Death With Dignity Laws Should Be Enacted In All States

[Midpack]

Instead of just Oregon, Washington, Vermont and to some degree in New Mexico and Montana.

I'll spare you the details, but my Dad has been shuttled between hospitals (three events), assisted living, skilled nursing and hospice for almost three months - from one episode of pain and suffering after another. The professionals charged with his care have made several mistakes with meds and diagnosis that have added to his pain. He was reasonably lucid and competent in Aug, he barely knows where he is today. He's been heavily sedated (Morphine every 2 hours) for weeks. He has made it clear he wants it all to end to anyone and everyone, he has had a documented DNR order in place for more than 15 years, and yet the professionals keep putting him through more misery. And there's nothing within the law his family or doctors for that matter can do for him.

Of course there are two sides, and death with dignity laws need some serious safeguards, but putting an elderly citizen through pain and costs against their wishes isn't the answer...

 

[target2019]

I agree 100%. Watched M-I-L decline for 7 years or more. If she had an option, I know she would have taken it.
We actually discuss this subject, and how/when we might decide, and not let others decide for us.

 

[MichaelB]

Midpack, sorry to heat this is happening to your DF.

 

[Car-Guy]

100% agree with a persons rights to make their own decisions about their life.

 

[CRLLS]

I agree whole heartedly about Death with dignity.

Midpack, I am sorry to hear of your situation.

My FIL was in a situation related to his Cancer. He was admitted to the hospital for breathing problems. A few days later, things were under control and he was released. As he was dressing to go home, he Code Blue'd in his hospital room. Despite his DNR, they resuscitated him. He lasted only a few more days. Fortunately he did not suffer long. He would have been in less pain those last few days if they just left alone per his request. I don't really blame the hospital for doing what they are trained to do. I just wish that they would post a big DNR sign on the door or some such indication. Looking up records to see find if he has a DNR filed before taking action isn't reasonable IMO.

My wish is that all states pass dignity laws by the time I need to, or have anyone else act on my behalf.

 

[ER Eddie]

Agree. We're kinder to our pets than to ourselves.

Having some forms in place can help somewhat (e.g., healthcare power of attorney, living will). That's no substitute for good Death with Dignity laws, though.

 

[cathy63]

I am so sorry to hear of your situation. I hope that your father and your family are able to find peace soon.

California also has a death with dignity law, which I support, though I am also deeply thankful that my loved ones who have died since its passage have not needed it.

 

[MarieIG]

My parents did not have end of life papers in place however, I did manage to supervise / oversee their end of life treatment.


It may have been that with my mother (who passed first) my father was agreeable to this; and with my father - there was no one else. I was the only child. I believe that when my mother was admitted to the hospital, (I was there) my mother was asked that if should could not make a decision, was there anyone who she wanted to make decisions for her, and both parents pointed at me.

I had to be called to approve any surgical procedures. (A doctor would call, and there would be a witness who would identify herself to document my instructions.)

I did find that the doctors were willing to dial back treatment when it reached the point that I believed it was what my parents would have wished. I was there on a daily basis, and knew what time the doctors made their rounds so I could pounce on them. Both my parents passed very soon after the decision was made to stop life prolonging treatment.

With my aunt, more recently, near the end she was given an increased dose of morphine which assisted her passing. She was receiving her end of life care at home. She and all her children were in agreement.

Do you have any paperwork other than the DNR expressing your father's wishes? Perhaps you and your sister could get together and ambush/consult the doctor who is currently in charge of your father's care?


This is without question one of the most painful, times imaginable. I am very sorry for what you are going through.

 

[imoldernu]

A very difficult question. Could be something DW and I will be dealing with in the neartime future.

Of course I'd like to be in charge of my own fate. That said, I still have responsibilities. What happens to jeanie, if I'm in the hospital (as I was a few months ago) and basically out of it. Suppose instead of a few days, it was two weeks. Alive, but not really responding. Under sedation. Not alert, but even with medication, not in a happy state.

Living in our CCRC, I get to see people who go into the nursing home in utter despair, and with serious health problems. Let me put it this way,... Yesterday, I went to Friday Coffee with Kelly, who just came back from two weeks in very serious condition in the nursing home, and is now back in independent living with Helen... he just turned 100, and she is 99. His comment? "Bob, I had to come back, because my insurance was running out." (He has millions). With that, he picked up Helen to drive out to IHop for breakfast.

I could go on with many cases, but how about this one: Donald (94) was given up for lost a year ago. Went from Independent Living to Assisted Living, to "Bounce Back" to Nursing. Very sad. Last week he came back from a trip to Florida...St. Pete... with his daughter. Tanned, and now back to playing bridge and dominoes.

Is that the norm? Of course not. Does that mean the I would not like to be able to make my own choices? No... BUT... before making the choice, I'd like to ask my loved ones if it would be all right.

What if I were in a depression and made the decision to die? My own decision. Would that be enough?
What of the future of those that I love, and what my passing would do to them?

Everyone has to make decisions, and I would not want to make the legal decision for the state or the country..

