Younger by Comparison … end of life decisions

Sometimes, when I am feeling very old, I look at my 100 year old grandfather and my 95 year old grandmother, and think, “I am a spring chicken by comparison.” While they can make me feel young, they are also a warning of what is to come. Growing old together is a wonderful thing, except when it isn’t. They live “independently” which means my aunt takes care of them and their home. They are lonely and oft times frightened about what is going to become of them. Years ago, they looked into assisted living facilities, but thought they were too young to make the move. Now, it is too late.
I write this to make sure you realize it is never too early to plan for the end of life. Much too often, when I was working with inpatients, I found myself in a conference room with adult children of a terminally ill patient who had no idea what their parent’s wishes were. Inevitably there would be arguing and tears, as no one wanted to be haunted with having made the wrong decision. Make clear your wishes now. It is a gift you give your loved ones. If it feels morbid, so be it. While we all want to look and feel younger, we are all headed in the same direction.

The following are some of the things you should consider:

Organ Donation — personal plug … do it. You won’t need them where you are going, and contrary to ridiculous belief, the doctors will not give up on you sooner because you are an organ donor.

Health Care Proxy — the person you designate to make all health care decisions for you if you are unable. Don’t do this flippantly. Pick someone who is comfortable with making difficult choices. More importantly, make their job easier by having a detailed Advance Directive.

Advance Directive — a written, legal document (you don’t need a lawyer) specifying all your wishes before you are incapacitated and unable to do this. This can be as detailed or as general as you like. For instance, mine says if I am in a coma, I’d like someone to tweeze my eyebrows bi-weekly. I don’t need everyone at my bedside staring at a scary, semi-living version of my high school yearbook picture. Click here to go to a site from which you can download advance directive forms.

Living will – this is one type of advanced directive.  It is written and can be as specific as you would like it to be.  It addresses what kinds of treatments you would want and what kinds you would refuse if you were able.  It will only be used if you cannot speak for yourself and you are in a situation that is deemed, by medical professionals, to be terminal.  For instance, if you get into an accident, everything will be done, that can be done, to save you.  Your living will would only come into effect if there was no hope for survival.

DNR – Do Not Resuscitate.  If you are in a hospital, you may see these signs over the beds of certain patients. When patients have a terminal illness or are elderly, they can choose to be DNR.  This means that if they suffer an event, like a stroke or cardiac arrest, health care personnel will not intervene to try to bring them back.  It does not mean that they will not receive the best treatment while they are alive.

Please don’t just tell your spouse or your children to “Pull the Plug” – This is one of my least favorite terms.  Doesn’t it have an awfully, easy sound to it?  People use it all the time to mean “just let me die.”  In its most literal usage, it describes the withdrawal of means (usually respirators) that are keeping a patient alive.  I have pulled the plug so to speak and believe me, it is a lot different than unplugging the toaster. Be kind to your family. Don’t stick them with the responsibility of figuring out what you would want. Just write it down, or at the very least, tell them. If you are yet to have this conversation with your parents, there is no time like the present.

Here is a touching parenting moment I read about somewhere:
My Living Will — Last night my kids and I were sitting in the living room and I said to them, “I never want to live in a vegetative state, dependent on machines and fluid from a bottle.  If that ever happens, just pull the plug.”    They got up, unplugged the computer and threw out my wine.  The little bastards.