Choices

[Deleted]

I have told DH in very specific language that I do not wish to be intubated.  He will not give me any direction on his wishes, saying "I'll tell you when the time comes".  I don't know what scares me more, the thought of lingering when he can't or won't remember my wishes, or the thought of having to live with him intubated until he dies.  He refuses to understand that he won't be able to tell me, that I will be left with an agonizing choice, certainly facing legal pushback from his family.  We hold one another's medical powers of attorney, and that scares the crap out of me right now.    

[Tennesseer]

Not surprising, donethat.

My sister's best friend is now receiving hospice care.  My sister and her friend are 67 years old.  The friend refuses to discuss with her husband or with anyone else what she wants to happen with her remains once she passes.  Will not discuss it at all.

The thought is what ever her husband decides to do once his wife passes won't really matter to his wife.  

[Tennesseer]

@donethat - have you thought about re-assigning your medical power of attorney to someone else?  Maybe someone younger than your husband?  

[justme]

I believe living wills are made for exactly this reason. I know doctors have asked about them but not sure how that gets to the hospital. My primary care is part of the main hospital here though so if I had one they'd see it too.

[Happy prose]

These living wills scare me. Maybe I don't understand them 100%. Do I want to live on tubes, etc for the rest of my days, nope. But I also want to be given a fighting chance. To me, that decision isn't black and white. I think a dr should decide, not my family who has no medical education. 

[pulmonarymd]

If I may weigh in. I apologize in advance if this becomes too long, and do not wish to offend anyone. This is my medical opinion based on over 25 years of doing critical care.

Living wills came into existence with the Karen Ann Quinlan case. She was a young women who fell into a vegetative state, and her family fought to remove medical intervention.

These pieces of Paper have significant limits. They are usually generic, and have vague and in most situations, less than helpful language. They can be helpful as a starting point of discussions, and sometimes help families make decisions. But it is a rare situation for us to remove support in an unconscious patient over a family’s objection.

A durable power of attorney for medical affairs is far more useful. The problem is picking that person carefully. Patients usually go to a default choice, without thinking if that person is capable of carrying out their wishes. In addition, many do not discuss their wishes, and then the decision maker is in the dark. Legally, we can follow this person’s lead, even over other Family members objection, although we try to get consensus.

Now, most decisions are not black and white, but require discussions about goals of care. Do you want aggressive care at the end of life, even though you have a worsening chronic disease, and are unlikely to live independently again, and will continue to require repeated hospital admissions. If you get repeated pneumonia due to aspiration, and need to eat a pureed diet with thickened liquids, is that acceptable. We cannot and will not make that decision for you. You need to decide what quality of life you find acceptable.

These decisions require ongoing discussions. For a long time, insurance did not pay for these time consuming visits, and then the death panel accusation came to the fore. Thankfully, that situation has improved, and covid has accelerated the acceptance of these discussions in many cases.

Patients are almost always overly optimistic with their assessment of their outcome, and families almost always insist on care beyond what we would recommend. Patients also do not die as physicians do. We have less intervention at the end of life, and a greater use of hospice care. Something everyone should mull over.

Just my 2 cents. Take it for what it is worth. I will not be offended if you disagree

[Tennesseer]

Being single with no immediate family, my medical decisions will be decided by my siblings if I am unable to make them myself.

If I need to be intubated, for example, I have told the sibs if it is short term and there is a very good chance of a 'full' recovery, keep me intubated.  But if I am intubated and out of it with no chance of getting better and unable to care for myself, end the intubation.  No reason to delay death. 

More than likely I will have no idea what is going on around me anyway.  The sibs are okay with making the decisions for me.  We all saw what Alzheimer's disease to our mom and though it was sad to see her slowly and eventually die, we were glad she was now free.

Death is the fare we owe for living.

[TheOtherMe]

My niece, who is a surgical nurse, is my medical POA.

When this covid thing started, we talked and I told her absolutely no intubation.  She is well aware of my other wishes and knows I have a DNR on file at the hospital.

