End of Life Advice

[TromboneAl]

My 91-year-old mom is about to die. She can barely get out of bed, and is not comfortable. She wants to die ("Help me find a way out" is what she said to sister 1) and has talked about going to Oregon (where sister 1 lives) to take advantage of the Physician-assisted suicide law there.

My three sisters and I are tag teaming the care, and I'm going there as soon as I retire.

Any advice or suggestions from some of you who have gone through this?

Thanks,

 

[Rich_by_the_Bay]

My 91-year-old mom is about to die. She can barely get out of bed, and is not comfortable. She wants to die ("Help me find a way out" is what she said to sister 1) and has talked about going to Oregon (where sister 1 lives) to take advantage of the Physician-assisted suicide law there.

My three sisters and I are tag teaming the care, and I'm going there as soon as I retire.

Any advice or suggestions from some of you who have gone through this?

Al, this is tough. I am sorry for all the anguish and pain, and wish you the best in negotiating such a difficult passage.

Without knowing details, here are some thoughts I hope you find helpful. Just a few things I learned from experience (I deal with end-of-life situations daily in my work).

If she has a good primary doctor, enlist him/her early into the process. Sometimes "about to die" doesn't turn out to be as quick as everyone assumes, and thus planning gets derailed.

If death truly is imminent, consider getting hospice involved. They do it best, and you do not have to have cancer to qualify.

A major move at this time (e.g. Oregon) should be approached with great caution; the move itself may create more emotional turmoil than whatever logistic benefits it may hold. It may be the right thing, but unless she is expected to live for months, I have rarely seen such last minute disruptions turn out all that well.

There is an approach to care called "terminal sedation." This is not euthanasia, and it is considered ethical and legal under many circumstances. Depending on the type of suffering she is experiencing, it can bring about a comfortable, non-prolonged passing. I have no clue whether your mom's situation is appropriate for this, but just so you know.

Take care of yourself, and make sure your sisters do too. The 24-hour vigil thing can be gruelling and sometimes drags out a long time.

Good luck and best wishes. Feel free to PM me if you think it would be helpful.

 

[TromboneAl]

Thank you, Rich!

 

[Zipper]

Once again Rich shows he's the #1 quality poster at this site.

 

[Dawg52]

Once again Rich shows he's the #1 quality poster at this site.

Yes, we have some pretty good advisers here. Rich for medical, Martha for legal, Brewer and others for financial.

 

[TargaDave]

Like Rich said, Hospice and medications to ease pain made a huge difference for my wife's mom. She had severe emphysema and weighed less than 65# at the end. I guess the steady morphine drip she got in the last month or so would qualify as "terminal sedation".

 

[lazygood4nothinbum]

i fell asleep last night thinking about the assisted suicide you suggest in your post. i dreamed during the night of assisting my own mom's suicide. still within the dream, after doing the deed with my brother, i couldn't stop crying. i woke up from the dream and my body was crying still, uninterrupted crying between being asleep and awake.

my ol'man killed himself. no questions asked. no discussion. no assistance required. mom in stage 5/6 of 7 of alzheimer's disease, in one of her last "conversations" (quotes used because words were becoming scarce by then), said to me "this is horrendous" and then "what can you do?" even though i was pretty sure she was referring to assisted suicide, at that point of her dementia, i could do nothing.

there is a big difference, in my mind, between physician assisted suicide at the end of life and aiding & abetting a person to shorten living. i have no moral problem with suicide and i only hope if alzheimer's is my fate, that i am able to act within my own window of opportunity.

but even barring dementia, i do not know that i would be able to assist my mother hadn't she utilized her window of opportunity or, at the very least, taken unquestionable and completely self-directed preparatory steps before hand. dementia of course complicates it all and so you can not confirm the original plan or if it is just a change of mind. there could never be enough confidence in one's decision to help such a loved one.

given that the terminally ill have some measure of independent mobility & reasonable mental stability, i think, at some point, our own hands are tied. it is not up to us to take that responsibility of a life and death decision for another. at some point, without prior action, we all get trapped and we have to learn to live with that.

 

[Cattusbabe]

Hospice is the way to go. My MIL passed nine months ago at 91 and was also begging for death. Even though DH and I were both health care professionals it was rough. Hospice was a God send. No question.
Hospice is about giving comfort and that was really what my MIL was asking for and what we her loved ones needed. I will keep you in my prayers.

 

[kcowan]

We did the hospice with MIL. Took 8 months. But at least she was comfortable. Had not recognized anyone for over 3 years before that. No one wants that!

