by Steve Rees, Ret. RN, Harpist
Dying Well
Over the past months and weeks, then days, I have participated in the death of my mother. As the events unfolded from day to day, then crescendoed into the final hours; then the final breaths, I was challenged to think of how we die. Not we as in me and my family personally, but more generally as a culture; A culture that has the technology, skills, and pharmaceuticals to prolong life well past the natural course of things, yet has not learned to differentiate between the questions, “Can we prolong this life” or, “Should we prolong this life?”
I know it seems awkward to write this article and then post it in a magazine that specializes in health and wellness, but is there possibly a “healthy” way to die? That was the question that reverberated in my mind as I watched the mortuary attendants prepare the precious body of my mother for transport and then roll her out the door to the van as my father, my sister and I held each other in an embrace that assured each of us that we had done our best and it had been enough to give our wife and mother the dignity that she deserved.
In a society that places so much emphasis on staying well and optimizing health; multitudinous diet plans and exercise routines; and health screenings and preventative medicine, so little focus is placed on end-of-life processes. I don’t want to minimize these efforts to ensure optimal health and wellness; suffice it to say that I have been involved in much of that process throughout my professional career.
What I am saying is that there is another side of the coin to be considered, and too few people that I converse with pay any attention to it. I am suggesting that there is a balance to be attained.
My mother was diabetic, blind, had several vascular surgeries, including heart bypass, and was now in stage 4 congestive heart failure. She was 90 years old and had been married to my father for 70 years. As the congestive heart failure began to take hold, she informed us one day that she did not want to go back to the hospital anymore. She asked us if there was a way she could just stay home and be kept comfortable and would we be able to support her in that decision.
Fortunately for us, we had a family member that worked for hospice services, and she cleared up our misunderstanding about how hospice works. She told us that a person does not need to be on death’s doorstep to be on hospice. The only requirement was that there was some medical supplemental service necessary to be kept out of the hospital and comfortable. They can ask their doctor to refer them to a hospice service for evaluation. In my mother’s case, she needed supplemental oxygen at times when she felt that breathing was difficult. Eventually, she would need Morphine to ease her breathing as she progressed towards the end.
Another important understanding is that Medicare will cover the costs of hospice. It has been shown that hospice care actually saves healthcare dollars because the person is not going in and out of the hospital, which is very expensive. The relatively low cost of supporting them at home makes sense on so many levels. The average person spends the majority of their healthcare dollars in the last few months of life. So, if we can take a more realistic approach to end-of-life care, we not only save those dollars but improve the quality of the life we have left to live.
We engaged a local hospice program, and from the very beginning, found all of the nurses and service people to be very thorough, professional and caring. Many times, they would see a need that we had not thought of and immediately order it, then have it out the same day. The doctor that was my mother’s case overseer came out several times to my parent’s home to see them and certify that the hospice service was still appropriate. He was also just personally interested in them; they were not just a box to check or a signature to obtain. Through the whole process many relationships were developed, and we felt that they were really part of our family.