Sunday, June 12, 2016

Ends

My favorite part of my job is hospice. This puts me in a tiny minority of pharmacists and healthcare providers. Almost all of healthcare is busily striving to extend life at any cost. Hospice is focused on letting people die with dignity and comfort. My hospice patients are one of two sorts: admitted with months and months left to live or only hours, maybe a day at most. I wish it were always the former sort of patient so families could have the time for healing and the patient wouldn't get more futile treatments. Friday we admitted the latter sort of patient and Sunday the patient needed more pain medicine because the patient surprised us all by surviving that long. The whole family was there with the patient when I walked in, drinking coffee and eating the cookies I've seen at every death vigil in a facility, yet nobody seemed to be tasting any of it. There's something transcendent about a good death where the family gathers to support the dying person one last time, then is together to lean on each other for support after the death.

My spouse and I are probably unusual in that we have told our girls exactly how we want our end of life care to look, where we want our memorial stone to be, and that we want to be cremated. We have told my sibling and my parents as well. My in-laws laughed and then hid when we tried to start that conversation. If I could have one wish, it would be that everyone considered their death and told their loved ones what treatments they want and don't want. We should all get that good death, surrounded by loved ones, with no more pain. May we all be so fortunate.

5 comments:

  1. We wrote it down once, though it's so hard to know what I would want in every situation until I'm in the middle of the situation. Though I did specify where I would want my memorial service and music played.

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  2. My mom (a hospice social worker for many years) has always been clear about her wishes. My father refuses to speak about it, other than he wants what mom wants. I've written down my wishes and told both my husband and best friend. It's important...

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  3. My parents have done the same for us. I consider it a blessing to know their exact wishes.

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  4. I agree, this is very important. Yet so many avoid it because it's an uncomfortable topic. Yet I've witnessed so many sad situations where someone is subjected to extreme forms of medical intervention to keep them alive when it is clear doing so is causing a lot of trauma and harm. All because they didn't specify. Many people struggle with the letting go. So we need to tell them it's okay and what we want.

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  5. Making your wishes known doesn't guarantee that you will get to die the way you want. I used to believe in or at least hope that there was something to the idea of the Hallmark death where the family gathers around and the person is ready to go etc. then my father died in his 80s. He was definitely not ready to go and it is not what I would call a good death. It was very hard to watch him still think that he was going to live and to be told by the palliative care people that basically uh no you're dying. I've thought about this a lot and I'm not sure there really is such a thing. Is it better to be healthy and die suddenly? Is it better if the person gets something like cancer and the family has months to get used to the idea? I don't know.

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