End of life issues

Modern medicine has progressed to the point that often death comes only after you are 'unplugged' so to speak. We keep our hopes up that time will be far in the future. We plan the way we want to go with our living wills, health care proxies, etc. But I do often wonder how do doctors and health care professionals decide when it does not do any good.

I am being morbid here? I don't think so. I read two articles recently that caused me to do some thinking (which I know can be dangerous but not morbid). 

The first one discusses dying connected to a machine. Do you want to die tethered to a machine? I do not thank you. I do not want to die connected to any machine which might be the least bit uncomfortable.

There is also the issue of what could be called 'futile' care. When does caregiving stop having a benefit? When are doctors continuing to treat patients when there is no benefit? There must be a fine line where the body is too weak or sick to respond to treatment or there simply are no more treatments available. Once that line is crossed, anything more than palliative care is futile. Even keeping someone on a machine could be futile if its merely keeping their lungs breathing and heart pumping.

The article talks about building trust between doctors and patients. But this also should include patients families so they understand that there is nothing left to be done.

A doctor question.

Here is an interesting question. A woman wants additional treatment for her husband who is failing rapidly from cancer. She thinks there must be something more that can be done. But the doctor knows there isn't really anything left to prolong his life.

I am sure oncologists and other doctors are put into this position by well meaning family members countless times. There is a point where the treatment of the patient extends to the family members, especially the primary caregivers. They do not want to lose their loved one and are grasping at straws for anything to save their life.  

The article I liked to is from the physician's point of view - what should they do? Where do they draw the line? How do they keep the patient as comfortable as possible and keep the family members happy?

It is a tough question. I would not have to be the one to have to answer this. I can also see me being the one grasping at straws and asking the doctor isn't there something else to try?

I'm cheap

My husband says its a bad day when I have to pay full price for something. I hate to do that. It drives me crazy. I have been known to buy something, see it go on sale, return it and rebuy it at the lower price or just go back to the store to get the discount. If there is a way for me to save money I will. Forget about paying for shipping on line, I don't. I have a B&N card so I get a disocunt. I always order enough to get free shipping.

So how do I feel about planning ahead? I am a fan because it saves money. If you go to the grocery store and plan so you have a list, coupons and reusable bags, you save money. I plan.

But now I need to add end of life planning. Why you ask? Because it saves money. I'm that cheap. It is now proven (through yet another study) that end of life planning saves money. Also, I have no desire to end up on a feeding tube and life support with drool running down my face. Unless the IV has red wine in it.

I come from a family of cheap planners. When my grandfather died, my grandmother planned her funeral as well and prepaid for it to save money. She also had an 'in case of death' envelope which contained all the necessary information on what should go in her obituary and death notice, what to do for her memorial service, her cremation, and where the hidden silver was (my aunt was supposed to know but didn't which is good but apparently it was moved years before but that's another story). Twenty years later when she died, we had all the information we needed. My point is, and I always need a point, is that its not my fault I am such a planner, its genetic. 

Actually where I work there is an Advanced Cancer Support Group and one of the big issues is to help everyone plan their end of life with a Five Wishes directive. They decide where they want to die - home, hospital, hospice, with whom, etc.  I think it is a great idea.

So now I will have to work on my end of life planning. I also don't want to be a burden on anyone left behind. And I want to be cheap even after I'm gone.