How to die

[robbridg]

Having experienced Hospice with my mother passing away, I second Hospice as greatly superior in care, assistance to loved ones remaining, and without the legal problems that will come from assisted suicide, nor the emotional aftermath of a suicide.

I agree. My mother passed away last fall and the Hospice people were very caring with my mom's end of life comfort. They cared for her along with the nursing home for 6 months. They were always available to my mom or me or my brother.

 

[donheff]

I know God will get me for this, but when I think of assisted suicide I have to say I wonder why people don't just decide to follow Nords's mother's path rather than involve anyone else when they feel it is their time to go. A horrific accident or debilitating illness of course might put the power and responsibility to feed/hydrate yourself in others' hands, so along with the question of assisted suicide, there's that consideration, too--how much emergency treatment would an otherwise healthy person want?

I think you answered your oewn question about why someone would choose not to try Nords' mother's approach. It often won't work and how much treatment (emergency or not) would an otherwise healthy person want.

As to God "getting you" for this, religion is certainly a factor in an individual's approach to end of life decisions but is not a factor that should be imposed on others. Not that you were doing that but others do -- witness Terry Schiavo's pathetic situation.

 

[Bestwifeever]

Don, what I was referring to are the medical interventions that put otherwise healthy people into Terry S.'s condition and who then are not able to choose for themselves to stop eating or drinking (I don't think allowing someone like Nords's mother to stop eating and drinking qualifies as assisted suicide). We all know or know of people who suffered severe injuries and are living for decades with the results of heroic medical measures at the time of the injury--alive, but absolutely miserable or brain damaged. So at a young adult age perhaps people should be able to put on their drivers licenses "no heroic measures" or something like that.

 

[donheff]

Don, what I was referring to are the medical interventions that put otherwise healthy people into Terry S.'s condition and who then are not able to choose for themselves to stop eating or drinking (I don't think allowing someone like Nords's mother to stop eating and drinking qualifies as assisted suicide). We all know or know of people who suffered severe injuries and are living for decades with the results of heroic medical measures at the time of the injury--alive, but absolutely miserable or brain damaged. So at a young adult age perhaps people should be able to put on their drivers licenses "no heroic measures" or something like that.

I see what you were saying and agree. I have taken all the steps I can think of to avoid "heroic" measures. A drivers license statement would be nice addition although I don't see many municipalities getting past the religious lobbies to put something like that in practice.

 

[Nords]

... I wonder why people don't just decide to follow Nords's mother's path rather than involve anyone else when they feel it is their time to go. A horrific accident or debilitating illness of course might put the power and responsibility to feed/hydrate yourself in others' hands, so along with the question of assisted suicide, there's that consideration, too--how much emergency treatment would an otherwise healthy person want?

Thanks, I'd like to think she wasn't suffering, but I just can't tell what was painless and what was her iron-willed self-control. I remember speaking to her on the phone a day or two after the hospital. She said they'd been able to set her broken leg but that the pain was unimaginable and she'd had enough.

I don't remember the details very well anymore (my father unfortunately no longer remembers them at all) but some sort of visiting nurse was at the house after Mom checked herself out of the hospital. I don't think it was formally called "home hospice" back in 1987 and it was certainly less than two weeks, maybe just one week. I don't even know if they were there as paid nursing care or just as friends. They knew Mom from the nurse's network and I think they were all honoring her DNR (or whatever we called it then). She might have been heavily medicated on Demerol or morphine; I just don't recall.

There are apparently a number of well-known signs that a patient has decided their time has come, so when Mom started running up the score on that count then Dad called us to "come home". I'm sure she and Dad had talked about how she was going to do it. Spouse and I flew in late the next evening and said hello to Mom, who was nonresponsive but reportedly able to hear & understand what was going on around her.

Next morning we'd all been sitting around her bed for an hour or so when she quietly stopped breathing. I do remember the nurse got a stethoscope on her heart and said "She's going." It seemed pretty uneventful to us sons (who'd been there less than 12 hours) but Mom & Dad had done an awful lot of heavy lifting over the previous decade to get to that point. Dad said it was especially difficult to persuade the orthopedic doctor/hospital to let her check out and go home. I imagine that he was more focused on healing the broken bone than on the big picture. Mom could be pretty testy on patient-care issues, especially when she was the patient, and I'm sure the doctor felt she was making incompetent decisions.

But I don't know just how bad things would have to get before I'd get tired of seeing what tomorrow would bring.

 

[landover]

There are other flavors of this topic. Someone I know is having a bypass surgery at 79. Is it really worth it? So there is a nonzero chance of dying immediately due to complications. And after so much of pain and possible dementia one may endure, is it really worth to live maybe 5 yrs extra and endure so much pain. Some websites recommends just medicines, like The Noninvasive Heart Center.

This is one example of kind of decision one need to take for quality of life question.

 

[unclemick]

Hospice is a nursing specialty that is very professional and private about their services, but their level of expertise related to end-of-life issues is superior to any other care provider currently available, in my opinion.

