When do YOU want the plug pulled?

In My Humble Opinion
1

Not the ‘plug’ so to speak. Life support is one thing…this is another I guess.

Backstory: My SO and I visited his mum for her 95th birthday in a nursing home over the weekend. Bit of a pointless excercise really, because mum is so far gone in her twilight state that any consciousness of what is going on around her is virtually absent. She doesn’t have any immediate physical health issues except skeletal pain from arthritis (which has progressively immobilised her over the years) and of course some degree of senile dementia which is very hard to determine because of the amount of narcotic medicaments she is on for pain relief.

It was a very sad and sorry sight. My SO only visits her irregularly because the nursing home is many hundreds of kilometres from where we live, and initially he didn’t even recognise her (another relative does visit daily). She lay curled into a sling-bed fast asleep, much like an infant. The arrival of all the family to wish her a happy birthday barely roused her, and of course there was all but no recognition on her part of who these people were. She did eventually wake and enjoyed a few mouthfuls of sponge-cake before closing her eyes and drifting back into sleep. Oh, and she’s been like this for the last five years btw.

This COULD turn into a rant, but I’d rather seek opinions about what others’ feel their “use-by” time should be. In my case, there is no freakin’ way I want to end up in a nursing home, no matter how well run and kindly the establishment might be. The minute I don’t recognise my kids, or when I spend more time asleep than conscious and aware of what is going on in the world, I’m outta here.

I regularly give instructions to my kids (somewhat tongue-in-cheek at the moment) about administering a lethal mix of some nice happy-place drug into my arm when I become a cranky old crone, but I’ve been making it more serious in more recent times. I don’t want them feeding me or changing my nappy. I don’t want them to watch my sad decline into full blown dementia or having to shake and prod me to wake when they visit. When my memory or my alertness goes, so go I…THAT is the end of my life IMHO, not when I stop breathing my emphysemic gasps or my heart goes pfhhht.

So, no plug as such, but when do you want the curtains drawn, the final encore called, the fat lady to sing in your life?

2

I’m pretty much the same. As a Catholic, on the one hand I respect the sanctity of life in any form, on the other hand I want to go sky-diving without a parachute as soon as my self-awareness dies. As a young buck, I’m hoping future advancements will alleviate the need for such a tumultous decision.

3

Pretty much if I end up with enough brain damage that I’m completely comatose, or if conscious/mobile, that I had less cognitive function than a Romero zombie. My sister and I have agreed to, quote cap each other, unquote, if we ever get like that.

Actually, we drew the line a little lower than that—even if we can still feed ourselves and use the bathroom, but we end up completely irrational, neurotic psychos, it’s time to say goodnight, Gracie.

Horribly incurable mental illness, too, for that matter, in my case. I lived with untreated OCD for a few years. I’m doing OK, now, but to go through something like that again, with no hope of treatment? I think I’d rather be dead.

4

The problem is that once you are in that state you aren’t capable of killing yourself, unassisted. Asking your loved ones to do it is asking them to commit murder and face the legal consequences.

This troubles me. No one wants to end their time like that. I wish we gave people the same consideration we give our pets.

5

I’d prefer not to live after I’m no longer useful. This includes, for me, being able to communicate with other people. So if I’m shaking and drooling but I can still safely change my great-great grandchildren’s diapers and entertain them with stories, so be it. If I need a little help changing my diaper but my mind is sharp and I can express that, so be it.

I think we’re terrified of really old people in this culture because we hide them all away, and the aging of the Baby Boomers is going to change that a lot. They’re not a generation to go gently into that good night - sooner or later, Depends are going to come in fashionable colors, and walkers are going to be fully wi-fi integrated status symbols. And maybe, just maybe, we’ll learn to value our elders again and not be so scared of granny poop.

But the minute I’m useless, I’d like to be put down, thanks. I don’t mind accepting aid, but I don’t want to be turned into a completely passive shrine to someone else’s memory of who I used to be. If I can’t talk (or type), then I’m no longer me. Communication is my key.

6

Having not been in a position where the intensity of my desire to stay alive has been tested, I really don’t know, and presumably won’t know until the time comes. And really, I’m holding out to be killed by falling space debris.

The plug won’t be pulled by anyone but me. I would not put members of my family in the moral/legal position of killing me.

I would take myself out if I were in enough pain or general misery that life didn’t feel worth living. Of course, by the time I get to that point, I may be incapacitated, and then I’m at the mercy of the health care system, heaven help me.

Similarly, I might be able to do it if I had dementia, but it was early enough that I’d still be able to act. My experience with people who have dementia tells me that this is unrealistic.

7

I came here to say how you feel right now, from a position of well being, youthful and active, could prove to be not how you feel later.

My Mother In Law and I used to discuss this quite often after she was widowed and in watching her peers face declining health and the sort of choices this forces on people.

