Why do we fight the natural process of death?

[bleedingheart]

Yesterday I was talking to my sister about her mother-in-law. This woman is 86 years old and suffering from Alzheimer's. She is in the later stages of this disease and does not recognize her family and basically babbles incoherently or cries most of the time.

I remember this woman as a very talented artist, a skilled seamstress (she taught me to sew) and a very well read woman. She had a persona similar to Audrey Hepburn...thin, somewhat aloof but sprite-ly and she cared about many many issues..

My brother-in-law is very upset by the whole situation. His sister died of MS three years ago, his father passed away earlier this year and now he is watching his mother further descend into the abyss. He loves his mom and he wants her suffering to end, however the health care system seems determined to keep her alive.

She is currently in a facility that is caring for her and as of two weeks ago, she started to refuse food and did not want to eat. The people there informed my brother-in-law that they started to administer some hormone to make her feel hungry to keep her eating.

I have to ask why? My poor brother-in-law doesn't want to seem like the callous uncaring son and beg them to stop and he isn't sure what his rights are....but as we were discussing....if she refused to eat and won't eat...perhaps this is nature's way of helping her on to the next stage after life.

She has a do not resuscitate order but that doesn't seem to apply to the refusal of food.

I have to ask....why are they trying to make her hungry? Why prolong her suffering and that of the family as they watch this once very talented woman descend further into this living hell.

[Wapsie B]

1. I agree with you.

I see people like that being given major surgery. If someone's DNR, make them comfortable and make their last days as peaceful as possible. For all the resources wasted on prolonging suffering of patients like this we could give everyone coverage.

[bleedingheart]

2. it costs $6500 a month to keep her in the facility

so I have to agree the money would be better spent on the living.

[Wapsie B]

7. I see so many procedures given to patients like her

that would be better spent elsewhere. I think you've come upon the third rail of medicine. It's a subject that many dare not discuss for fear of being seen as uncaring.

[bleedingheart]

8. if someone would have told her 10 years ago that this is what would happen

she would have probably jumped off a cliff, however her descent into Alzheimer's was stealth like and before we knew it...her mind was gone.

[Bluerthanblue]

22. fuck the money- that should NEVER be a

deciding point on anyones life- but the fact that she will not ever regain what she has lost to Alzheimer's, and the quality of life she is living, IS an issue.
My life directive states no food, no water, no lifesaving measures, and if the md.'s believe i'm in pain, all the med's necessary to make the last moments as bearable for my family to know i'm at as much peace as possible- (narcotics aren't costly- and don't have to worry about becoming an addict)-
Money, as the reason for making a life ending decision is one that people will NEVER be at peace with- and something that this, the supposedly most wealthy country in the world should NEVER let become the deciding factor.

Because, when you come down to it, Money is the ruler, god, authority, and power behind everything precious then- and who wants to live in a world chained to a master that is paper????-

No regrets, that's my most fervent wish for my life, and my family that I leave behind- live as if there was no tomorrow, and die like there is one- of a kind no one can describe-

[Az]

3. Presumptions

You presume you know what the next stage of life is or that there is a next stage. All we know is that when this "stage" of life ends there is nothing more we can do.

We extend hope to continue in this life because it is all we know. Some suspect there may be something else after this. But we cannot know that. To that extent we deal with what we can know.

It is for this reason that we extend the hope of continued existance to those who are not currently experiencing existance as we would hope. It is why we do not simply switch off people in a coma. They are not existing as people in any way that we experience it. But we extend hope that they will one day be brought back to us.

In the same way someone suffering a catastrophic failure of the mind and quality of life is extended the same courtesy. In the hopes that we may be able to find some gleam of hope for them here and now.

I agree that if they clearly express a desire to leave this life it is their right to do so. But in the absense of their direct request their wishes should be followed. But caregivers will continue to struggle to find a way to return them to a quality of life worth living.

[bleedingheart]

9. sadly there is no hope in this situation only despair and a state of

persistent grief.

Now I had a friend whose 3 year old had leukemia and up until the end we all had hope that she would recover and be well again....I recall her being in pain and her dad being afraid that she would be a morphine addict if they kept up-ing her doses...and I remember her mom saying..."if she gets better the least of my worries will be having a 3 year old morphine addict"..

