End-of-Life Issues

End-of-Life Issues

Although health care in this country has made it possible for Americans to live longer and more active lives well into their late senior years, serious illness and death are as much a part of life as birth and living. With old age come chronic illnesses and serious diseases. Most of these can be treated with good medical care, but often they cannot be cured. When a loved one becomes ill with a serious and incurable disease, Americans often rely on the same support systems that they depended on during earlier, happier times: family and friends.

These support systems can help with important care decisions as we become sick or unable to take care of ourselves. There are many things to think about, and there are many services available to help someone facing end-of-life issues. Even people lucky enough to be with family may need some extra help.

As we age, many people begin to think about planning for these end-of-life issues. Family and friends can help by talking about the choices to be made. Very often a person will want to prepare a living will while he is still healthy. This allows the person to make choices now about what care he wants to have if he becomes seriously ill. For example, some people may decide that if their heart stops, they do not want medical professionals to make it start again. This is known as a DNR order. The living will is a legal document that must be followed. In the living will, a person can make very clear what medical procedures he will allow.

A living will can be very clear about what machines someone will allow in her care plan. Someone may decide that if she is no longer able to breathe on her own, then she does not want to be placed on a ventilator. She may state in the living will that she does not want a feeding tube.

A person can also create a legal document called Power of Attorney that will allow another person to make all medical decisions. If someone is so sick that she cannot express herself, then the person she chooses will make decisions about health care. This person is usually a family member or a friend who knows exactly what the person’s wishes are.

For someone facing the end of life, hospice care provides comfort and many services. A team of people will come to the home and make sure that the dying person is as comfortable as possible. The most important thing they hope to do is be sure the dying person has the best quality of life in the time he has left. The team includes doctors and nurses who will supervise any medical care. Because hospice care is for the dying, medical professionals are not focused on treating the illness; they are only concerned with making sure the person is comfortable and in no pain. Volunteers may help with taking care of the house and offering time off to family members who don’t want to leave their loved one alone. Most health insurance plans will cover hospice care.

This isn’t always an easy or happy subject to bring up, but it’s an important one that will make things easier when a serious illness happens.

LIA: Alan, did you hear about my great-grandmother? You know that she’s been sick for a long time now. The doctors have diagnosed cancer. I’m afraid the prognosis is not very good.

ALAN: Yes, I did hear the news. I’m so sorry, Lia. How is she doing?

LIA: Well, you know my great-grandma. She’s doing just fine! We’re all feeling a little sad about the diagnosis, but Granny is very upbeat about it.

ALAN: Your grandmother’s mom has always been very sensible.

LIA: She started to get her affairs in order when she first got sick. And she is very clear that she doesn’t want to be on machines at the end of her life. We told her, “Granny, you could let the doctors who know medicine make this decision for you.” But Granny made a living will so she is the one deciding what kind of care she will get. Some of my aunts are a little upset. They think the doctors should do anything and everything to keep Granny alive, even if it means using machines to keep her lungs working.

ALAN: How about asking your aunts to talk to someone at the hospice center?

LIA: Right now they are too upset to think calmly.

ALAN: What about having them speak to the doctors again? Or, why don’t you call the chaplain at the hospital? Maybe he can help with their fears.

LIA: That’s a great idea. Maybe the chaplain can give them some comfort, so that they can see that what makes Granny comfortable is the most important thing.