End-of-life Care

The strides made in medical care over my lifetime are incredible.  We have been able to prolong life through ever evolving drug discoveries and medical technology.  Still, at some point, death takes us all.  So for children of aging parents, the question is, how much technology and medical care should be used in the name of prolonging life in someone well advanced in years - someone unable to make those decisions for themselves?  What comfort level should we aiming for?  Are we OK with our loved one struggling in anxiety and anger with the paraphernalia used to pump in life-giving substances and extract waste? 

What does it mean to allow a loved one to die with dignity?  Does the level of alertness give us the clues to follow?  Do we only make the hard decisions if someone is comatose? 

I have been spending the past few days at my mother's hospital bedside as she continually fights with her oxygen mask.  She has been incoherent and for the most part, unresponsive - we can't understand her - although she opens her eyes and nods to my questions. She has dementia, and her ability to speak has become much less recently.  Though she understands some things, she quickly forgets I've told her that she needs the oxygen to get better.

This morning, she's more alert.  Which makes her even more anxious about the oxygen mask, and now the intravenous as well.

Last night I spoke to a friend who has been visiting my mom for years...they had a close connection years ago, and she and her husband have been ever faithful to care for and about Mom.  We talked about Mom's constant irritability with the oxygen mask.  She said, "You know, your mom has the right to refuse the oxygen.  She has a right to be comfortable."  She said this with much love, as she referred to a visit they made with Mom at the nursing home, just before she entered hospital.  She spoke about the peaceful look on Mom's face as they visited, even though she was unable to speak.

Her words give me cause for thought.  How much do we fight with her to prolong her time in this, her 10th decade?  Will removing the oxygen and IV give her a certain peace, or will she struggle then, even more, against breath and dehydration?

Her increased alertness also makes for her desire to get up on her own, and want to 'go home' - back to the nursing home.  It's difficult to see your loved one tied down in a chair or bed - what's to be done?  What is the quality of life for someone requiring sedation to keep their anxiety level down? 

Is the struggle I feel more about appeasing my discomfort or hers?

My mother has always been a woman of faith - we are assured that when she takes leave of this life, she will be completely healed and living fully and joyfully in the next.  This is no justification for any decisions that we make, but certainly colors how we look at life and death.

We will see how today goes and speak with the physician tomorrow.  In the meantime, the dichotomy in my mind continues to churn, for there are no easy answers.