I live in Houston and have worked as a nurse. I have a lifelong passion for traveling, nature, and photography (preferably all together!).
Making Your Wishes Known
Everyone who has reached an age sufficient enough to be making life decisions should consider getting a living will in addition to any other type of legal document one has secured. Those are also vitally important.
Please accept this bit of advice from the perspective of having been in the nursing profession. I have seen the good, the bad, and the ugly decisions that are made for people once they can no longer tell the doctors and other decision-makers what they might have wished regarding medical care for themselves.
I'll give you two examples of bad decisions, in my opinion.
Real Story Number One
This first story has to do with a terminal cancer patient that I attended as a private-duty nurse. It was one of the very few private-duty cases that I ever accepted, and I felt an obligation to remain on the case until the death of the patient. It was not easy! I'll call him Mr. Smith.
He was a lovely man with metastasized cancer that had spread over his entire body. Mr. Smith was most often in pain. His veins were poked and assaulted with so many intravenous fluids and medications that they were harder to find and keep open and free-flowing.
When they finally had to try to find some available veins in his feet because the other sites had been exhausted, he screamed out with pain. I elected not to inflict this suffering, and the floor nurses had to follow the doctor's orders instead.
Mr. Smith quite often hallucinated. So had he spoken to doctors about his wants and desires at that point, they probably would not have deemed his decisions lucid and worth following. Thus his family made the medical decisions for him, and they decided to prolong his life.
At the time, there was a severe blood shortage in Houston. I often wondered why they kept giving Mr. Smith blood when his case was terminal, and other people undoubtedly needed the blood to survive. I thought that this was a shame!
The odor coming from his room was horrendous. I understood why most of the other private duty nurses bailed out of caring for him. My stomach often lurched, and I never did vomit but most often had to fight that feeling each day when I first entered his room.
His family did come to visit him but never stayed in the room for long. They would gather and visit with each other in a nearby lounge. They told me to get them if anything rapidly deteriorated.
Mr. Smith's final relief came soon after his attending doctor gave me a verbal order (which I happily charted) to discontinue the I.V's when the next time came when his veins could no longer support one. The doctor was going on vacation and told Mr. Smith that he would see him in the next life.
When he was no longer able to receive fluids and medications, he quite peacefully slipped into a semi-comatose state and quietly died. All the many needless weeks of suffering had come to a close.
Had Mr. Smith had a living will (also called an advanced directive) and his intentions regarding care "above and beyond" the ordinary, especially if chances of a full recovery looked grim, this long-drawn-out scenario might never have occurred. His peaceful death could have come earlier, and he would have suffered far less pain!
Real Story Number Two
Another example goes back to my student nursing days when I volunteered to be in the hospital. They told me to sit with a patient that was in a private room and was in a full coma. He was hooked up to all kinds of medical paraphernalia, including a respirator. At that point in my desired nursing career, it was a bit scary for me!
His family wanted to "keep him alive" until family members from other parts of the country could get there to see him. Yes, his body was in that bed, but he was hardly alive in any other sense. He could not breathe on his own, and he was determined to be brain dead. The only thing moving was the heaving of his chest in time with the noise of the respirator.
Was this the life he would have wished for himself?
It did not take me long to realize that I did not want my life addressed like these examples at an end-stage. With a living will, one has choices. It is a simple form that can be signed and notarized. Make sure your family members or others that might be caring for you know of its existence. Give a copy of it to your doctor.
Whatever you decide to do, consider making your wishes known before any need. Don't get stuck in situations outside of your control. You might end up suffering needlessly, not to mention the ridiculous costs of ongoing medical care when there is no chance of a successful recovery.
Do an online search for living wills. You can print out forms that meet various state requirements and all at no cost. My heartiest recommendation would be that you protect yourself and make your wishes known today. Tomorrow could be too late!
Quality of Life Issue
We have a friend right now who is in the position of being able to follow her husband's wishes regarding end of life care. He is in his 90s and has numerous medical issues in addition to Alzheimer's Disease. Hospital visits are frequent. He can no longer swallow anything but small bites of pureed food. Presented to her is the idea of engaging hospice.
Doctors have floated the idea of installing a feeding tube. Thankfully our friend's husband has a living will that specifies that he does not wish to have a feeding tube, among other notations. He can no longer communicate effectively, given his present state. His decision to have a living will in place is making the choices easier for his doctor and wife.
It is a very loving thing to do for those who may have to make heart-wrenching decisions when caring for patients or relatives. Quality of life is at stake. It can often be of more importance than the length of life, especially if pain and suffering are involved.
This content is accurate and true to the best of the author’s knowledge and is not meant to substitute for formal and individualized advice from a qualified professional.
© 2008 Peggy Woods
Comments are always welcomed.
Peggy Woods (author) from Houston, Texas on