End-of-Life Choice, Palliative Care and Counseling

Viewing Advance Directives as a Celebration of Lifeby Sonja

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by Dianne Day
Press-Citizen
February 9, 2013

I only know one thing for sure in my life these days, and that is that I will someday die.

How, when or where is a mystery, but it will happen — that I know.

No, I do not have a chronic or terminal disease. In fact I am quite healthy.

Do I have a choice of how, when or where I will die? Do I have a choice of deciding for myself when medical treatment changes from benefiting my quality of life, to being a burden which only prolongs my death? What role does my doctor play in all this? How do I choose someone to advocate for me in these matters, if I am no longer able to communicate my wishes?

Writing about these questions is far easier to do than answering them.

I have been an advocate for others before: for my husband, my mother-in-law and father-in-law. I am one of the lucky ones, for I have no regrets that the decisions I made on their behalf were the right ones, and family and friends supported them. We talked often about their quality of living, and when they would be ready to die.

But it was not always smooth.

One day, I got a call from the nursing home where my mother-in-law resided. She was in the advanced stages of Alzheimer’s. The nurse on duty had determined that there was something wrong with her, had called the doctor, who in turn said to call 911 and have her transported to the hospital for tests. I got to the hospital only to find that she was connected to a number of tubes and that several tests had been ordered.

I was shocked! Although she had not spoken a word for several years now, I could easily see she was afraid, confused and trying to tug at those invasive tubes they had put in her body.

When the doctor arrived, he politely told me to go home and await the results of the tests that were ordered.

I told him in no uncertain terms that there would be no tests, no surgery, no treatment and that he was to get her back to the nursing home and never do this again. I said that I was not leaving until she was back in the nursing home.

To my amazement he agreed. My mother-in-law was transported back to the nursing home and continued to live for another year, comfortable and safe where she was.

For that I am thankful.

When I became a facilitator for Honoring Your Wishes, I found a process that I can use to help myself and others plan for their own care, whether they are 25, 75 or 100. For me, this has been an important journey, one that helps me and others to explore our own beliefs, taking time in a safe environment, and ultimately to give the gift of a clear advance directive to loved ones.

Most of us do not want to talk about this. Is it up to our doctors to bring this up only in a crisis situation? Shouldn’t we be informed about our health care options, even when healthy, and especially when we have a chronic or terminal illness, and to discuss these with our doctors and family?

My hope is that we can overcome our fears of losing loved ones, and of them losing us. These conversations can be the best gift of love we can provide to those who are close to us.

My goal is to read my advance directive on my birthday as a celebration of life, of my taking responsibility for myself and not leaving it to others.

There is no right or wrong answer here. You make your choice, I have made mine.