I was hesitant to write a post possibly so depressing as this topic… but decided to go ahead because it's something that is so important and not enough awareness is raised about it. It's just something people don't like to talk about… sort of like talking to your pre-teen children about the “birds and the bees”…but worse because it's about loss. Talking about it is not meant to be morbid, but meant to facilitate communication- you want your voice to be heard…and you want your loved ones to make decisions you want, for you when you aren't able to.
What the heck am I talking about, you ask?
Well, yesterday was the first annual National Advance Care Planning Day in Canada. With our current health care system under stress and due to be even under more stress as baby boomers retire and age, it is important to ensure that we know what our loved ones' wishes are. Why is it so important? It's important because I doubt our current health care system can't endure health care costs related to $5000 a night hospital stays for much longer. It is important because death often doesn't happen the way we envision it. Many people, when they think of end of life, think of it as a peaceful event, we think of being able to tell our loved ones how much we care about them, and how much we value their relationship and effort over the years. However, oftentimes death does not happen this way.
If we don't let our loved ones know about wishes for a peaceful death, the ‘system' takes over. The paramedics that come and perform resuscitation on an 83 year old frail body, they send your loved one to the hospital, and because no one knows what your loved ones wishes are, they put him in the ICU. He will be hooked up to a machine. Because so much time has lapsed between when the paramedics are called and when ‘heroic' measures are performed, your loved one's brain is not functioning and he is unable to respond to you. Days elapse and the doctor and health care team asks for the family's opinion– what did he want? Did he want to have heroic measures done on him? After a few days, and many tears, much discussion, the painful decision is made to pull the plug. He isn't there anymore, he wasn't there anymore to begin with, after the ambulance took him away.
How do I know?
Because this happened to my grandfather.
My grandmother didn't know what my grandfather wanted. They never talked about it. My grandfather never talked to my parents or my aunts and uncles about it because it was taboo.
Oftentimes, the talk of death and end of life planning is so taboo that its not discussed. People might not know that their loved one wants to die peacefully and without “heroic measures” performed upon them. Many people don't understand that life prolong measures may result in broken ribs. Many people don't understand what it might entail to be in an Intensive Care Unit (ICU), hooked up to a machine that is keeping you barely alive. The line between life and death is blurred in the ICU, and oftentimes, many of the patients admitted don't make it out.
Planning your care at the end of life doesn't have to be a huge ordeal full of paperwork and a visit to the lawyer or notary public. It can be as simple as a conversation. You won't know unless you ask. Hopefully you won't ever have to decide for your loved one and act on his or her best interests, but just in case you do, it would be helpful to know what they might have wanted you to do.
After the difficult death of my grandfather, and after the surprise and baffled questioning from the physician as to why it wasn't discussed between my grandmother and grandfather, I have learned from this experience. I asked my mom and dad what they would want us to do in the event that they are unable to make decisions for themselves.
It's a time we can put aside to reflect on our values and beliefs, and share them with our loved ones. We all deserve to die with dignity, and we should try our best to ensure that our loved ones do just that. So to close, may I ask that you please talk to your loved ones about what your health care preferences are and how you want to be treated at the end of life. The loss of a loved one will still result in painful grief for the life lost, but at least it could be a dignified death, and if the scenario played out differently, the way he likely would have wanted, he would have been in the arms of my grandmother at the end of life, and not suffering- hooked up to a machine, in the last few days of life.
Readers, do you find it difficult to talk about death and dying with your loved ones? Do you have a similar experience with advanced care planning you want to share? What would you have done differently? Again, I'm sorry to be a Debbie Downer, but I think this conversation is important to have with the ones you love.