[Happy prose]

Jul 1, 2020 7:45:02 GMT -5 pulmonarymd said:

If I may weigh in. I apologize in advance if this becomes too long, and do not wish to offend anyone. This is my medical opinion based on over 25 years of doing critical care.

Living wills came into existence with the Karen Ann Quinlan case. She was a young women who fell into a vegetative state, and her family fought to remove medical intervention.

These pieces of Paper have significant limits. They are usually generic, and have vague and in most situations, less than helpful language. They can be helpful as a starting point of discussions, and sometimes help families make decisions. But it is a rare situation for us to remove support in an unconscious patient over a family’s objection.

A durable power of attorney for medical affairs is far more useful. The problem is picking that person carefully. Patients usually go to a default choice, without thinking if that person is capable of carrying out their wishes. In addition, many do not discuss their wishes, and then the decision maker is in the dark. Legally, we can follow this person’s lead, even over other Family members objection, although we try to get consensus.

Now, most decisions are not black and white, but require discussions about goals of care. Do you want aggressive care at the end of life, even though you have a worsening chronic disease, and are unlikely to live independently again, and will continue to require repeated hospital admissions. If you get repeated pneumonia due to aspiration, and need to eat a pureed diet with thickened liquids, is that acceptable. We cannot and will not make that decision for you. You need to decide what quality of life you find acceptable.

These decisions require ongoing discussions. For a long time, insurance did not pay for these time consuming visits, and then the death panel accusation came to the fore. Thankfully, that situation has improved, and covid has accelerated the acceptance of these discussions in many cases.

Patients are almost always overly optimistic with their assessment of their outcome, and families almost always insist on care beyond what we would recommend. Patients also do not die as physicians do. We have less intervention at the end of life, and a greater use of hospice care. Something everyone should mull over.

Just my 2 cents. Take it for what it is worth. I will not be offended if you disagree

This is exactly my point! I do have one question- you stated it would be rare for you to remove support over family's objection, but would you leave a patient on support over family's objection? When I had surgery, my fear was to wind up on a vent for life. But, I wanted a chance if a dr felt I only needed a little help in the beginning. I was afraid my husband would panic and say pull the plug too quickly! My surgeon promised me he wouldn't pull the plug unless 100% necessary, but who knows. Thankfully it never came to that.

[Happy prose]

Jul 1, 2020 8:55:50 GMT -5 TheOtherMe said:

My niece, who is a surgical nurse, is my medical POA.

When this covid thing started, we talked and I told her absolutely no intubation.  She is well aware of my other wishes and knows I have a DNR on file at the hospital.

But many people are only on the ventilator for a short time. You wouldn't want that, even for a few days, if they gave you enough drugs? 

[pulmonarymd]

Jul 1, 2020 11:26:39 GMT -5 Happy prose said:

Jul 1, 2020 7:45:02 GMT -5 pulmonarymd said:

If I may weigh in. I apologize in advance if this becomes too long, and do not wish to offend anyone. This is my medical opinion based on over 25 years of doing critical care.

Living wills came into existence with the Karen Ann Quinlan case. She was a young women who fell into a vegetative state, and her family fought to remove medical intervention.

These pieces of Paper have significant limits. They are usually generic, and have vague and in most situations, less than helpful language. They can be helpful as a starting point of discussions, and sometimes help families make decisions. But it is a rare situation for us to remove support in an unconscious patient over a family’s objection.

A durable power of attorney for medical affairs is far more useful. The problem is picking that person carefully. Patients usually go to a default choice, without thinking if that person is capable of carrying out their wishes. In addition, many do not discuss their wishes, and then the decision maker is in the dark. Legally, we can follow this person’s lead, even over other Family members objection, although we try to get consensus.

Now, most decisions are not black and white, but require discussions about goals of care. Do you want aggressive care at the end of life, even though you have a worsening chronic disease, and are unlikely to live independently again, and will continue to require repeated hospital admissions. If you get repeated pneumonia due to aspiration, and need to eat a pureed diet with thickened liquids, is that acceptable. We cannot and will not make that decision for you. You need to decide what quality of life you find acceptable.