She was strong willed and adamant that she would never, NEVER want to live with her children. Her father had lived with them for several years when she was raising her family, and, though her kids thought it was terrific, she would not hear of it, no matter the circumstance. She was very forceful about, ‘it’s off to the old age home for me!’. And she was actually quite judgmental about her friends who chose this option, very negative. She was a strong, vibrant, well spoken woman with decided opinions on this topic, and had every intention of ‘walking the walk’ when the time came. When we would talk about it, I would always say that I doubted her family would be okay with this attitude when it came right down to it.

But then, well, the time came. She had a devastating stroke that left her entirely bedridden and in need of a great deal of care. Outside of a few months she spent in full time care, (while we found and bought our house) we did that care for 6 long years. Yes, it was hard, very. Yes, she was sometimes in the old age home for short visits (respite for us) and yes, she universally hated it. She needed a lot (LOT) of care and they just don’t have the kind of staff required to provide the level of care we could in our home (with a lot of support).

It was a long and difficult journey for us all. But I learned a lot about end of life issues. Like don’t be so certain you’ll feel the same way when the time comes. Seriously. Accept that your current attitude reflects where you are right now and understand that when it’s happening to you your perspective may change.

At the end there was almost 10 wks where she couldn’t speak and we weren’t sure she even knew who we were. Those were very trying times for us, to be sure. But would I have wanted her life foreshortened? I don’t think so. I watched her effectively go through the process of dying and I couldn’t shake the feeling that it took her ten weeks because she still had some reason to live. And while that reason wasn’t revealed to me I sensed she was working through things before she was willing to let go of life. There were many times while she was in our world only a little and only for a few moments. And during those moments the things she spoke of and about made me realize that though she appeared to be doing nothing to us she was actually having a very active emotional and internal life.

Those ten weeks looked, to an outsider, like just the unnecessary prolonging of life perhaps, but to us it looked like she wasn’t yet ready to go.

And I would have been afraid to intervene to hurry things along. Afraid that those weeks she was all but lost to us, for all I know, may have been her most lucid and clear times, for her. What if your last moments are your most important moments? What if, lying in that bed for however many weeks, you’re actually doing the emotional work you’ve managed to avoid throughout your life? What if it’s really that time that allows you to go peacefully into whatever comes after?

We didn’t elongate her life with intrusive interventions, as was her wish. She was in no pain in the end. Glad as I was for it to end, I was very sad to see her go. And I miss her more than I can say.

I guess I came in here to say don’t be so sure that what you think now won’t change as you age and circumstances change. After all how many of the things you thought you were so sure about at 16 do you still feel completely sure about now?

Say whatever you feel about these choices people have to face, and what you would do, but be prepared that, like many of the things we say, “I would never…” to, sometimes things turn around and come out different than we expect.

8

When it becomes obvious to all that I no longer care about life and can’t function, do whatever moves them to do. My family that is. I trust them to make the best decision for me when I am no longer capable of making it myself. If I outlive them all, then I’ll just hang around as long as I can for spite.

9

I’m with the dominant trend here. Let me go when I’m no longer able to tell you I want to stay.

If I see it coming, I will likely make the arrangements myself to ensure that my wishes are honored and that no one else has to bear that burden.

10

Thank you for sharing your story, elbows. I struggled alot with not slipping my grandmother something that might shorten her 7 months of dying, with a tube in her throat and no way to tell us anything at all. It tore me apart to watch her like that, totally helpless to stop it.

I truly hope that what you described is what she was doing before she finally let go.

It sounds like you did a tremendous job for your mother-in-law and I hope you know just how rare and exceptional you are for being there for her when she needed you.

11

I’m pretty much sure that if I’m at the point where I can no longer give meaningful consent to a life-prolonging procedure due to an inability to understand or retain the information because of dementia, it is not in my best interest to have that procedure. That means no amputations, no PEG tubes, no IV antibiotics, no major surgery, no chemo or radiotherapy, no breathing tubes and no heroic measures in the event of a cardiac or respiratory arrest.

If I’m in a coma, I want one month, and in PVS 6 months, before artifical hydration and nutrition is removed. That time is for my family and friends to make arrangements and satisfy themselves I will not recover.

If I can still eat and drink and appear to enjoy it, that’s fine with me, feed me. If I refuse to eat or drink I don’t want artifical hydration or nutrition imposed upon me.

I don’t want anyone to euthanise me, because I think that’s a heavy psychological and spiritual burden to impose on someone. I will not be committing suicide.

I’m OK with allowing nature to take its course with some sedation and analgesia, and have been at enough “good deaths” to know that there are worse things than passing away in hospital while on a morphine/midazolam pump.

12

The moment my existence becomes more of a burden to others than a pleasure to me, I’ll take the bullet, please.

