For the last several years, we have been dealing with my father who has had several strokes and is in pretty bad shape these days. He can’t do anything anymore. Can’t get out of a chair, go to the bathroom, go to bed or get out of bed without assistance. We finally had to put him in an assisted living place because my mother just can’t do it by herself anymore.
My father is unable to do the things he used to enjoy. He can’t read a book which he would do all the time. We have been getting him books on tape but I don’t think he understands them and with his short term memory being shot, he can’t remember anything other than from his childhood or military service. After listening to a book for a while, he seemed to get annoyed with it and want to turn it off even if it was on a topic he’d normally love.
He does have a living will with a do not resuscitate order. I just wonder if there should be something else included. For me personally I would say if I was in his condition I would not want to go on anymore. Sure, I’d be alive but I wouldn’t be living. I’m sure if we asked him before all his problems he’d have said the same thing.
I’m reminded of the scene in Soylent Green where the old man goes to the suicide clinic is given some medication and watches scenes of nature with classical music as he drifts off. It has been a few years since I’ve seen the movie but I really think that is a very humane way to treat the end of life. Keeping people alive at all costs now seems rather cruel.
If I was in my fathers position I would definitely prefer to listen to Gustav Holst’s The Planets while watching space scenes on a big screen as I drift off into my eternal sleep. I’m sure my father would enjoy the same type of death. I do hope if I ever get into the same situation that my father is in, society will have progressed enough to realize that death is not a bad thing. In some cases it is preferable to the alternative.
Just hope that by the time you are apt to be in his condition, society will have matured.
But cases like Terri Schiavo are still going to happen.
Just reading that: The President of the United States of America returned from vacation early to sign a law forcing the poor woman to be kept on artificial “life”.
Just make sure you don’t end up in Florida or Texas.
I don’t think we’ll ever get to a point where we can ask to be killed if X happens. I do think that being able to choose death will be considered fairly normal for people with terminal illnesses or chronic severe pain who are sane.
Even if we did allow this, all it would take would be someone filiming doctors chasing a guy in a wheelchair with a needle yelling, “But sir! You requested this when you lose your mental competence!” “Go to hell, you bastards, you ain’t killin’ me!”
Maybe his life is not as bad as you imagine. Maybe he takes whatever pleasure he can from what little is left to him, and maybe that is better than nothing.
I’m sorry you’re dealing with this, Cumberdale. I’ve been there, with my grandmother and Alzheimer’s, and my mom is showing signs, so I know I’ll be there again before too long, and…well…it’s genetic, so chances are pretty good I’ll be the patient someday. It’s painful to think about.
With grandma, we got the DNR signed by the doctor, and then we all sat and talked to my mom, who had power of attorney for healthcare, and as a family we talked about what grandma had told each of us about end of life care. It would have been a lot easier if she had done a Living Will, but she hasn’t, so we had to figure it out together. Luckily, we all agreed, unlike many families where these discussions lead to drama and court battles.
After that, it was just a matter of time. A lot of time. When I started to get depressed sitting with her, if two myself, “she may not have much of a life yet, but I can’t change that. I can try to make today the best day it can be, though.” And so we’d go for a walk, or get ice cream, our we’d play cards with rules that changed with every hand because she couldn’t remember them…because playing cards with a friendly lady (I don’t think she knew who I was at that point) was more fun than staring at the wall.
You can’t fix this. The best you can do is communicate end of life decisions to his medical team today (feeding tubes and breathing tubes are the two big ones not covered by a DNR that I think you might want to discuss) and then you just make each day as good as it can be. Don’t compare it to the good days of the past, because they won’t compare. But little pleasures will still be had. Hold onto those.
If you would like some ideas about the kind if things to think about and talk to his nurses and doctors about, this website is fantastic. I highly recommend doing your own end of life care planning there now, so your loved ones can at least not worry about guessing what you would have wanted. Don’t make them guess. Tell them. https://mydirectives.com
I only just mentioned this in another thread: a friend of mine is about to lose his father. His father is very, very sick – dying – and has chosen not to receive food any longer. He is in hospice support, and has chosen this way to die, rather than allow the disease to torment him any longer.
No one wants this…but everyone accepts it. It’s not unreasonable. The pain, and the side-effects of the painkillers, are too much to withstand. It would be monstrous to use force against him to make him live further, in agony, when this, as sad as it is, is the most reasonable way to leave life in his particular case.
Other cases may differ. (I don’t support the use of suicide to end the lives of severely depressed individuals. In most such cases, therapy exists that can restore a reasonable quality of life.)
(I also want strong protections against abuse, so that no one is ever pressured to end their lives – say, by relatives who are eager to receive an inheritance.)