These decisions require ongoing discussions. For a long time, insurance did not pay for these time consuming visits, and then the death panel accusation came to the fore. Thankfully, that situation has improved, and covid has accelerated the acceptance of these discussions in many cases.

Patients are almost always overly optimistic with their assessment of their outcome, and families almost always insist on care beyond what we would recommend. Patients also do not die as physicians do. We have less intervention at the end of life, and a greater use of hospice care. Something everyone should mull over.

Just my 2 cents. Take it for what it is worth. I will not be offended if you disagree

This is exactly my point! I do have one question- you stated it would be rare for you to remove support over family's objection, but would you leave a patient on support over family's objection? When I had surgery, my fear was to wind up on a vent for life. But, I wanted a chance if a dr felt I only needed a little help in the beginning. I was afraid my husband would panic and say pull the plug too quickly! My surgeon promised me he wouldn't pull the plug unless 100% necessary, but who knows. Thankfully it never came to that.

Unless a patient stated otherwise, we will give patients the benefit of the doubt and give them a chance to declare how there disease go. Very few diseases have a 100% mortality or survival. So, you begin treatment and reassess. At 48-72 hours, you usually have a sense if they are responding to treatment. Now, that doesn’t mean I do not have a feeling as to how someone will do from the beginning, as you do develop a sixth sense after all this time, but I rarely act on it. Re-evaluation at that time can help to clarify what patients want. In my experience, we drag some of these cases out unnecessarily. We are good at prognostication at both ends, people are likely to survive or die. Much more difficult in between. Since we are talking sboug a human life, it is better to err on the side of caution.

Now, the bigger issue is what sort of quality of life is likely after someone recovers. Do you want to live in a nursing home. Or be severely limited and live a bed to chair existence. Those are more difficult questions.

One of the more difficult issue with covid has been the course of the disease. It has not acted in the fashion we normally expected. So we needed to readjust our expectations

[flamingo]

My Dh is my medical POA, and i'm his. We both know what each other wants. He's a little older than me, so it's important to me to know his wishes, since it's likely he'll need end of life care before I do. But it's not a given, so I'm not shy about telling him what I want/don't want. I've made sure my parents know too. My mom is a nurse, so I know my DH will confer with her about me, if something happens while she's still alive. I would probably confer with her about my DH if I can. She really understands "medical speak" and it helps to have her explain/translate things for me.

We've gone through the death of Dh's parents and now are dealing with end of life stuff for my grandparents. It's not the most pleasant subject, but I'm not shy about talking about my wishes. I make my parents talk about it, too, because I'll be the one making their decisions, and I want to know their wishes.

Quality of life is important for my family. So we all know where we stand. It's not always a fun conversation, but we feel it's necessary.

[TheOtherMe]

Jul 1, 2020 11:28:48 GMT -5 Happy prose said:

Jul 1, 2020 8:55:50 GMT -5 TheOtherMe said:

My niece, who is a surgical nurse, is my medical POA.

When this covid thing started, we talked and I told her absolutely no intubation.  She is well aware of my other wishes and knows I have a DNR on file at the hospital.

But many people are only on the ventilator for a short time. You wouldn't want that, even for a few days, if they gave you enough drugs? 

No.  With covid, there seems to be long term damage to lungs, etc.  I don't want to live that way.

[pulmonarymd]

Jul 1, 2020 13:44:01 GMT -5 TheOtherMe said:

Jul 1, 2020 11:28:48 GMT -5 Happy prose said:

But many people are only on the ventilator for a short time. You wouldn't want that, even for a few days, if they gave you enough drugs? 

No.  With covid, there seems to be long term damage to lungs, etc.  I don't want to live that way.

Disease has been around for 6 months. No one knows long term consequences

[Deleted]

I highly recommend "Being Mortal" by Athul Gawande.  The first half of his book deals with changes needed in LTC facilities but the second half is a thoughtful discussion of end-of-life issues.  He's a doctor and his father, also a doctor, chose to continue with spinal cancer and not treat it because he loved his work and treatment would have put an end to it.  It gave me great comfort that my mother and DH, both of whom had diagnoses for which treatment would have had little chance of success, chose hospice care instead. 