No hospice nurse will ever say that they assist with suicide. That's not what they do. But, as professionals, they may provide interventions that allow for a peaceful death with dignity. They work very closely with the family and the patient and other health care providers that are involved, and depending on the situation, can gracefully assist with an end to suffering.

Yep. They did a good job - friend of thirtyfour yrs, cancer. Me, one granddaughter and a DIL present.

heh heh heh - I still harbor visions of a bottle of vodka and a Michigan snowbank and the appropriate flaming arrow shooters(good shots only) and wooden boat for dispensing with the body. In this day and age it's probably illegal, immoral or raw meat for lawyers unless I croak in a quiet place overseas though. . Seems one just can't have any fun anymore.

 

[Moemg]

I think hospice does a great job . The problem is convincing the family or the Physicians that it is time for hospice .

 

[Nords]

heh heh heh - I still harbor visions of a bottle of vodka and a Michigan snowbank and the appropriate flaming arrow shooters(good shots only) and wooden boat for dispensing with the body.

I sure hope you guys wait until someone's dead first...

 

[ls99]

I sure hope you guys wait until someone's dead first...

Nah, would miss all the arm waving.

As for me, I just want to drop and be done. Like my brother. He opened the fridge door to get one ice cube for his scotch, which he used to take his digoxin with( long story, I'll pass on the details) had massive burst aorta, was dead before he hit the floor.

 

[Meadbh]

There are other flavors of this topic. Someone I know is having a bypass surgery at 79. Is it really worth it? So there is a nonzero chance of dying immediately due to complications. And after so much of pain and possible dementia one may endure, is it really worth to live maybe 5 yrs extra and endure so much pain. Some websites recommends just medicines, like The Noninvasive Heart Center.

This is one example of kind of decision one need to take for quality of life question.

My mother had an aortofemoral bypass at age 80, for severe painful vascular disease. She bounced back and got 11 good years before dying of something else. It was absolutely worth it.

 

[DblDoc]

I think hospice does a great job . The problem is convincing the family or the Physicians that it is time for hospice .

That and having the family stick to the decision. All too often I see patients brought into the ER and then hospitalized because family have rescinded the DNR/DNI, Comfort Care only decisions. There is also huge variation across the country in the proportion of patients who die in the hospital vs in hospice care.

DD

 

[Purron]

There are other flavors of this topic. Someone I know is having a bypass surgery at 79. Is it really worth it?

Maybe. Maybe not. Depends on the person. Seen peeps in theirs 80s go through more arduous surgery and have 10+ years of quality life. Others, not such a good outcome. Important thing (IMHO) is to have the power to make a decision for yourself...and if that's not possible, to rely on legal directives and folks that love you and want to do what they know you’d want. This is a big factor in the health care battle we're all trying to work through.

When my time comes, I hope I'm wise enough to get through this with dignity. Life is so precious - we only get one (depending on your religious/spiritual beliefs of course). We can talk about it and relate to loved ones who've been through it, but when we face the end, it's a very daunting decision. Haunts me big time.

 

[GregLee]

Important thing (IMHO) is to have the power to make a decision for yourself...and if that's not possible, to rely on legal directives and folks that love you and want to do what they know you’d want.

Well, the point was that undergoing additional medical procedures may sometimes give you many more years, even if you're already old. Do you think that you will be the best judge of that likelihood? Are the folks that love you going to be good judges? I'm skeptical. What do you know, and what do they know that qualifies them to make the best decision?

 

[Dreamer]

I don't think that I could end my own life and I know that I could not end a loved ones' life. However, if I am in pain, give me drugs and plenty of them. I want to think that I am back living in the 70's.

 

[grumpy]

Well, the point was that undergoing additional medical procedures may sometimes give you many more years, even if you're already old. Do you think that you will be the best judge of that likelihood? Are the folks that love you going to be good judges? I'm skeptical. What do you know, and what do they know that qualifies them to make the best decision?

I have long maintained that if I knew that I was going to die after a long and painful illness, I would willingly sacrifice 5 healthy years to avoid that. I have spent too much time in hospitals and in pain already in my life.

 

[Purron]

Well, the point was that undergoing additional medical procedures may sometimes give you many more years, even if you're already old. Do you think that you will be the best judge of that likelihood? Are the folks that love you going to be good judges? I'm skeptical. What do you know, and what do they know that qualifies them to make the best decision?

I'd like to hear your alternative. Who would be best qualified to make the decision?

 

[MBAustin]

When my father was in ICU (due to a hospital-acquired infection) for two days before he died, I saw several patients who had been there for many days (weeks?) with little or no family visiting, no observable consciousness of their surroundings, and some seeming to be in distress at times. My father passed quickly, before he could be moved to the hospice. But I shudder to think of the potential suffering those other patients endured, not to mention the cost, of them being sustained for days, weeks, longer, because of a lack of advance planning and thoughtfulness on the part of the patient and/or their family.

