End of Life Discussions
One of the most difficult discussions for anyone, is a discussion about death. Especially when we are talking about what we want to have happen when we are at end of life. The discussion must come early before we are faced with a crisis. End of life conversations are actually continuing conversations about preferences and priorities.
Some interesting statistics were recently published about how people who have managed their own impending death.
A greater percentage of people have accepted their diagnosis of a terminal illness when they have had counseling. However counseling was not as helpful to people who want to know their life expectancy.
A large majority of people are concerned more about their comfort than their life being extended. The report reveals that people generally do not want to die in an intensive care unit.
A large segment of the population has completed a DNR or Do Not Resuscitate order. This is a form that states a person’s wishes not receive CPR if you stop breathing or their heart stops.
An even larger segment of the population have completed a living will, durable power of attorney or heath care proxy. This is an important form that will allow health care professionals and family members to honor your wishes when you can no longer make decisions for yourself.
Outpatient Hospice services are often preferred by most people who are end of life. Hospice does not hasten death or prolonging life. Hospice helps the person have comfort through end of life. Inpatient Hospice units are another option for someone to not die at home.
The use of life sustaining measures like a feeding tube are used less when people have counseling about end of life. A younger person who has every opportunity to recover from health crisis may only need nutrition by the use of a feeding tube for a short period of time. Older adults who can no longer have quality of life due to a degenerative disease, must consider not using a feeding tube to sustain or prolong their life.
When the body is end of life and shutting down, it is a very natural process for the body to not feel hunger. Many people fear that they are “starving the person to death!” I remind family members that the body cannot metabolize food and using a feeding tube would actually be more painful for the dying person.
Dehydration and the lack of water is also not a painful process because the human body generally becomes so sleepy until the person is unconscious. When IV fluids are given while the body is shutting down, the additional fluid begins to work against the person because their kidneys have shut down and cannot eliminate the fluid from the body.
Cremation is certainly a more affordable option, but some people feel strongly about traditional burial. Some people do not want a funeral and others want a large celebration of their life. It is important that your wishes are carried out as you wish.
Every person should talk with their family about their wishes before they are faced with end of life decisions. A wonderful gift for any family is to plan out your traditional burial or cremation, so it is a telephone call for a family who is grief stricken with the loss of someone that they love.