One question he asked his patients was, "What, to you, is living?"  One said that as long as he could watch football and enjoy chocolate ice cream he'd be fine.  My standards are far higher (and they may change as I age) but DS knows that if I survive treatment I'm likely to be bedridden or have lost my mental faculties, then don't bother with treatment.   Intubation sounds awful and I'd like to avoid it at all costs but if I have a chance of full recovery, do it.  If I'm likely to survive but spend the rest of my life on dialysis and can never ride a bicycle again, well, game over.

[pulmonarymd]

These decisions should always be based on what one considers being alive. It is amazing what some families consider being alive. Some will accept basically having a heartbeat. These patients are not technically dead, but are unconscious and on a ventilator chronically. On the flip side, if you fell and broke your hip, you likely don’t return to your prior level of function, but are still otherwise functional. Most people fall somewhere in between. Not easy to decide

[Happy prose]

Jul 1, 2020 13:44:01 GMT -5 TheOtherMe said:

Jul 1, 2020 11:28:48 GMT -5 Happy prose said:

But many people are only on the ventilator for a short time. You wouldn't want that, even for a few days, if they gave you enough drugs? 

No.  With covid, there seems to be long term damage to lungs, etc.  I don't want to live that way.

My daughter and her husband both had the virus, and thankfully seem fine.

[Happy prose]

I also think your opinion changes when you're smacked with this situation yourself. I remember watching my husband's uncle going through chemo treatments, and saying I would never. Well I did, and although a horrible experience, I'd be first on line if I ever needed it again. And when weighing your options/outcome, sometimes you just have to roll the dice. I was only 44, with a crappy prognosis. Well here I am, super healthy. The only thing I can't do is run marathons, which I never desired to do anyway!

[Deleted]

Jul 1, 2020 14:46:34 GMT -5 Happy prose said:

I also think your opinion changes when you're smacked with this situation yourself. I remember watching my husband's uncle going through chemo treatments, and saying I would never. Well I did, and although a horrible experience, I'd be first on line if I ever needed it again. And when weighing your options/outcome, sometimes you just have to roll the dice. I was only 44, with a crappy prognosis. Well here I am, super healthy. The only thing I can't do is run marathons, which I never desired to do anyway!

I agree.  I discovered with DH's final illness that what people say they don't want often conflicts with reality when it happens to them.  I remember trying to discuss a DNR order with DH in an ER, and he told the doctor that he wanted "everything" done for him.  That's not what his directive said, and we had to really talk through what "everything" actually meant in his head.   We had the same discussion after his release from that hospital to go on hospice since the nature of hospice is not to do "everything possible" to keep someone alive but rather to make them comfortable.  He finally told me to do whatever I needed to, but he didn't need to know what I decided.

He was dying (and actually died 3 weeks later in his sleep), but humans sometimes cling to life no matter what.

[countrygirl2]

It's like MIL, I know she does not want to live like she is. In the beginning she said she just wanted to die. She got covid at 93 and survived. She has always been physically healthy. 

We had not been able to see her for months and mentally she has declined more.  It's sad watching that, for her would have been a blessing to go. Her dementia is not going to be curable or better.

There were 27 in her nursing home that died. I'm sure they were in poor health, to me that is a blessing in disguise. Others would think my view is horrible.

I had to make the decision to no longer treat mom. She insisted on having a tube put in her stomach, I did not want to but she did. I don't think she had a clue, the doctor chewed ME out! She raised up off the gurney and looked at me and said I would not let you starve to death.  I would not have done it, she was cognizant after she was off the meds for awhile, so I did not say no. It wasn't but a few days and the stuff started backflowing, she was losing weight rapidly and they wanted to give her more. I put signs all over do not lay her down. I guess the aids did and she aspirated the stuff. She had pneumonia. The EMT carried her in his arms to the ambulance she was so shrunken. In the ER she had places all over her arms from pokes, I finally said, no more. Don't do anything else. The ER doc said I'm not sure she will make it if we did. She died the next morning.  She put herself through agony and for nothing. Will I be wiser? I don't know.  We delude ourselves into thinking we will get better. Sad to give up life.  