[bonito]

12. That was a great reply, and sometimes we succeed in bringing

about a better quality of life even though it looks hopeless from the medical views, I know this first hand. Peace

[DemExpat]

4. Family getting very close to the doctors and nurses in charge is the only

answer to this IMO.....my sisters and I had to step in when my Dad was in a nursing home dying from a brain tumor. Someone had to be there often to make sure he was getting good care, and to consult often with the staff about what we (and he) wanted.

We ended up taking him home with Hospice care to die a comfortable and palliative care only death.

It is extremely painful to see this prolonging of suffering and futile avoidance of the natural end IMO.

My sister who works in Emergency nursing has a lot of trouble with the care that they must provide to some very old people who are hauled into the hospital even while they are asking, begging sometimes, to be allowed to die... the staff has to intervene and get them stablized for more suffering in the nursing home again.

:cry:

DemEx

[bleedingheart]

6. i know what you say about the ER visits

she was taken to the ER just recently and it seriously upset her and that was when she stopped eating so they are pumping her full of "eating" hormone.

[salin]

5. Years ago I signed a living will for each of my parents

that included not wanting food or water when they were at the end (ala this is all that would keep them alive.) On their doctor's recommendation they had each of their children sign on that we would not override their intentions.

It was hard to sign. The idea of one of my parents dying due to dehydration was (and is) awful. However, living when one is past living was worse. So signed it I did.

It never came to that with my father, who died at home after a long bout with cancer, in the company of his beloved wife (and my wonderful mother.)

And my mother is still in great health. It does occur to me, upon reading this, that I should ask where that document is were we to need it for her.

I am very sorry for the pain of these circumstances for your family. May she soon find the peace she seeks.

[DemExpat]

13. The hardest thing I have ever done in this life was deciding

with my sister and Hospice doctors to take my Dad off a medication that was keeping him alive, even in the state where he lost control of his bowels and urinary tract and needed diapers. If you had known my Dad, this was his ultimate degradation, and he KNEW it even in his advanced stages of not being able to talk....
It was excruciating, but it was what he wanted (to go home and die) and could no longer tend to for himself.

Bittersweet. :cry:

DemEx

[salin]

15. Hospice was great

for my father. He spent little time in the end at the hospital. When my mother needed more assistance as my father's illness futher incapicitated him, they provided it such that she could tend to him and he could live out his life in his "dream home" that they had built together and that brought him such peace.

[Shine]

10. Because our tendency is to be AFRAID of what we can't control

Afterall, death is the Ultimate Mystery and in this country, at least, it is a taboo subject. I am a hospice volunteer and my experience is that most people are uncomfortable with discussing end of life issues. Our society glorifies Youth and we hide our aged and our sick away in these depressing homes. I am hoping as more baby boomers age and these issues get more prevalent for more of us, the social mores will shift. I guess time will tell...

I agree with you that death is a natural process, but sadly, in the medical model of responding to illness, too much effort is made sometimes to avoid it, and esp. in a situation like your family is facing, it's devastating. It's strange how these doctors just don't seem to "get it" sometimes. Allowing death and making peace with it seems to go against everything in their training, so they'll go to great lengths to avoid it.

Her refusing to eat is a completely natural process in her journey towards death. Perhaps your family can look into getting hospice care for her. To be considered "hospice appropriate", she needs to have been given by a doctor a prognosis of 6 mos. or less and she also needs to not be receiving any treatment for her condition, beyond palliative care (pain management). Hospice is an incredible organization and if your family decides to go that route, you will have a tremendous and high caliber level of support.

I wish you and your family many blessings during this difficult time. Be gentle with yourselves... :hug:

Peace,
Shine

[bleedingheart]

14. my father-in-law who is 84 just told us that he is ready

he is in great shape so far and is of sound mind...but this summer he basically said..."I have lived a full life, I am prepared for the next stage, what ever guided me into this world will surely guide me out"..

We hope that he of course will be with us as long as possible in good health but I think that he had a wonderfully healthy attitude.

[Bluerthanblue]

23. beautiful Mystery... so well stated Shine....we fear childbirth too..

