I am experiencing the impending death of an elderly family member, our matriarch, my Granny. Thankfully, she will be able to pass on in peace. Our family knew what she wanted the end of her life to look like. We had very much agreed with her wishes.
Despite whatever differences our family may have on other fronts, we are a unified front for her now. We are sure about our decisions for her. When a doctor had come in and suggested she be transferred to a large medical center for very aggressive treatment we were able to smile and nod in understanding. Her kidneys have failed as a part of the dying process and her doctor wants to help by “fixing” this. Most of the people in the small community my Granny lived in knew her well and this doctor is no exception. He wants to do everything his training in the healing arts has given him to stop death. It is his imperative. When we were able to talk with him and describe what we knew were her wishes, he understood, but seemed defeated somehow.
I have worked in intensive care unit settings as a respiratory therapist prior to becoming a doctoral intern in psychology. I have assisted in brain death determinations on patients a day old to 104 years old. I have been a part of ethics committees questioning the continuation of aggressive treatment via life support. I have been in situations where a very few medical staff, usually three of us, an MD, RN, and RT, remove life support alone because a dying person’s family has fractured and no one can emotionally or physically attend the death. I have seen and heard reactions to death by medical staff despite the denial that they are affected. Broken professionals are leading broken families at times and creating poor outcomes for dying patients.
What is a “poor outcome” in death? The medical community most certainly identifies death itself as a “poor outcome.” Aggressive treatment is used too often with dying patients and this is something I personally identify as a poor outcome. The message that there is still hope is easier to deliver than there is no hope. I disagree with the idea that there is no hope in the dying process itself, if it is recognized. There have been great strides made in awareness of death and dying, but too many still die in pain and with modern medicine trying valiantly to “save” them. Why? Most medical staff in intensive care units know they do not want the same measure of treatment they provide to others every day. This should provide a better guide in the care administered in these settings. The more I practiced in medical settings initiating and maintaining life support, the more times I administered care I would personally never want. This happened to most all I worked alongside regardless of religion, culture, or creed.
I hope at some point to be able to help other families and medical teams in providing a death like my Granny’s for others–where there is a sense of calm and not a flurry of anxious activity meant to avoid what cannot be avoided. Our family and her medical team are sitting with her calmly. There is no push to “save” a life when the proper course is to simply be with a life until its end.
Rain Blohm, MS
WKPIC Doctoral Intern