Why Are We So Afraid To Let Our Loved Ones Die?
The ultimate act of selflessness is allowing your loved ones to die in peace.
I worked in Intensive Care units for most of my adult life and my professional career; there was always one thing that I never understood.
Why do family members rarely respect the wishes of their loved ones
In my 15 year career, it is the one thing that I never fully understood. I mean, I know “you don’t want them to leave you” how much more selfish can we as a human species be when you see your family member suffering from a tracheostomy, fed with a g tube.
It means you can no longer eat, need assistance breathing, bathing, and help with the bathroom. If you are reading this, I am sure you might think I am exaggerating, and I wish I were. I do not exaggerate on such a serious topic.
People who can no longer take care of themselves in the US get placed in nursing homes. Yes, and you all know at least one or two in your town.
Imagine every city in the US with a few of these beauties. They are horrendous and an abomination; I do not support the nursing home industry.
Most people inside did not receive the chance to die with dignity; someone in their family took away from them. Okay, not all of them have had the opportunity to die taken away from them, my grandmother had the chance to die, and she refused.
Let me tell you the story. Not your usual account; most of those allowed to pass will take it. Not my grandmother and I know why, but that is a story for another day.
I have a grandmother; she is in her mid 90’s, she is in a nursing home.
Six years ago, she was taken from her assisted living facility and brought to the ER; she fainted again at dinner. Grandma has been passing out for about ten years; she goes to the hospital, gets some fluids, and is released home.
Sometimes her electrolytes are low, and usually, it is her blood pressure; she has always had low blood pressure, and I, too, have this same issue. Yet I am not an 80–90-year-old woman; my body can sustain it.
So yet again in the ER. My aunt calls me and says her Potassium is also low; they want to admit her and monitor her heart. When your Potassium is low or high, it can lead to cardiac arrhythmias.
I say okay, what are the doctors saying and nothing unusual. I am the only medical professional in the family so far, nothing abnormal.
I told my aunt I would see her on my next day off, which was in a day or so. I went after work that night because my aunt called me in a panic, my grandmother had decided to stop eating.
I tell her it’s okay, and if you know anything about animals near the end, they stop eating before they die; it’s a natural way to ease the process. Many elderly stop eating or have decreased appetites, such as my grandmother.
She is in her 80’s; if it is her time to go, it is her time to go. She has an advance directive saying DO NOT RESUSCITATE or INTUBATE.
She wanted to die in peace; she does not want anything out of the ordinary done, most elderly patients have this now, and they obtain it while they are “Sound mind and body.”
It’s legit; it’s legal, let them go in peace, I beg of you.
Did you know that you can overrule their wishes if you are Power of Attorney?
I am not sure how legal this is, but I have seen it done so many times, making me sick each time. The family members love to take over control, whether for monetary reasons or they are not ready to let them go; the grounds are always selfish and make me want to throw up.
I was always the only and first nurse to call palliative care to have them keep an eye on the patient, and it’s the ethical thing to do.
Let them die in peace, and it is their wishes. Yet it usually does not go this way unless you have a nurse like me who believes in death and will always be a patient advocate even on their death bed, even if it is my grandmother.
Also, my family knows I will pull their plug without an issue. Now it’s a running joke, “don’t get sick; Sara will pull the plug”, it is a joke, yet they all know it’s the truth. And have each talked to me and designated me the “plug puller.”
Maybe I am cold, or perhaps I respect death and a person’s wishes even in the end.
Grandma ultimately got admitted for FTT, better known as failure to thrive, so she was receiving fluids, and since she was a DNR/DNI, the only thing to do was to treat her, but nothing invasive.
Which is fine; she got some fluids and pain meds if needed. Speech therapy to evaluate her swallowing and speaking. She did not want to eat and would tell us no.
A person can go for quite a while without eating, and she is receiving hydration. My grandmother also had a diaper, which she said kill me before I ever have a diaper. I am not into killing patients; that is a different kind of medicine.
Each day we were at the hospital with her, at one point, my grandmother became unresponsive still with her DNR in place; they would not intubate her.
Unconscious, yet her vitals were rock stable; she was breathing on her own; this was not an emergency in my eyes. I told my aunt, I think this is the time, and she started having what we know as the “death rattle” in her breathing.
We at this point called the family, and my siblings were all there since I told them; I had seen this a thousand times, and it could be the end.
My aunt decided to call her “best friend,” also a nurse. She has not worked at the bedside for over 40 years for a consultation. In the meantime, I tell the nurse we want hospice called and palliative care if we need them in the hospital.
We needed to arrange for her to go home on hospice. After my aunt spoke with her friend, she decided to call A GI doctor to have grandma evaluated for a Gtube so she could “eat” and what she thought “wake up.”Shaking my head, but she’s the POA, but I had a plan.
Now is when it got fun, and I seemed like the biggest bitch in the world, but I would do it all over if I had to.
I decided to take the week off work and go into the hospital early. I know doctors round early, and the GI doctor would be rounding; I caught him before he spoke with my aunt and asked him to give me his honest opinion, and I did not want the Gtube, but I was not POA; it was my aunt, and she was a mess.
He said if she wished to do it, we would do it, and I explained I am a nurse and know how this works; then he told me he thought it was a bad idea and would make things worse; I said, please tell that to my aunt.
Side note why can doctors not be honest?
He was frank with me because nurses and doctors have a bond; we speak the truth to one another.
So he said he would speak with her, he called her; naturally, my aunt came to the hospital a mess. I had to tell her that my grandmother did not want that and why she would keep someone alive who would end up a vegetable in a nursing home.
I had to be blunt and to the point; sometimes, you have to be honest. I said we could make her comfortable, take her home, and visit with her.
If she goes to a nursing home, she will get bedsores, infections, and in and out of the hospital, plus that tube feeding shit is toxic chemicals and disgusting.
I asked my aunt if you were lying in that bed would you want me to tube you and shove you in a nursing home to rot?
That is what you are doing to her. After some time, she agreed with me, and we took her home on hospice.
My grandmother was lucid; she would come in and out of consciousness, still not eating and refusing pain meds. The death rattle was still there, but not as bad as in the hospital- as a nurse, that is weird, 99.9% death rattle =death.
My aunt’s friend also came to visit, and she has always been someone I admired and looked up to, she told me that it was inappropriate to do what I did, and the first time in my life, I looked at her and said, you are wrong, and I’m afraid I can’t agree with what you are suggesting.
That was the last time I spoke with her.
My grandmother was like that for 21 days exactly, then one day, my aunt called and told me to come to visit, so I did.
Guess who was up walking around the apartment, and we went for a walk around the block, my grandmother.
I have no idea what to say, except sometimes not interfering with the course of nature is the best thing to do.
My grandmother is now in a nursing home because my aunt can not care for her, but she is still walking around; she does not speak much, but we are not doing anything to keep her alive, a few medications for her cholesterol but nothing life-altering.
So sometimes, no intervention is the best intervention. Instead, we as humans need immediate results. Trach, peg, and send them to the SNIFF, but they are still alive, and most people are selfish assholes and do not think about the person and what they would want.
So put yourself in the shoes of those dying. Would you like to die with dignity or be shoved in a nursing home ridden with disease, Cdiff, MRSA, infections, understaffed now with covid?
If you asked each of those people when they were still coherent what they would have wanted, they would say to die in peace at home surrounded by those I love.
Now please give your loved ones that same honor. The elderly deserve respect, and dying with respect is the ultimate act of selflessness that we humans can do.
XOXO
S.
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