Oregon has a ‘death with dignity’ law on the books, which is one reason we live here. The qualifier is that you are required by law to administer the cocktail to yourself and to be able to communicate to the person licensed to give it to you that you know exactly what the result will be.
But you are not in his position. It is still his life, limited as it may be. Have you asked him about this? Has he communicated a wish to die? Have you discussed this with your mother?
True, it is his life and at least I haven’t discussed it with him since his troubles. However, we did discuss it before and if he knew, he would have said not to call the ambulance after his last stroke. As he is now, he’ll pretty much agree to anything, whether he understands or not.
Yes my mother and siblings have discussed this and we all feel guilty for thinking what we think but again he did make his thoughts known before all this happened. Of course none of us are going to do anything to hasten his death. We just know he wouldn’t want this however we’re still going to do whatever we can to make what time he has left as good as possible and we won’t just shove him somewhere out of site and out of mind.
Has the doctor given you a timeline? Does he expect that your dad has less than 6 months left? If so, I’d urge placement into hospice. Either home hospice, if you have people to act as caregivers, or inpatient hospice if you don’t (I’m guessing you don’t, since he’s in assisted living).
In hospice, the focus is on making people comfortable and making each day as pleasant as possible, but not on curing them. His pain (if any) will be managed, he will be well cared for, but if he has a DNR and is in hospice, then they won’t subject him to measures designed to extend his life or fight his disease. (Although a DNR is not a requirement for hospice, but many people, even many nurses, believe it is. If a patient has a DNR in hospice, they will do CPR if their heart stops beating. So make sure his DNR is up to date; they expire after a year.)
You can always, at any time, take him out of hospice care. If he gets pneumonia and you find that you and your family don’t want to let him go, and want that treated, you have him discharged from hospice care so he can receive treatment for the pneumonia. You can re-enroll him in hospice again if that becomes the thing you want to do.
(Please verify this information with a hospice agency in your state; that’s how it works in my state, but it may vary.)
So if you and your family all agree that letting nature take its course is the best way to go, and his doctor agrees that death would not be unexpected in the next 6 months, then ask his doctor for a referral to hospice.
This is the part that scares me. I am one of those people who thinks differently. Every time I start to believe that this should be a personal choice, and that if people choose to be killed because they are old and sick, then that’s their right, someone comes along who presents the argument that everyone should want the same thing. I have said it before – I will support your right to choose to die if you can guarantee me that my right to live will be respected and upheld absolutely. But I can see how easily we go from “right to die” to “well, I can’t understand why anyone wouldn’t want to die” to “everyone should want to die” to “let’s just kill everyone who is old, in poor health and unable to protest.” How do we prevent families from pressuring the old and infirm to sign away their rights – especially when inheritance is involved? Or does it just not matter because you “can’t understand anyone who thinks differently”?
If you truly support a right to die, then you need to support a right to live as well. Because until you do, I can’t support your right at the risk of losing my own.
For the record, most of my family doesn’t agree with my choice, but I’ve made certain that they know what it is. My Mom and I have a deal: she will keep me alive, and I will pull the plug on her at the first opportunity.
Slippery slope is a fallacy. That does not mean slippery slopes don’t exist. If most people choose to die, then those who choose to live will be regarded as leeches and selfish moral degenerates.
And herein lies the rub. In a case as posited by the OP, no one can ever know for sure what the patient is expriencing. The case of an assisted suicide where the patient can, as Chefguy mentioned, communicate understanding and self administer is different. It’s the cases where the patient cannot communicate but still has measurable brain activity that make end of life decisions extremely difficult - and certainly not black and white. There is no verifiably right answer at that point. My view in that type of case is to err on the side of life. YMMV.
This is not some hypothetical. It is something that has happened to me not only IRL, but in this thread. How is a person who wants to be kept alive supposed to respond to someone who says, “I cannot understand anyone who thinks differently”? What if it is your family, telling you that they don’t accept the validity of your position. And why is no one (other than my mother) just willing to make the agreement with me – sure, if you will allow me the right to die, I will allow you the right to live?
I’m not sure who “no one” is, unless you mean friends and family, who I can’t answer for. But the default medical position is to save and prolong your life unless you’ve left instructions to the contrary. So in that sense, everyone agrees with you. Personally, I agree with you…for you. That’s why Advance Directives are so important. They’re not just for, “I don’t want a feeding tube,” they’re also for, “I definitely want a feeding tube, and a ventilator, and I don’t care if you have to drug me unconscious to tolerate it.” That’s my dad’s wishes, actually. My mom is ready to die if she gets a bad hangail. I, and their doctors, will treat each according to their individual wishes, because they’ve let me know what those wishes are.