End of Life Care Plans

Syndicated from Madness: Tales of an Emergency Room Nurse by Girlvet, December 16th 2010.

Do you have a plan for End of Life Care?

According to a story on 60 minutes in August of this year, we spent $55 million on end of life care last year. People are dying when this money is spent. The thing is we won't let them.

Who makes the decision to keep someone going with procedures, more tests, etc. when someone is dying? In my experience it is the family, often the son or daughter. I would be willing to bet that 90% of us have never discussed what our parents, let along spouses want done, if they are dying. Sons and daughters, spouses have a hard time letting go of a loved one naturally. No one wants those they love to die. So often times mom or dad are kept alive on machines until it is obvious nothing can be done for them or they die whether you want them to or not.

My mother had dementia at the end of her life. She was physically in pretty good shape, considering she had smoked for 60 years. She was in a nursing home. She developed a UTI. Routine, no big deal. They sent her to the ER. Because she seemed sicker than a normal UTI, they admitted her to tele. Overnight she had trouble breathing and ended up on ICU on bi-pap. She was septic. Everything started going downhill as her organs malfunctioned. The choice was intubate her and do a whole bunch of stuff or let her go. She probably never would have got off the vent.

We let her go. I don't think I ever specifically discussed what she wanted done. Even some one like me, who has seen death, seen people try to make decisions in these kind of situations, hadn't had that talk. I knew my mom wouldn't have wanted to be kept alive with machines and medications, so my brother and I let her go. It was hard, but it was the right thing to do. We spent her last day around her bed. It was hard. My mom and I were close. It was a very difficult decision to make.

I see a day coming where it will be required that everybody in this country have a plan for end of life care. I also see a day of rationing of health care like they do in some other countries. It is inevitable. The expense is too great.

Have you discussed a plan with your family members?