When to pull the plug?

The ever so smart 'them' tell us to have the important discussions ahead of time. You know the discussions about life support, casket choices, funeral ceremonies, and all that. Those uncomfortable discussions that should not be avoided.

The young man in this video was taken off life support at his request and died shortly after. You need to watch the video to get the whole story.

I fully support this decision. He made his opinions known prior to his fall. He repeated his wishes twice to the doctors and to his family members.

I am so glad that there was no dispute, no need to call in lawyers and get a judge to sign off. This is the way that these decisions should take place - with no fanfare, no discussion - just the confirmation needed.

Hospice shouldn't be a 'bad' word

What do we think when we hear the word 'hospice'? Face it, you probably think 'they are a goner' and wait for a funeral notice. How supportive and positive is that?

I have long suspected that hospices are not as bad as we think. Yes they offer palliative care when patients get to the point where they are no more treatment options. But they offer an alternative to nasty treatments. If you were the patient, how do you want to spend your last days/weeks/months?

Choice A is undergoing aggressive treatment which cause all sorts of nasty side effects resulting in discomfort and unpleasantness and you are either a patient at the hospital or taking frequent/daily trips for addition medical adventures? Choice B is receiving palliative care where your comfort is of utmost importance that is offered either in the privacy of our own home or at a facility which is quiet and full of caring people focusing on pain and your and your family's emotions?

Me I want choice B? I am a wienie. I do not want to die full of tubes and pain. I want to to go quietly (after trying as many options as are available). I do not want pain. I do not want to die alone in a hospital. Let me go write this down before I forget so that when the time comes my wishes are honored. (Damn, I'm turning in to my grandmother who had an 'in case of death' envelope - 2 by the time she died at 96 - full of little pieces of paper with instructions.)

A friend of mine who died from breast cancer a few years ago was receiving hospice care at home. I visited her about a week before she died and brought her take out Pad Thai. She was happy, cheerful, and on oxygen. Her mother and step father were visiting for a few weeks. But while there was no hope for treatment, she spent her last days pain free, living with her family and visiting with friends. That's the way it should be.

Hospices are trying to rebrand themselves in terms of the care they offer. People think of hospices probably just as you do - the goner thing. But hospices offer palliative care for months where people actually live longer and more comfortably than those undergoing aggressive last minute treatment.

One of the problems is doctors are referring people to hospices later and later. There are several theories on this including costs - hospice care costs less than hospital care but that means the hospitals lose the income from the patients. Also, doctors may be hesitant to admit they can no longer help a patient and by referring them to hospice, they are admitting defeat

Me I'll be signing up for hospice care when I need it. But I hope that is many years from now.

So what do you want?

No not at the drive through, but at the end. At the end of life. Do you know what you want? Do you want hospice care, do you want to fight until the bitter end, do you want to take the opportunity to die at home?

No one wants to die but its going to happen to all of us at some point. There is always the possibility we will be hit by a bus tomorrow and that's it. No questions on end of life treatment. Or you can get a terminal diagnosis tomorrow with 4-6 weeks left. So what do you want?

Apparently its not just for you but for your family members. If you have solid plans that are shared with family they do not have to go through the agonizing process. And it has long term effects in less depression in family after the death.

Funerals and deaths are all about those left behind. They may be for the dead but they really are for others still alive. So do your family and friends a favor and tell them what you want.

This is what I want - a do not resuscitate order, no last life extending treatments, I want to be peaceful and die comfortably - either in a hospice or at home. But first I will host my own memorial service - a big bash that I can attend with all my favorite foods (and if you don't like them, tough cookies), live band, dancing, and lots of fun. So in another few decades, look for your invitation to the party of the year. Then you all can figure out what you want to do after I'm gone.

Its a different perspective

There is a 20 year old woman in the US who has had cancer for ten years of her life and has now been told that she has between six weeks and four months left. Her friends threw her a bridal party complete with a wedding gown and it will be featured in an upcoming issue. She doesn't appear to have a boy friend who she might be marrying but I think she just wanted the party.

On one hand, it seems a bit silly. Why go through this party stuff if she's not getting married? But on the other hand, if it is something she wished she could have done - get married that is - there is nothing wrong with it.

I think if someone told me I had between six weeks and four months, I would start making a list. Often people just die with no notice. You could get hit by a bus, be in a car or plane crash, fall off a ladder, hit your head diving into a pool or lake, or any number of reasons. You have no time to get your affairs in order and figure out what you want to do before you die because you don't know you were about to go.

If I knew I had at least six weeks, I would start planning. I would plan my funeral and figure out what I was going to be cremated in. I would figure out what I wanted done with my ashes. I would go on a few trips. I would walk on the beach as much as possible. I would forget about my diet and eat fried clams as often as I wanted. Ice cream every night as well. Sit out in the sun with no sunscreen - I'm not going to be around long enough for wrinkles and I might as well have a nice healthy tan. If it was winter, maybe I would go skiing one last time. It would not matter if it made my back hurt. Because I would not have to worry about doing long term damage. I could have a lot of fun.

There's a country music song that talks about living every day like you were dying. Hmmm... its all a matter of perspective.