I remember the feeling of "oh what am I getting into!!!" as the days led up to the birth of my second child- (my first died in utero)- And as much as I desired this child, I was afraid... of the unknown challenge.
Space isn't the 'final fronteer' and most of us will never go to 'outer space'- but ALL of us will die- someday... somehow. And it is the unknown entity of it that scares us I believe- the reality that we DON'T control our lives ultimately- perhaps those of us who have struggled with suicide, are in reality, partially 'control freaks' at heart- though I'm living proof, that even THAT isn't fail-safe.

I wish this woman had had a chance to really put down her wishes in detail- mine are very spelled out- no forced feeding, no heroic measures, no water- pain relief if it appears to be necessiary- I so wish that humans could see death as less of something to be feared, avoided, and denied... especially when it comes at the end of a life well lived, but as another passage... something that may not be rejoiced about by those left behind, but Also, not something seen as a horror, or a ...failure...by those who spend their careers trying to keep 'death' at bay.
It is hard to 'die well'. I agree hospice is a very VERY good option- and one which sees that death is not simply something that 'a person' experiences, but that a circle of family, friends and community go through- while honoring, and respecting the needs of that person, who is entering their final fronteer.

I too, wish much comfort, peace and support to all those who are grieving, and losing the familiar presence of a beloved fellow being-
and a safe and peaceful journey to the traveller-

blu

[etherealtruth]

11. Hospice

Encourage them to contact a hospice to coordinate her end of life care. In most circumstances they will help facilitate the care that the family wishes (representing what she would have wanted). They will also provide support and information to the family.

[bleedingheart]

17. I am going to ask them if the have the option to start with Hospice

[etherealtruth]

19. If there is not a hospice available ...

They may want to ask her physician to provide comfort / palliative care only; they will want the Dr. to write orders to that effect, also.

My best wishes to all involved.

[goclark]

20. My friend asked the doctor to "make his mom comfortable"

and that is what they did.

They were not trying to save her, they were trying to make her comfortable.

It was very peaceful when she died.

[Kingshakabobo]

16. I guess some doctors just can't grasp the idea that starving IS

part of the natural process. I mean, they wouldn't violate the DNR order with a ventilator or surgery but they won't stand by and let her starve herself. I'm sure the Schiavo circus clowns didn't help with that situation.

[shance]

18. That is a wonderful question to be asking.

I think there are a few reasons. I think a large reason is an overlying intolerance to face certain realities of life, namely death.

On a more cynical note, I believe greed does play a factor in sustaining peoples lives for the sake of pharmaceutical and medical industries.

[TNDemo]

21. Just hope he does not succumb to the pressure and get a feeding tube.

We all know what it takes to get one of those removed. I just went through this with my mother with Alzheimer's. She got it in her 50s and finally died right after her 70th birthday. Her brain was gone so I saw no reason to make her body stay alive. I let nature take its course and when she quit swallowing I didn't intervene. She seemed very comfortable and motionless over the days it took to pass but if there was so much as a sound I called for morphine. I truly don't think she ever felt any discomfort. It has been two years now and I still think I did the right thing. Alzheimer's is such an incredibly undignified disease. She was a very dignified woman once and she deserved to go with dignity and not be basically an organism being kept artificially alive. People do truly suffer with this disease - it's not being happily demented. It is being terrified, hallucinating, unable to cope with life in any form. I couldn't watch her suffer any more. The physical was far less awful than the mental and emotional. Good luck to your family through this.

[Shine]

24. This question raises another important issue about how

important it is to make clear what our end of life wishes are, AHEAD of time.

The whole Terry Schiavo drama brought that lesson home, big time.

Death happens. It's the Great Common Denominator of us all. So we might as well do our families a favor and make clear, in writing, ahead of time, how we want it to be dealt with. It's a huge gift, in the end.

I had a hospice client recently who was absolutely amazing in this regard. I'd never known anyone to be this organized. She had worked EVERY little detail out ahead of time. She knew what songs would be played at her service, who would be her pall bearers, had arranged all the food and flowers...I kid you not. It was pretty incredible and her memorial was truly beautiful. O8)


~Shine