13

I’m with DianaG and others. This raises the socially complex issue of euthanasia. I’m all for it. Many countries permit assisted suicide and such measures.

If I am slowly approaching the state where I am more of a burden to others and I am not enjoying any quality of life, prep me, test me, figure out how many parts of me will be useful to others who need them, tube me and gut me like a fish. Seriously.

My existence and presence in the lives of others has little to do with my corporeal presence. I miss my Dad, he’s been dead almost 2 years now. I still have him inside of my heart and mind. When I’m essentially dead, please, someone finish the job.

My mother is a retired Hospice nurse who knows a thing or two about death and dying and has made it quite clear to me that she needs to be allowed to die if she winds up in a vegetative state.
Cartoonivese

14

I sometimes jokingly say that if I get a bad cold that I can’t shake in a week, it’s time to pull the plug.

More seriously, I have the following as my advance health care directive:

I direct that life-sustaining procedures (including artificial hydration and nutrition) should be either withheld or withdrawn if I have an illness, disease or injury, or experience extreme mental deterioration, and if doctors selected by me or by my family determine that there is no reasonable expectation that I will recover to a sufficient extent to enable me to enjoy a meaningful quality of life. It is obviously impossible to foresee all of the circumstances in which I would feel that this direction is applicable, but without in any way limiting the general scope of the foregoing direction, I would certainly include (a) my being in a coma for a sufficient period, or my suffering such brain, heart or other physical damage, that in either case it is unlikely that I would be able to perform enough bodily functions to render my life bearable and enable me to have some enjoyment out of life, or (b) my losing my mental faculties to the extent of being unable to recognize my family and friends or my surroundings, or to understand where I am and what I am doing, or to communicate coherently, and there is no reasonable expectation that this situation will be reversed.

15

I hope there isn’t a plug to begin with. I hope to be able to be coherent enough to refuse treatment that would be the start of some slippery slope. I don’t want to be revived even with the idea that I may have meaningful time left.

And I agree with

especially the bolded part.

16

The next time I get a telemarking call, espcially through the office switchboard where they are supposed to screen them out. Either pull my plug or shoot me repeatedly in the head.

17

If my husband/son/other appropriate party is in a position to pull the plug without incurring legal consequences, I would like the plug pulled when I no longer recognize them and seem to take no pleasure in living.

Although it is hard to argue with the proposition that “you may feel differently when the time comes,” I’m assuming that I won’t feel much of ANYTHING, in the way of coherent, rational thought, at that time. So what I think now should do just fine as a guide.

I think it is important to clearly communicate your wishes to loved ones while you are still mentally alert. My son is too young; it would be morbid for me to force him into this kind of a discussion. However, I have told my husband in no uncertain terms that he should pull the plug (if it won’t get him into trouble) and then feel, not only no guilt, but glad that he has respected and loved me enough to do what I wanted.

The worst thing you could do to a loved one would be to put them in a position where they were complicit in pulling the plug, but later had to agonize over whether that decision truly reflected what you wanted, or was influenced by what was convenient for them. I would never want someone I loved to live with that uncertainty.

18

Razorette and I have a small circle of friends who spend every Friday evening trying new wines and solving the world’s problems. On a recent Friday evening the issue of euthenasia came up. We agreed among ourselves that Oregon state law allows euthenasia (maybe it does, maybe not; in our world, it does). We further decided that we are going to devise an intelligence/memory test that each of us is to take every year after our 65th birthday. When any one of us fails the test, it’s time to “move to Oregon.”

On a more serious note, my wife and I both have iving wills that have explicit instructions and leave almost no discretion to family members. The bad news, according to our attorney, is that the will is really nothing more than an instruction to our families, and that it’s possible for them to thwart our will. On the other hand, we’ve talked it over with our sons and both have agreed to honor our wishes, no matter how painful to them it might be. We even jokingly indicate our three acres of land and say, “Then all of this will be yours!”

19

Soon. :frowning:

20

This brings up a good point. My son is a bit older than yours, IIRC, but the Terry Schiavo case really helped us discuss this issue as a family, and we all weighed in on it, even him (12 at the time). It started off as a Current Events discussion over dinner, and then I turned it into a “what would you want if you were in her position?” discussion. It was very insightful, into his thoughts around death and dying, and also around living and loving.

I also feel better know that HE knows what I want and what his father wants, so there’s no danger, Og forbid it should happen while he’s still young, that he will think I “killed” his father or vice-versa. He knows for certain, from our own mouths, that we don’t want hydration or nutrition for more than a week, or six weeks if two out of three doctors surveyed think there’s a chance for a meaningful recovery. The last thing I want is for my family to be fighting over my deathbed, so everyone gets to hear it from my mouth at least once, in addition to having it in writing.