I am a medical care professional, retired clinical pharmacist. I have seen end of life care often.
The absolute most important thing about of end of life care is it must reflect the wishes of the patient with no exceptions. That is why it is very important each and every one of us to write down their wishes for end of life care. I have.
In short my end of life care instructions are if there is any chance of quality life left, do everything they can to preserve my life. If there is no chance of a quality life I must be kept pain free even if the pain medications stop my respiration and I thus die. No heroic measures are to be done to preserve my life if I am terminal.
One must also discuss this with his or her spouse in detail. Nothing you write about end of life care is valid if your spouse or loved one does not want this once you are no longer competent due to your illness. He or she must be in agreement with your wishes, otherwise your wishes are meaningless.
Years ago I worked with a home care hospice service. All my clients were terminal. Oddly enough it was a very satisfying work. We provided parental iv nutrition, antibiotics and pain therapy for these people. All of this was under the supervision of their physician but we were the ones in their house every day. It was a team effort of physician, nurse, and pharmacist. By doing this we allowed them to die with dignity in their homes surrounded by those that loved them. It was good work.
Most of us die in a hospital. It is a cold sterile place to die. I would much rather die at home with my dogs, cats, and wife. I might even be able to sit on my back porch and watch the deer and animals. I like watching them and the deer are most tasty. I am a country boy living not in a city nor town.
It really is better to die at home and a hell of lot cheaper than a hospital if you have a long term terminal illness.
Death should have dignity!
The hardest part of the job was collecting our medical equipment after they had passed. You are not supposed to get close to your patients but that is hard not to do. They know they are dying and want to talk to you about things, mostly trivial and sometimes heart breaking.
Without exception the loved ones of the patient would hug me and thank me and there were many tears, some of them mine.
It was damn good work! I liked what I was doing for them.
There is a time to die. Make sure it is on your terms and instructions.
Thank you for that description of your service to the dying. It was spot on. I’ve done the pastoral care in the Hospice situations for 26 years. Believers usually pass peacefully and with certainty. My job is to bring what comfort I can regardless of their beliefs. Yes, it is rewarding service.
Thanks for that, discussions about who decides and how things are organized are very important.
Hospice has been used with a number of family members and friends here too. No gubamint official was involved, the family under the direction of trained personnel was assisted in easing the passing of loved ones at home. In almost every case, it has been a cancer or heart related passing.
It hurt to see them go, but it was some comfort that they passed with family there and pain was minimized as much as possible.
Wifey and I have both opted to keep us going as long as possible.