Back then I did not understand hospice so did not take it. Now I know I should have I will for hubs as he absolutely does not want to live if he cannot do what he wants. We both also have DNR's.

[Deleted]

Jul 1, 2020 18:32:28 GMT -5 countrygirl2 said:

It's like MIL, I know she does not want to live like she is. In the beginning she said she just wanted to die. She got covid at 93 and survived. She has always been physically healthy. 

We had not been able to see her for months and mentally she has declined more.  It's sad watching that, for her would have been a blessing to go. Her dementia is not going to be curable or better.

There were 27 in her nursing home that died. I'm sure they were in poor health, to me that is a blessing in disguise. Others would think my view is horrible.

I had to make the decision to no longer treat mom. She insisted on having a tube put in her stomach, I did not want to but she did. I don't think she had a clue, the doctor chewed ME out! She raised up off the gurney and looked at me and said I would not let you starve to death.  I would not have done it, she was cognizant after she was off the meds for awhile, so I did not say no. It wasn't but a few days and the stuff started backflowing, she was losing weight rapidly and they wanted to give her more. I put signs all over do not lay her down. I guess the aids did and she aspirated the stuff. She had pneumonia. The EMT carried her in his arms to the ambulance she was so shrunken. In the ER she had places all over her arms from pokes, I finally said, no more. Don't do anything else. The ER doc said I'm not sure she will make it if we did. She died the next morning.  She put herself through agony and for nothing. Will I be wiser? I don't know.  We delude ourselves into thinking we will get better. Sad to give up life.  

Back then I did not understand hospice so did not take it. Now I know I should have I will for hubs as he absolutely does not want to live if he cannot do what he wants. We both also have DNR's.

I really appreciate you sharing that story. Today DH and I talked again.  He truly did not understand what intubate meant.  We do have DNR's but I don't think they are valid on the intubation issue.  Intubation is not resuscitation.  I don't want to think of death if there is a possibility of life with any quality.  Even more, I don't want to think of life without quality.  Life here is always complicated because of his hearing loss which leads him to not hear or misunderstand many things. And perhaps the onset of dementia plays a role there too.  

[Deleted]

Jul 1, 2020 19:29:46 GMT -5 @donethat said:

Jul 1, 2020 18:32:28 GMT -5 countrygirl2 said:

It's like MIL, I know she does not want to live like she is. In the beginning she said she just wanted to die. She got covid at 93 and survived. She has always been physically healthy. 

We had not been able to see her for months and mentally she has declined more.  It's sad watching that, for her would have been a blessing to go. Her dementia is not going to be curable or better.

There were 27 in her nursing home that died. I'm sure they were in poor health, to me that is a blessing in disguise. Others would think my view is horrible.

I had to make the decision to no longer treat mom. She insisted on having a tube put in her stomach, I did not want to but she did. I don't think she had a clue, the doctor chewed ME out! She raised up off the gurney and looked at me and said I would not let you starve to death.  I would not have done it, she was cognizant after she was off the meds for awhile, so I did not say no. It wasn't but a few days and the stuff started backflowing, she was losing weight rapidly and they wanted to give her more. I put signs all over do not lay her down. I guess the aids did and she aspirated the stuff. She had pneumonia. The EMT carried her in his arms to the ambulance she was so shrunken. In the ER she had places all over her arms from pokes, I finally said, no more. Don't do anything else. The ER doc said I'm not sure she will make it if we did. She died the next morning.  She put herself through agony and for nothing. Will I be wiser? I don't know.  We delude ourselves into thinking we will get better. Sad to give up life.  

Back then I did not understand hospice so did not take it. Now I know I should have I will for hubs as he absolutely does not want to live if he cannot do what he wants. We both also have DNR's.

