Friday, September 26, 2014

Aligned in death

a good deathDeath is a certainty for all of us, but the “where” and “how” are increasingly our own choice.

I’ve been in the room for a handful of deaths and have heard clients and friends recounting stories about many more.

Contrary to what some may believe, there are good deaths.

Hildy’s was one.

Hildy was the elderly neighbor that my husband, Peter, and I cared for. Her death at age 86 was quite remarkable.

She was at home, in her own bed. She had ceased eating and drinking a few days before. Her breathing was not labored but slow, intermittent and shallow.

Although she could not talk, we were told she wasn’t in any pain.

Her favorite music was playing. The window shades were open to reveal her lovely rose garden.

Her friends and neighbors had been by, one by one, to visit and let Hildy know how much she was loved.

Her husband, Fred, was not anguished. He held Hildy’s hand lovingly, expressed his devotion and reminisced about the good times during their 60-plus years of marriage.

There was a nursing student in the room to ensure Hildy was clean, warm and comfortable at all times.

When Hildy died, we called hospice and they came to the house and called the mortuary for us. They waited while we said our goodbyes to Hildy and were there to comfort Fred, Peter and me after her body had been removed.

At the time we had no idea how we contributed to Hildy’s good death.

Because she had not expressed her wishes to anyone, Fred, Peter and I did our best to create an environment we thought she would have wanted.

As is often the case, some of our own values influenced our decisions for Hildy too. With Fred’s permission, we urged her doctor to place Hildy on hospice and discontinue any medical treatment meant to cure her. We were diligent in making sure she was comfortable and pain-free.

Today, with a lot more knowledge about death and dying, I can see the important role we played in Hildy’s good death. Because none us had “the conversation” with Hildy or each other about her wishes, things could have turned out quite differently.

Somehow we were aligned, and that helped to make Hildy’s death a good one.

My friend Linda, one of five children, had a very different experience.

Linda and her two sisters took turns caring for their mother as her condition worsened. One daughter provided handson care, another was the power of attorney, and a third handled financial affairs.

The daughters, each a strong personality in her own right, had differing views on how mom should be cared for and were never aligned with each other or their mother’s wishes.

As Linda’s mother grew sicker and weaker, she found herself in a revolving door of hospital visits.

During her last and final hospital stay, she had a stroke and a heart attack.

Her advance directive was not very clear. Four of her five children were at the hospital and could not agree on whether to resuscitate.

Linda said her final and lasting memory of her mother was of her having her ribs cracked open during CPR, which was to no avail.

Linda’s mother’s death was not peaceful, and it traumatized my friend. She tells me how she wished she had known then what she knows now.

When I talk to people about the kind of death they want to avoid, almost everyone has a story to share. Many of them are like Linda’s.

On Tues., Sept. 30 at Senior Concerns, 401 Hodencamp Road, Thousand Oaks, we will host a panel presentation, “The Final Exit: Creating a Loving Experience for You Both.”


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Tags: death,hospice,POLST
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Tags: end-of-life conversations

Andrea GallagherAndrea Gallagher

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