Monday, March 7, 2011
I am very much for end of life care. I feel that someone at the end of their life should be let go peacefully instead of being put through painful tests and procedures, generally prolonging things for a long time.
Recently we had a very sick cancer patient whos wife would not let him go. He would be admitted, discharged, re admitted, re discharged, over and over. Despite all the counceling the wife received, she refused to put him on hospice. It got so bad that the hospitalists got the ethics board involved b/c the care was so futile. Finally, after a lonnnng and painful course, the patient died.
Yesterday I had a very different experience. I had an 85 year old female come in from home with her daughter. Her daughter had been caring for her since her stroke 3 years prior. She was unable to talk and could not eat on her own. Her quality of life looked very poor. She came in for decreasing mental status. She looked very ill. It was obvious she didn't have long left if we did not get aggressive in treatment (including a ventilator).
Of course, she was a full code. I had the normal talk with the daughter. Most families that I deal with refuse to make the patient DNR. They usually want everything done. I think there is guilt involved....maybe they think if they make them DNR they are saying they don't love or care anymore. But this patients daughter was very rational. She said, "you are right, she has suffered enough. Just make her comfortable."
So I got them both a blanket, turned down the lights, put on some music, turned up the oxygen, made the room peaceful, and gave just a little bit of pain meds. I checked on her every 20 minutes.... more so the daughter felt like I was doing my best to keep her mom comfortable. Within 2 hours she died....peacefully. I hugged the daughter, called the chaplain, and it was done. No dragging things out.
Maybe I'm just a death panel liberal, but I think this is the right way to do things.
Posted by SerenityNow at 7:48 PM