Wednesday, February 19, 2014

This Is The End, My Only Friend

A few weeks ago I was in the sauna at our rec center after my swim. Two senior guys were in there as well. I got talking with one of them about a variety of topics, one of which was recent elderly deaths in our families. He had an aunt approaching her 100 mark in a nursing home.  Jim just lost his mother at age 102, also in a nursing home. Jim's Mom was on hospice and had filed all her end of life directives papers with her medical people. This man's aunt had done nothing. As our conversation progressed, it became evident that even though he was in his 70s, he expected to die at home peacefully in his sleep with no need for any directives about his disposition if things didn't pan out his way.

"Are you expecting that if something bad happens to you that the hospital or nursing home will take care of the problem for you?" I asked.

Though he hemmed and hawed, eventually he admitted that was exactly what he was counting on happening if something went wrong.

I decided to update my living will and other health care directives when I was recently due for retina eye surgery. I had to get them notarized at the bank and incredibly found the notary trying to obstruct me. She first told us she and her mother at 80+ in a nursing home didn't have any end of life directives. Jim offered to give her his extras and she refused. Then she said, "I can't do this for you. I don't know whether you are under duress or not," she began. She didn't get any further as I said, "You're not a judge or jury.  They are the only ones capable of determining an issue like that. Your signature is merely that I came in front of you and signed it. So let's just do that, now."

I had just had my first run in with someone who wanted to interfere with my making my health care directives. I couldn't believe it!  Was she next going to take out a copy of Darwin's Origin of the Species and burn it in front of me?!

I had just listened to one of my NPR podcasts and learned that there is a big separation in thought going on in the USA. Non-doctors are generally not doing anything about their health care directives, trusting that they will die in their sleep or their doctors will handle it. Yet over 90% of all doctors have signed every single health care directive which exists for end of life decisions. When interviewed about why as a body they were so vehement about having these documents done for themselves, they said that non-doctors are clueless about how bad it can get. For example, you really better have a serious heart problem if you plan on dying in your sleep because those are usually the only people who do. Also, don't believe the CPR miracles on these tv shows.  CPR only works 8% of the time and 3% of those will end up vegetative. They went on and on and on but it was clear, no one was going to have any say in ending their lives other than them.  And much as they hate lawyers, these documents made them eager to show up for an appointment.

Both Jim and my sister Dianna have handled the extreme parental end of life situations which have unfortunately occurred in our families. They made sure the parents signed the right documents and even then have had to go to hell and back to get things done right. Neither of them can imagine dealing with the hospitals, the doctors, and nursing homes without having those documents. We've had extremely long lived people who became incapable of just about everything. They only entered institutions when it became impossible for any other kind of care. Jim's mother wanted everyone to go further than the papers, i.e. just end it, but we do not have laws here in Ohio yet enabling any form of assisted suicide. (five other states are working on this and one state has it.) The most that be could done for her was morphine relief on hospice which went on for 14 months.

So, folks, I'm with the doctors on this one. I have signed all end of life documents and am of the "pull the plug" school of thought. They are on file with my hospital.  When I go in for surgery, Jim has his own copy if the hospital loses its. I have spent a lot of time in hospitals being a cancer patient. I really don't want to spend much more time in there or related institutions.

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