I really appreciate you sharing that story. Today DH and I talked again.  He truly did not understand what intubate meant.  We do have DNR's but I don't think they are valid on the intubation issue.  Intubation is not resuscitation.  I don't want to think of death if there is a possibility of life with any quality.  Even more, I don't want to think of life without quality.  Life here is always complicated because of his hearing loss which leads him to not hear or misunderstand many things. And perhaps the onset of dementia plays a role there too.  

Yes.  And it can be "merely" confusion.  DH begged an ER doctor to amputate his leg because it hurt so bad after a fall.  It was badly bruised but not broken.  I know it was painful, which is why we were at the ER.  The ER doctor asked me if DH hit his head at the same time.  I had to do a tough love conversation with DH to tell him to remember all those westerns he would watch where the soldiers would beg, "No, doc . . . not my leg!"

DH had minor cognitive problems, but I think it was mostly confusion brought about by pain and his overall illness (congestive heart failure).  We had him checked out by a neurologist shortly before, and he said that overall he was fine.  He could remember those 3 words they test with even after we got home. 

[irishpad]

Jul 1, 2020 17:47:54 GMT -5 @bamafan1954 said:

Jul 1, 2020 14:46:34 GMT -5 Happy prose said:

I also think your opinion changes when you're smacked with this situation yourself. I remember watching my husband's uncle going through chemo treatments, and saying I would never. Well I did, and although a horrible experience, I'd be first on line if I ever needed it again. And when weighing your options/outcome, sometimes you just have to roll the dice. I was only 44, with a crappy prognosis. Well here I am, super healthy. The only thing I can't do is run marathons, which I never desired to do anyway!

I agree.  I discovered with DH's final illness that what people say they don't want often conflicts with reality when it happens to them.  I remember trying to discuss a DNR order with DH in an ER, and he told the doctor that he wanted "everything" done for him.  That's not what his directive said, and we had to really talk through what "everything" actually meant in his head.   We had the same discussion after his release from that hospital to go on hospice since the nature of hospice is not to do "everything possible" to keep someone alive but rather to make them comfortable.  He finally told me to do whatever I needed to, but he didn't need to know what I decided.

He was dying (and actually died 3 weeks later in his sleep), but humans sometimes cling to life no matter what.

My dad was diagnosed with terminal leukemia last fall and immediately decided to be on DNR.  His sense of humor was fun though because he would show off the DNR bracelet and quip "Now I get a free deer hunting license"  (DNR = Department of Natural Resources)

[Bonny]

Jul 1, 2020 18:32:28 GMT -5 countrygirl2 said:

It's like MIL, I know she does not want to live like she is. In the beginning she said she just wanted to die. She got covid at 93 and survived. She has always been physically healthy. 

We had not been able to see her for months and mentally she has declined more.  It's sad watching that, for her would have been a blessing to go. Her dementia is not going to be curable or better.

There were 27 in her nursing home that died. I'm sure they were in poor health, to me that is a blessing in disguise. Others would think my view is horrible.

I had to make the decision to no longer treat mom. She insisted on having a tube put in her stomach, I did not want to but she did. I don't think she had a clue, the doctor chewed ME out! She raised up off the gurney and looked at me and said I would not let you starve to death.  I would not have done it, she was cognizant after she was off the meds for awhile, so I did not say no. It wasn't but a few days and the stuff started backflowing, she was losing weight rapidly and they wanted to give her more. I put signs all over do not lay her down. I guess the aids did and she aspirated the stuff. She had pneumonia. The EMT carried her in his arms to the ambulance she was so shrunken. In the ER she had places all over her arms from pokes, I finally said, no more. Don't do anything else. The ER doc said I'm not sure she will make it if we did. She died the next morning.  She put herself through agony and for nothing. Will I be wiser? I don't know.  We delude ourselves into thinking we will get better. Sad to give up life.  

Back then I did not understand hospice so did not take it. Now I know I should have I will for hubs as he absolutely does not want to live if he cannot do what he wants. We both also have DNR's.

I don't think you're horrible, I think you have a clear vision as an outsider looking at quality of life.

