My husband just threw a suitcase into the truck and is headed off to his mother's bedside. Last evening she suffered a mild heart attack, her younger son with whom she lives took her to hospital, in the emergency room she went into cardiac arrest and was resuscitated twice. She then had another heart attack and is now in the ICU with four intravenous needles stuck into her.
My first impulse when my BIL phoned me with this news last night was rage, rage that this fragile ninety year old lady with many problems coping with daily life had been subjected to such drastic medical procedures. Since I was not there and therefore do not know the exact circumstances, I have talked myself down. Her family members who were there did their best, I am sure, to decide things under emergency conditions. But I am left feeling very sad for her and worrying a lot over what will happen to her now.
I have thought more than once that we treat our animals better than we treat our old and terminally ill. A friend's nephew died last week from colon cancer, died slowly and in agony when the morphine that was being administered failed to control his pain. My mother was extremely fragile both mentally and physically in the last year of her life but when she started to bleed from the bowel my father and I authorized surgery that was successful in the short term but neither brought her comfort nor prolonged her life. Looking back, I see that it was not necessary to subject her to all that. It frightened her and hurt her. When the family dog suffered from a similar problem in her extreme old age we had her quietly and mercifully put to sleep and euthanized.
As a society, we do not deal well with extreme debility and death. As individuals, I believe, we put off thinking about the extremely emotional and divisive issues surrounding mortal illnesses. It seems to be easier for people to let things slide until their loved ones are in terrible pain or fear. By the time the crisis hits, I strongly believe, it is too late to manage it rationally. We go into crisis mode, we deal with things piecemeal, and we screw up. I did, for my mother. I also had to deal with the final illness and death of two of my childless aunts, and by the time I got to my aunt Marion, who had terminal cancer at age 79 and was afflicted with dementia as well, I had learned enough to manage things so that she died peacefully, early enough to prevent the worst ravages of her illnesses. I had learned!
One of the things I learned is that it is essential to speak to the medical people ahead of time, to have the paperwork (in Ontario, a Power of Attorney for Personal Care and a signed Do Not Resuscitate (DNR) order) in place. You need the names of all of the contact people -- for home care, placement in nursing care, specialist doctors -- on file and it is best to discuss with them what they can provide specifically for the person you are in charge of. I did research on nursing homes and, and this is vital, found one where staff members understood what I wanted for my aunt and were prepared to work with me. Other things that are useful to know include what drug regimes are available and what are their side effects. But, first and last, you need to know what you want done. And not done. When they come in with the cart and the paddles you need to know what the person would want and what you are going to do.
I so wish that we could have options for people who are dying in pain. As long as our doctors are subject to criminal procedures if they help, as long as relatives who help are prosecuted and sent to jail, as long as the drugs and regimes that would help are hard to find and expensive, as long as nursing homes are poorly funded and understaffed, we will continue to fail our loved ones when they need us the most. And as long as we as a society fail to address these problems rationally and with respect for differing points of view, we are contributing to the failure. It's a hard thing even to discuss, but it needs to be done.
There's a weird cartoon here with quite an interesting discussion on the topic. You want an euthanasia teeshirt? Look here. There's so much internet debate and info, that I'm not even going to try to filter it. I do however draw your attention to this statement, from the Ethics Committee of the College of Family Physicians of Canada. It says in part (paraphrased) that your loved ones may tolerate the seemingly intolerable if they know you love them. Other parts of it make better reading. I am not about to lead a crusade, but I wonder sometimes if I should.
May 8 update: MIL has survived all the nonsense with no cognitive damage. In fact, JG says she is 'cranky' , an adjective which speaks well of her state of health. If she has enough energy to crank over monitors, IV's and catheters, she'll make it.