Republican
Wednesday, April 27, 2011

When family members take on the responsibility of caring for a loved one nearing the end of life or are called upon to make health-care decisions on behalf of their loved one because he or she is unable to speak, suddenly the enormity of this responsibility looms large.

What would my loved one want? Do we continue with yet another medical treatment?

Do we withhold high-tech life support? Do we want intensive medical interventions that may prolong suffering?

How far do we go? How do we assure quality of life as the end nears?

Of primary concern is the question, “How do we honor those we love, respecting the dignity of their values and preferences for life care?”

As an individual, your decisions matter. This is especially true when it comes time to examine how you plan and prepare your health-care and quality-of-life decisions as they communicate your wishes for end-of-life treatment.

Did you know that nearly 70 percent of Americans say they would rather die at home, surrounded by family members? Yet in Massachusetts this expectation is reversed; 70 percent die in nursing homes or in hospitals, often spending their last days hooked up to high-tech life support machines. Fewer than 25 percent die at home.

Recently, family members caring for their dying mother at home related how grateful they were because their mother had made her wishes known and clearly communicated what she desired and wanted.

“She made it easy for us because all we have to do is follow what she wanted,” they said.

This reality does not remove the gamut of emotions that accompany them as they tend to their mother. But it does remove the struggle of having to decide on their own without the assurance their decision would in fact really be what their mother wanted.

They do not have to worry about the guilt, remorse or uncertainty that comes when loving guidance is not clearly communicated.

Do yourself and your loved ones a favor. Be willing to enter into conversations about what health-care choices you would desire if you were unable to speak for yourself. Convey your wishes through an advance directive. Advance directives enable others to know in advance what your choices are.

A “health-care proxy” documents the person you select to be your voice when you cannot speak for yourself.

A “living will” documents what kind of medical treatments you would or would not want at the end of life.

Quaboag Valley Hospice is available to offer assistance by providing literature and tools to assist with thoughtful reflection on health care choices. They are also available for group presentations and additional information as needed. They may be reached at (413) 283-9715.

Most importantly, remember and affirm that your decision matters. Take the time to reflect on what you desire for your health care and what quality of life means for you. Then offer your gift of love by adequately communicating your choices so your wishes and life may be fully honored.

The Rev. Domenic K. Ciannella, an Episcopal priest, is hospice chaplain with Quaboag Valley Hospice of Wing Memorial Hospital in Palmer. He is also certified as a grief recovery specialist and is well versed in crisis intervention and pastoral care.