A Living Will .net

Most children of aging parents will find themselves making healthcare decisions for their parents. Even when their parent has completed a living will and an advanced medical directive, there will still be decisions to be made. This is because the advanced medical directive cannot possibly anticipate every medical condition that may occur and because most elderly patients at some point will be too weak to make their own decisions.

Most children as decision makers will have little knowledge of the aging process and the medical choices associated with that process. It can be intimidating and confusing when one hears conflicting and complex medical information especially with a critically ill parent in the hospital. In addition to lacking knowledge of medical issues, we face the emotional component of the decision which is acknowledging that our parent is declining and may die soon. It is very normal to deny how ill our parent may be and to avoid facing it because it is so emotionally painful. This lack of basic medical knowledge, coupled with our denial, however, can lead us to make poor decisions that we come to regret years after our parent has died. It robs us of the opportunity to have final conversations with our parents that allow old misunderstandings to be voiced and forgiven, memories and history to be shared and true connection to be achieved.

A good starting point in communicating with our parent is to understand what may be important to them in the final months of their life. What do dying patients want? Researchers put this question to a group of terminally ill patients, their families and their healthcare providers to identify what would constitute a good death. We can use this information as a starting point to understand what may be the concerns that our parents are experiencing as they face their final months.

The participants in this research study identified six components of a good death. The first wish voiced by the patients was that their pain and symptoms be controlled. They feared dying in pain and experiencing shortness of breath. The participants were assured that pain and shortness of breath can be easily controlled with medication. Their second wish was to have the communication that allows them to participate in decision making. The participants said that unexpected medical situations had occurred with their illness previously causing decisions to be made in a crisis situation. The patients felt very empowered when they were informed that their condition was changing and they were able to participate in treatment decisions. It can be helpful for children to have conversations with their elderly parent helping the child to understand what the parent’s wish may be when their condition worsens. For example, would they want to receive artificial feeding or fluids if they were imminently terminal? Where would they want to be in their final days of life? The third wish of the patients in the study was to be better prepared for death. They wanted to know what to expect during the course of their illness and they wanted to plan for events that would occur after their death such as planning their funeral. The fourth wish was that they would die with a sense of completion. This wish involved faith issues, life review, resolving conflicts, spending time with family and saying goodbye. Issues of faith, although highly individual, were often described as important in their healing process at end of life. The fifth wish was that the dying person wanted to contribute to the well being of others. They wanted to continue to share their time and knowledge and to be of use to others. Finally, the patients wanted not to be viewed as a patient with a disease but rather to be affirmed as a whole person, unique in their life, values and preferences.

It is certain that death is the final stage for all of us. Children who have the opportunity to participate in their parent’s final weeks of life can be left with a deep comfort in knowing that they did their best during a difficult time. There is help available. If your aged parent is declining in a hospital, you can request your local hospice to consult and assess their appropriateness for hospice care. With hospice involved, you can be assured that the concerns outlined above will be attended to and will result in a comfortable death for your loved one.

Betsy Murphy http://www.GuidetoCaregiving.com Providing families with easy to understand medical information to help them identify when dying begins and when recovery is no longer possible. Essential information on communicating and caregiving in the final weeks of life, controlling pain and promoting comfort.

Visit my website at the above link for more information on end of life care.

Milton Friedman’s Free to Choose (1980), episode 2 – The Tyranny of Control. part 2

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