One more thing... I would certainly not consider a DNR as the sole legal ok to allow a person to die.

 

[MarieIG]

I understand exactly what you are saying. My father got UTIs a few times which led to confusion made him appear as if he had severe dementia. He was hospitalized and his physician asked if I wanted to forego treatment. That was a NO. Soon afterwards, Dad was back to cracking jokes with the doctor, and his doctor pulled me aside and commented, I am really amazed to see him like this . . .

 

[easysurfer]

100% agree with a persons rights to make their own decisions about their life.

+1.

IMO, sadly I think the care given is based for the convenience of the place providing the care and not the patient.

I remember losing my mother and dear friend in their final weeks. They were so often sedated that it was difficult to have a conversation with.

 

[ERD50]

So sorry to hear you are dealing with this. I also agree with others supporting some sort of end-of-life choice. Hopefully something can be in place when our time comes.

My FIL spent a little over a week on the edge, and even in that time, we were all just wishing his time would come sooner rather than later so he could have peace. I can't even imagine this going on for months.

You might be able to make a stronger case if he;s in hospice? Maybe this varies by state, but when my Mom agreed to hospice (heart failing, and no chance of any further surgeries/treatments), they were pretty strict about "for comfort only". I actually had to ask that if she had some injury that was treatable, but unrelated (say a cut or something), where treatment would improve her quality of life for that time, if it would be denied. But they said cases like that would be treated.

Unfortunately, with my FIL, I got the feeling that the hospital (prior to hospice) was trying to wring every $ out his stay that they could. How many tests and Doctor visits do you need on someone who you have been told is dying, and there is nothing to be done? We even had the "kidney Doctor" come to us and tell us that his kidneys were still functioning well. What's the point of these tests and visits?

Take care of yourself, these are trying times.

-ERD50

 

[Midpack]

A very difficult question. Could be something DW and I will be dealing with in the neartime future.

Of course I'd like to be in charge of my own fate. That said, I still have responsibilities. What happens to jeanie, if I'm in the hospital (as I was a few months ago) and basically out of it. Suppose instead of a few days, it was two weeks. Alive, but not really responding. Under sedation. Not alert, but even with medication, not in a happy state.

Living in our CCRC, I get to see people who go into the nursing home in utter despair, and with serious health problems. Let me put it this way,... Yesterday, I went to Friday Coffee with Kelly, who just came back from two weeks in very serious condition in the nursing home, and is now back in independent living with Helen... he just turned 100, and she is 99. His comment? "Bob, I had to come back, because my insurance was running out." (He has millions). With that, he picked up Helen to drive out to IHop for breakfast.

I could go on with many cases, but how about this one: Donald (94) was given up for lost a year ago. Went from Independent Living to Assisted Living, to "Bounce Back" to Nursing. Very sad. Last week he came back from a trip to Florida...St. Pete... with his daughter. Tanned, and now back to playing bridge and dominoes.

Is that the norm? Of course not. Does that mean the I would not like to be able to make my own choices? No... BUT... before making the choice, I'd like to ask my loved ones if it would be all right.

What if I were in a depression and made the decision to die? My own decision. Would that be enough?
What of the future of those that I love, and what my passing would do to them?

Everyone has to make decisions, and I would not want to make the legal decision for the state or the country..

One more thing... I would certainly not consider a DNR as the sole legal ok to allow a person to die.

That’s why I said at the outset “Of course there are two sides, and death with dignity laws need some serious safeguards, but putting an elderly citizen through pain and costs against their wishes isn't the answer...“ Not considering death with dignity laws because there may be exceptions leads to unnecessary suffering for others.

My Dad is over 96 and I can assure you he’s well beyond recovering, is in excruciating pain off and on, and being given morphine every 2 hours, he is begging for a way out when he is conscious. Holding out hope at some point becomes cruel? The situation he is in is exactly what he’s told us he wanted to avoid.

 

[Jerry1]

My Dad is over 96 and I can assure you he’s well beyond recovering, is in excruciating pain off and on, and being given morphine every 2 hours, he is begging for a way out when he is conscious. Holding out hope at some point becomes cruel? The situation he is in is exactly what he’s told us he wanted to avoid.

Is he in hospice? My limited experience with hospice is that the morphine flows and the end comes pretty quick. The few I’ve know about did not ever regain consciousness once morphine began.

DW and I are very concerned about this issue. Both for ourselves and that her mother has Alzheimer’s. Given that an Alzheimer’s patient cannot concent, their path is more difficult than I think it should be.

 

[Scrapr]

I'm sorry Midpack. This last year has been lots of experience with Hospice. Dad & Mom died in Memory care after being on hospice. Dad struggled on for longer than we expected. FIL died at home on hospice. It was a struggle to get hospice involved but once they were in they provided some comfort.

My only advice is stock up on the morphine. Early & often. Advocate for additional if he is looking pained. The Cheyne Stokes breathing near the end is painful to watch.

 

[easysurfer]

Midpack -

Does your father have a living will? If so, shouldn't the doctors/hospital honor that as isn't the very purpose of a living will for the situation that your father is in?

