Travel To Health - As Night Draws Nigh

As Night Draws Nigh

A Life Worth Living

In Dr. Robert Martensen's book—A Life Worth Living, he states that:

When it comes to dying in America these days, many of us depart the world, if not entirely alone, then in the company of mere strangers, the ones like health care practitioners who staff hospitals. Meanwhile, those who have mattered most to us remain just offstage, in an ICU lounge perhaps, waiting for a nurse's announcement that we have "passed."

Have you been with someone who is dying? Experience tells us that there are better and worse ways to die in a hospital[2-6]. At the moment when someone you love may be most alone, it seems the only comfort you can provide to him/her is staying with them if circumstances permit.

My Story

When my mother was diagnosed with cancer, doctor told us that she would have only a few weeks to live. The moment she was admitted to the hospital in Washington D.C. area, I and my sister decided to accompany her to walk her through the last moments of her life.

Fortunately, my mother was assigned a single room and I was able to sleep over in one of the sleeping chair. In the day, my sister accompanied her by the bedside. In the evening, I did my part . Not every health care practitioners can face dying patients comfortably. Some of them would rush through their daily routines and stay away from the dying patients as far as possible. There was only one exceptional nurse from Philippine who had an angel heart. After finishing her routines, she would help my mother to turn her sides and clean her back. Most of time my mother just roamed her eyes around the room without many responses. She seemed to wonder where she was. However, my mother would always smile to the nurse whenever she showed up in her room.

To make her feel more comfortable and at home, we have brought her CD's and played music for her every night. These were Christian Hymns. They were played beautifully and gracefully into wee hours of the evenings. Some nurses had stopped by and told us that they also enjoyed the music. At regular intervals, we would help nurses with their daily routines. In addition, with our presences, nurses seemed to feel more comfortable when they stepped into the room. Therefore, our presences were appreciated and well accepted.

As a dying patient, my mother's doctor offered more helps on reducing her pains than other unrelenting and burdensome treatments. In our case, morphine was prescribed and the dosage was increased gradually. In one morning and at the presence of me and my sister, my mother first showed signs of struggling with her breaths, then she breathed her last breath and passed away peacefully.

The Weaver

When I stayed overnight in the hospital, I came upon this poem on the hospital's computer—The Weaver:

My life is but a weaving

Between my Lord and me,

I cannot choose the colors

He worketh steadily.

Oftimes He weaveth sorrow,

And I in foolish pride

Forget He sees the upper

And I, the underside.

Not till the loom in silent

And the shuttles cease to fly

Shall God unroll the canvas

And explain the reason why.

The dark threads are as needful

In the Weaver's skillful hand

As the threads of gold and silver

In the pattern He has planned.

- Author Unknown

5 Myths about end-of-life issues

Based on a HEALTHbeat article from Harvard Medical School, here are a few myths that shouldn't get in the way of creating a health care power of attorney or living will:

Myth: More care is always better.

Truth: Not necessarily. Sometimes more care prolongs the dying process without respect for quality of life or comfort. It's important to know what interventions are truly important. It's often impossible to know that in advance. That's where the advice of a health care team is invaluable.

Myth: Refusing life support invalidates your life insurance, because you are committing suicide.

Truth: Refusing life support does not mean that you are committing suicide. Instead, the underlying medical problem is considered to be the cause of death.

Myth: If medical treatment is started, it cannot be stopped.

Truth: Not starting a medical treatment and stopping a treatment are the same in the eyes of the law. So you or your health care agent can approve a treatment for a trial period that you think may be helpful, without any fear that you can't change your mind later. However, be aware that stopping treatment can be more emotionally difficult than not starting it in the first place.

Myth: If you refuse life-extending treatments, you're refusing all treatments.

Truth: No matter what treatments you refuse, you should still expect to receive any other care you need or want — especially the pain and symptom management sometimes called intensive comfort care.

Myth: Stopping or refusing artificial nutrition and hydration causes pain for someone who is dying.

Truth: Unlike keeping food or water from a healthy person, for someone who is dying, declining artificial nutrition or intravenous hydration does not cause usually cause any discomfort. In fact, many patients are able to avoid symptoms like nausea and bloating, and it may even lead to a feeling of mild euphoria in some

Takeaways for Our End of Life Decisions

Here are the four takeaways shared by Dr. Carolyn McClanahan's experiences of helping her friend deciding on the next steps:[17]

A couple weeks ago, I had a good friend diagnosed with an aggressive glioblastoma (brain tumor). She underwent surgery. Of course they couldn't get it all and I visited to help her and her children decide on the next steps.

#1 - Doctors – do not force patients to make treatment decisions when they are just learning the diagnosis!!! Tell them the diagnosis, give them the options, and the statistics about those options.

Set up an appointment the day after to help them make decisions. Had I not been prepared in advance, my friend would have been railroaded into aggressive useless treatment. We are now making memories with the time left.

#2 – Doctors – always offer a palliative care consult for any serious disease. Study after study shows that early palliative care prolongs life and quality of life while undergoing treatment.

Patients – insist on early palliative care. This is not the same as hospice. This is focused on helping your quality of life while undergoing treatment. It also eases the way to hospice if treatment is not working and leads to a better end of life.

#3 – Most important – we had a long conversation about her “being mean” worry. I reminded them that when she was her lovely self, that you had to love and relish that moment.

I reminded them if her personality changes, or if she is exhibiting odd behaviors, that isn’t her, that is the disease. Love the person, hate the disease. Love her harder when the disease is taking hold.