Dad started to give up. Actually said he wished he were dead. Fell against the bedroom dresser and broke his hip. Was gone in 3 days. 95

He was active and out and about until a stroke 6 months before. Then 4 months before they lifted his driver's license. Probably had another stroke that caused the fall.

 

[cute fuzzy bunny]

We're getting a double dose of this. After having a scratchy nose and headaches for a couple of months my 14 year old nephew was diagnosed with a tennis ball size tumor in his brain thats putting out tendrils. More tests to see if its malignant and if/how if can be removed or treated are coming up this week.

We had a day to consider this when my dad called to say that his brother went in to the hospital to treat a dog bite incurred when someone with an unleashed dog attacked his tiny dog and killed it while he was taking it for a walk. Doctor noticed he seemed a bit yellow and had a test run. He's got cancer of the liver and pancreas and has about a month to live. They're putting him on morphine sometime in the next week or two. This is the guy who survived a grenade being thrown into his bunker while sleeping in vietnam and lost an eye to a botched eye surgery.

We'll be more closely involved with my nephew as he lives an hour away, but my dad and I may be taking a trip back east to tend to my uncle and aunt as they figure out how to deal with this. They were a year or two away from retiring.

14 and 58. Better get your living on folks.

 

[Rich_by_the_Bay]

We're getting a double dose of this.

Oh, man. Bummer, Ted. All my best wishes.

 

[Cattusbabe]

14 and 58.  Better get your living on folks.

True that.

 

[SteveR]

Sorry to hear about your family health issues CFB. Sometimes when it rains it pours. I hope you and your dad can have some quality time with your uncle before he is so sedated he does not know you are there. As for your nephew, wow that is a tough one for someone so young.

Hang in there.

 

[Scrooge]

14 and 58.

Some years/months/weeks are like that. A friend of mine lost her mother, husband and uncle -- pretty much the whole family except her son -- all within a year. Oh, and her dog died too!

 

[REWahoo]

CFB, really sorry to hear all the bad news. Remarkable how bad things seem to happen in rapid succession. My mom, my mother-in-law and my son-in-law's dad died within 6 weeks of each other. Those were dark and sad days.

Hope things turn out better for your family than they now appear.

 

[lazygood4nothinbum]

similar situation here. my best friend died then my dog died all while i'm watching mom die in slow motion. this never happened when i was a kid. i chalk it up to "getting old sucks."

 

[Outtahere]

My thoughts and prayers are with your nephew, uncle and family members having to deal with this.

 

[larry]

I agree with the Hospice, they are wonderful. My sister was with our gpa when he died and after that she became a hospice volunteer. Great organization.

 

[Dmeriksen]

by every second our life moves towards end.. we should accept this realty.

 

[Dreamer]

CFB

Sorry for all the family troubles. They are so young. I hope that things go well for both of them. Sounds like your uncle has been through a lot.

 

[grumpy]

For anyone facing the terminal care of a loved one or if you want to be prepared:

http://www.compassionandchoices.org/services/

Grumpy

 

[audreyh1]

I really regret not getting hospice involved with my mother (terminal cancer). We just didn't know any better at the time and for some reason my Dad didn't think it was time to get them involved yet. I think she suffered more than she should have. Looking back I really wonder what we were thinking?!?!

I know better now.

Audrey

 

[Aaron]

I also agree that Hospice is great and can be a big help.  My grandmother was there for the last 3 weeks of her life and it was a very comfortable environment, for both her and the entire family. 

My dad was able to bring in a keyboard and play music, and we also had CDs that my grandmother enjoyed.  Thinking back, having music made things a lot more comfortable when family just wanted to think and reflect on memories.  This hospice had very nice outdoor gardens, fountains, benches to sit on, etc. to help people relax. 

I just found out that my grandfather is probably down to his last month or so.  He had cancer 10 years ago and it seems like it came back, so he knows the routine, and has refused any kind of medical tests or treatment.  I think he’s accepted that it’s his time to go and has enjoyed a long, full life, but it's still hard on the family.

 

[astromeria]

My father stayed at home--hospice came to him. That's what my mother said she wants, too, if it comes to that.

 

[Brat]

An untimely death is a tragedy.  

Lingering long when ill or frail in old age is tough.  In my experience the MD recommends hospice care to the family, encourages them to use it as a resource.  As the physician commented the last phase can be longer than predicted.  It is important for both the patient and family to have appropriate care and help.

BTW, the Oregon Physician Assisted Suicide law requires that the patient request assistance, that the patient be in the late stage of a terminal condition, they obtain a second opinion who confirms the condition and mental capacity of the patient.  Only then may the primary care physician write a script for meds that the patient may take to end their life.  No one can administer the med.  As a practical matter Alzheimer’s and dementia patients cannot use this option.