The end of life: when an important conversation is often a difficult one
Gallup Park 2010
Dennis Sparks | Contributor
The most difficult and perhaps the most important conversations we can have with loved ones and doctors concern our preferences regarding the care we wish to receive at the end of our lives. Our culture makes it easier to talk about our sexual predispositions and personal finances than the quality of life we would like in our final weeks, days and hours. As a result, many of us avoid those conversations until it is too late, and, as a result, we are subjected to treatments that not only diminish the quality of our lives but also shorten them.
Everyone benefits from conversations about end-of-life issues we initiate with family members, health care providers, and clergy or other spiritual advisers. We can use tools such as “Five Wishes” to clarify our thinking, knowing that we can always change our mind if new conditions present themselves.
Such conversations not only ensure that our end-of-life care matches our wishes, but also they remove a substantial burden from families who are too often required to make consequential decisions in stressful situations with little or no guidance. These difficult but important conversations are a priceless gift we give both to ourselves and to our loved ones.
Dennis Sparks’ “Things Observed” essays and photos encourage readers to see familiar things in new ways. He can be contacted at dennis.sparks@comcast.net.
Comments
DoctorDA
Sun, Aug 15, 2010 : 5:45 p.m.
As an Intensivist, one who cares for "the sickest of the sick", I applaud education directed at the lay public which promotes discussion on End-of-Life decision-making. This has been a subject of great interest to me both on a professional level (how to best serve my patients and their families) but also on a more personal level with my own family. One of the most painful decisions we can make is how far to advance with medical care. Caught in that decision with my own loved ones, none of us wants to "give up too soon" and for each of us "too soon" is highly specific and individualized, enmeshed with our own core value systems, if you will. And yet, some of the worst heartache I have seen for families has been when the person has not informed his or her family in advance what they wish and there is no "right answer" medically. Even the strongest relationships can be taxed when medical science fails to give clear answers as to what to do next. Some families choose to prolong the dying process beyond reasonable hope, paralyzed by the decision. Others fight viciously, and still others choose not to even discuss the issue. By way of stark contrast, families who have had more than a cursory discussion about whether or not to engage life-supportive measures prior to a life threatening event tend to experience greater relief when we are all able to point out that this was their loved one's choice. As a doctor who has these discussions with families regularly, I often having never met the family or the patient before the life-threatening illness. My observation is that when done in a loving, compassionate way, families can have this discussion long before any threat of illness with less sadness. Later, when the choice needs to be made, it is a gift for the patient and his or her family that they do not have to rushedly decide and agonize over "what's right." So, my hat's off to your blog and it's embedded reference as to how to speak with your doctor!
CommonSense101
Sun, Aug 8, 2010 : 7:42 p.m.
Indeed, it's irresponsible not to have "end of life" discussions with loved ones. After all, we are born to die. It's never too early to talk about the potential for death and one's wishes. Even parents to be should get on the same page before the birth of a child just in case the unthinkable happens. There should be no surprises and no delays when one's time comes and decisions are required. To prolong pain and suffering is, also, irresponsible.