When I had my will drawn up about a year or two ago, I made sure to have a living will to spell out my wishes. Yet, at the same time, am not sure it would be followed 100%.

I feel for you.

 

[Richard4444]

Best wishes and prayers sent Midpack,

I have been through it as well and it is heart wrenching painful. Hurts to even relive it as I type, but all ultimately went well.

Rich

 

[Midpack]

Is he in hospice? My limited experience with hospice is that the morphine flows and the end comes pretty quick. The few I’ve know about did not ever regain consciousness once morphine began.

DW and I are very concerned about this issue. Both for ourselves and that her mother has Alzheimer’s. Given that an Alzheimer’s patient cannot concent, their path is more difficult than I think it should be.

He is in hospice now, in a skilled nursing facility. But the hospice folks and the SNF haven’t been on the same page, they just made a colossal week long mistake so bad my Dad was crying because of the pain one morning despite morphine. The medical professionals have done some good things and they have good intentions, but they aren’t coordinating with each other - my sister has caught lots of mistakes, some were avoided but some were after the fact. This morning another new nurse appeared who didn’t know anything about my Dad, my sister had to intervene - and he and Medicare/Tricare are paying $ for this? My Dad will pass away, helpless, after weeks in pain. Why?

Again, I’m not at all cavalier about death with dignity laws, but there’s no good reason I can think of to put my Dad through this - he is begging for it to end.

 

[MichaelB]

Midpack, have you spoken with the director of the facility to reaffirm your father’s wishes and to complain about the treatment he is receiving? Unfortunately, this might be the only way for you to help him get the attention he needs and deserves.

 

[Spock]

I was toying with the idea of pro-actively adding a "should it ever be legal" verbiage in my medical directives.


Otherwise, we almost have it now under the name of hospice. Mom was moved to hospice after a broken hip repair... morphine morphine and more morphine. anytime she moved or moaned = more morphine. Combined with no IV liquids and the outcome is inevitable. Mom had been stating she wanted "out" for months, Dad told Drs about the DNR with every hospital admission.... yet he still wanted all her meds to continue while in hospice... confusing times.

 

[Midpack]

Midpack, have you spoken with the director of the facility to reaffirm your father’s wishes and to complain about the treatment he is receiving? Unfortunately, this might be the only way for you to help him get the attention he needs and deserves.

Yes, my sister is there and she has. I am 1200 miles away and I’ve visited of course but sister is there 3 times a day. But my Dad’s GP, hospital ER (yesterday), hospice, SNF/AL aren’t coordinating with each other. I could give the most recent example but it’s pretty gruesome, so I’ll spare you all. And we can’t imagine moving him and starting all over again at this point. My Dad should have another choice, and he would in 5-6 starters.

 

[ERD50]

In a more general sense (but also applies here I think), if one is able, is there any reasonable way to "throw money" at this problem? To buy more comfort?

My Mom was pretty well off, and we found a very nice assisted living place for her. But considering her situation (she was not going to live for another decade or anything), she could have spent much more. But even though we are in an area of some high income zip codes, I didn't really find any "higher end" places. But they must be out there. But it really wasn't clear how to go about spending more (oddly). Seems most of these places are geared towards the majority of people with very limited funds, and try to make the most of Medicare. I recall several conversations where they said "Medicare will only pay for xyz, so...", and I'd say - well, what are the options if she pays out-of-pocket, and it seemed difficult to get an answer. I don't think they know.

The hospice people were good, but looking back, I wonder if I could have just paid for an added nurse or aid to better attend to her needs. The regular staff was pretty good (she received hospice care while she was in the Assisted Living facility), but sometimes they were stretched and my Mom would wait for someone to deal with her issues.

-ERD50

 

[Midpack]

Thanks for all your thoughts folks, honestly. But I need to unplug from this thread for a while.

I was really making a statement about death with dignity laws most of all, they should exist in all 50 states for some circumstances IMO.

 

[donheff]

I'm with you on this Midpack and the programs should be accessible to real people in real time. DC passed a death with dignity act almost two years ago. About six months ago when the Washington Post reported that not a single person had yet to use it and only two doctors had signed up. The Post said local health officials put too many barriers in the way for almost anyone to get through. DC officials often over-reacts to the potential for Congress to intervene on any Home Rule actions that are the least bit controversial. I agree when the conservative approach moves the ball forward in the face of a possible Congressional veto but this seems like a complete standstill. Why bother.

 

[youbet]

Midpack....

What state is your dad in?

We had no trouble in regard to MIL's deteriorating health and "letting her go" here in Illinois. MIL (in a NH) had DNR and "no hospital" directives in place along with a hospice evaluation. This was after a series of 3 - 5 day trips to the hospital took place over a few months. She was kept comfortable and passed peacefully.

Has your dad been evaluated by hospice? How did your discussions with his doc's and caregivers concerning palliative care go? Does he have a single doc considered to be "his doc?"

Just curious, is your dad in a private pay or Medicaid situation?