 

[GregLee]

I'd like to hear your alternative. Who would be best qualified to make the decision?

I don't have an alternative to suggest. I suppose the doctors would be best qualified to estimate the likelihood of treatment leading to an appreciably longer and healthier life.

 

[Nords]

When my father was in ICU (due to a hospital-acquired infection) for two days before he died, I saw several patients who had been there for many days (weeks?) with little or no family visiting, no observable consciousness of their surroundings, and some seeming to be in distress at times.
... But I shudder to think of the potential suffering those other patients endured, not to mention the cost, of them being sustained for days, weeks, longer, because of a lack of advance planning and thoughtfulness on the part of the patient and/or their family.

I've noticed that when patients don't get visitors, at least half the time it's due to the way they've treated their family over the years. Karmic payback.

 

[old woman]

I like morphine, it relieves pain and suppresses breathing so can cause death.

My dad was about 80 and a smoker, he had some heart attacks and a stroke and lung problems. The doctor came to the house and said he had kidney failure and was having total system shutdown. He didn't have a DNR but when they took him to the hospital I told the driver to drive slowly that dad wasn't coming home again. He spent two days on morphine in the hospital before moving to a nursing home. He died a few hours later but the morphine let him not hurt. The morphine might have made him die quicker since it supresses breathing, but that would be a good thing, he was done living and ready to pass on.

 

[rescueme]

I've noticed that when patients don't get visitors, at least half the time it's due to the way they've treated their family over the years.

++++1

 

[MichaelB]

I think it's easier to talk about end of life options and choices while we are younger and healthier. When the time comes, however, we may not be mentally alert or physically capable. We may also have a different view on the trade-off and cost of staying alive. This is a rational discussion and I suspect at that moment of truth, reasoning will have little to do with the choices most people make.

 

[calmloki]

Several years ago my Mom found out her swelling midsection was cancer amongst her lady parts. She also had paid reservations for another Central American trip.. We talked and I urged her to go on the trip, as regardless of the treatment it might be her last chance. She made it about a week or so in and we had to retrieve her from Mexico as she was in way too much pain. She got surgery which also involved removal of a section of her bowel and resection. Cancer was causing obstruction and was invading that area as well. The surgery was not a success - the resection of the bowel didn't hold and contents of the bowel developed a path to the surface of her abdomen. Lots of pain, expensive nutrients via IV, other food ending up between her skin and a big plastic bandage over her stomach.

After some weeks in hospital she went to a nursing facility. After a month or so there she threw enough food in the trash to claim to the doctors that she was eating enough nutrients by mouth to be released home. She went to a little house we fixed up with the contents of her mobile home (my gal - took lots of pictures of the interior of Mom's mobile, we moved everything, and she arranged everything in the same relationship it was in down south). Mom was there for a week, we had Christmas, and the power went out so we carried her to our house to stay. We were trying to get hospice care set up and realizing just how unprepared we were for someone that needed some serious care. She had asked me what was going to happen - things couldn't go on the way they were! Told her that if she didn't eat she wouldn't make it.

On NewYear's Eve predawn she fell partially from her bed, her vitals were not good. Sat with her till others woke and showed up, was convinced she should go to the emergency room, though it was obvious to me she was dying. At the ER I told the head doc I felt she was dying and wanted nothing done to prolong her life, indeed, if she could get a hot shot to do that. Was told that's not what they did, however, morphine (I think) was given to reduce breathing distress and I encouraged it's repeated use as time went on in an attempt to hasten her easy parting.

She lasted about four more hours with two of her kids and our partners by her side. She was out of it on drugs. Think her demise was hastened by well meaning staff trying to suction her airway - "stuff" was backing up from her stomach. I have regrets, some things could have been handled better, but given her condition and future I wish I'd argued to keep her at home or at least refused the suctioning and asked for morphine even more frequently. I was pretty numb though. Nobody gets out alive, but the manner of one's passing might be changed.

 

[Sarah in SC]

A friend's father did that and apparently that is not a physically traumatic way to die (and that is the peaceful, died-in-their-sleep death that nature initiates for the lucky ones). I know God will get me for this, but when I think of assisted suicide I have to say I wonder why people don't just decide to follow Nords's mother's path rather than involve anyone else when they feel it is their time to go. A horrific accident or debilitating illness of course might put the power and responsibility to feed/hydrate yourself in others' hands, so along with the question of assisted suicide, there's that consideration, too--how much emergency treatment would an otherwise healthy person want?

Feever, this is where I pitch one of my and T-Al's favorite happy reads, Loving and Leaving the Good Life, by Helen Nearing. It details the chosen end for her husband, famed back-to-nature guru Scott Nearing. Feeling his mental acuity declining, he simply stopped eating and then drinking. From her depiction of his life and end, it was quite peaceful. That's my plan.

Plan B is for my younger cousin to take me out in the woods one morning and if I find my way back, great, if not, die of exposure. Cheery thought!