I've got a similar opinion. Dad's been in a nursing home since mid-Feb when he broke yet another rib. He's miserable and begs to let out of "San Quentin". Because of Covid 19 the patients are essentially confined to their rooms except for when he heads to the gym. He's basically blind, deaf and in the beginning stages of dementia. He's got terminal squamous cell cancer but has responded well to immunotherapy.

But I wonder what we're doing. My friend's father died of the same cancer but he died peacefully in his sleep about a year and a half ago. What is going on with my father seems like a dragged out form of torture. If it were up to me I'd say discontinue the immunotherapy and let him go because this isn't living.

[Deleted]

Jul 2, 2020 11:54:47 GMT -5 Bonny said:

I don't think you're horrible, I think you have a clear vision as an outsider looking at quality of life.

I've got a similar opinion. Dad's been in a nursing home since mid-Feb when he broke yet another rib. He's miserable and begs to let out of "San Quentin". Because of Covid 19 the patients are essentially confined to their rooms except for when he heads to the gym. He's basically blind, deaf and in the beginning stages of dementia. He's got terminal squamous cell cancer but has responded well to immunotherapy.

But I wonder what we're doing. My friend's father died of the same cancer but he died peacefully in his sleep about a year and a half ago. What is going on with my father seems like a dragged out form of torture. If it were up to me I'd say discontinue the immunotherapy and let him go because this isn't living.

I totally agree with you and countrygirl. I'm also pragmatic. What is all the treatment costing and could it be better spent taking care of people who are younger and have a better chance at a full recovery, or providing more preventative care?

I hope that when it's my time I have enough marbles left to decide when aggressive treatment is a waste.

[TheOtherMe]

What Bonny describes is not living.  If that is going to be my life, I have told my niece to let me go.

She is pretty practical.  Being a surgical nurse, she has seen patients where they keep doing surgery on some elderly person because the children wanted them to have it.  She says it may buy them another week or month, but with less quality of life than they had before.

I am very glad that my mom was able to make the decision about stopping treatment and going in to hospice care on her own.  The cardiac surgeon was not happy with her, but the hospitalist told her that she got to make her own decision about her life.

Dad's dementia was too far along for him to be able to make his own decisions.

[Tennesseer]

Jun 30, 2020 19:33:06 GMT -5 Tennesseer said:

Not surprising, donethat.

My sister's best friend is now receiving hospice care.  My sister and her friend are 67 years old.  The friend refuses to discuss with her husband or with anyone else what she wants to happen with her remains once she passes.  Will not discuss it at all.

The thought is what ever her husband decides to do once his wife passes won't really matter to his wife.  

She peacefully passed away this afternoon.

[Happy prose]

A bit off topic- when my dad died, it was almost like he left us financial instructions in the briefcase he had. Made it so easy for us. After that, I made my daughter a packet, and gave her all bank account numbers, retirement accounts, life insurance, etc. Over the years, your accounts seem to be all over the place. I left her names and numbers with who she should call. When necessary, I make changes to the packet. She is co-owner or beneficiary to everything I have. (I only have one kid) As far as final wishes, my only one was cremation and don't have me laid out. After that, she can do whatever makes her happy. If she wants a mass, great; sprinkle me a sea, great. I was more concerned with one of my accounts just being forgotten. Lol.

[Happy prose]

Jul 2, 2020 17:36:47 GMT -5 Tennesseer said:

Jun 30, 2020 19:33:06 GMT -5 Tennesseer said:

Not surprising, donethat.

My sister's best friend is now receiving hospice care.  My sister and her friend are 67 years old.  The friend refuses to discuss with her husband or with anyone else what she wants to happen with her remains once she passes.  Will not discuss it at all.

The thought is what ever her husband decides to do once his wife passes won't really matter to his wife.  

She peacefully passed away this afternoon.

Sad. Do you know if she ever told anyone her final wishes?

[Tennesseer]

Jul 2, 2020 17:45:16 GMT -5 Happy prose said:

Jul 2, 2020 17:36:47 GMT -5 Tennesseer said:

She peacefully passed away this afternoon.

Sad. Do you know if she ever told anyone her final wishes?

Silence.

Now, she won't care.