Are You Prepared for Dying?
I was thinking about writing a full blog post about this, but that would take too long, and I just need to get some thoughts out quickly.
Note: The Question was NOT “Are you prepared for DEATH?” but “Are You Prepared for DYING?”
All of us face this question at various points in our lives, whether it is regarding a child, a parent, a spouse, a pet, or ultimately ourselves. Recently I have been faced with the question more personally because of several things:
1) The passing of my maternal grandmother almost 2 years ago. She was 94 years old and had lived a very good life, and in the end, she went the way that probably all of us would prefer – peacefully in her sleep. No pain, no suffering physically….but it was less than 5 months after having to give up the home in which she’d lived since 1949 and moving into a nursing home. But at least there were no tubes, no surgeries, no cancer and chemo or radiation, nothing like that.
2) My parents are both turning 70 this year; my Dad’s 70th was in March, and my Mom’s is in October. While my Mom is still doing quite well, Dad has been having a number of health issues for the last 7 years. Medications, minor heart procedures, his mobility is decreasing somewhat. And at the moment, my parents are touring Ireland and England for almost 3 weeks; before they left, I spent some time talking with my Mom about what to do if Dad has any unexpected health problems while they’re abroad. Dad truly loves traveling….but for how much longer? Fortunately, we have the financial ability that I could drop everything and fly to them on a moment’s notice if anything happened, but….how much longer can they continue their travels?
Fortunately as well, I know that my parents have spent time planning for their retirement and aging by putting in place DNR (Do Not Resuscitate) orders, getting their Organ Donation cards, having more than adequate life insurance in place, disability insurance, wills, and all that. I think they’ve even spent time looking at where they will move when they’re ready to move out of their home…..but we’ve never really talked about it.
3) My dog Lady is now over 15 years old and in obvious decline. I have to help her up from the floor almost every morning now because of spinal stenosis, arthritis, and weakened leg muscles. Once she’s up, she still gets around pretty well as long as the ground isn’t too steep, and stares are almost impossible for her.
4) Many of my relatives and patients are growing older; I’ve even been saddened by the death of a few elderly patients.
5) 18 months ago, my wife’s identical twin sister was diagnosed with breast cancer. She responded successfully to surgery, chemo, and radiation and is now back to almost full strength. Naturally, my wife got checked out extra thoroughly, too, and her scans all came up clean to our great relief.
Rarely has a book moved me as this one did. At 43 years old, married for 9 years, with a 20-year old and an 8-year old daughter, I am becoming increasingly aware of my own mortality. This book brought me face-to-face with the reality to come, and it made me realize that I am not prepared. Not prepared for my parents to become debilitated or ill; not prepared for it to happen to myself or my wife, and of course not for our daughters. Who can ever be prepared for that?
As nations progress towards higher levels of financial prosperity, significant shifts occur in family structures, mobility, size, and responsibilities. Medicine has gained incredible abilities to treat (and sometimes cure) many diseases that were rapidly fatal just a few decades ago – but at what cost? As families spread across countries and even the world, shifts in responsibility for providing care for the sick and elderly shift – and often they shift to hospitals, nursing homes, assisted living homes. Medicine is about trying to “fix” things….but life is a terminal process, and at some point, we must all decide when and how to stop “fixing” things. But the challenges of knowing when and how to make those decisions are big and daunting..and they require us to truly look Death in the eye, to actually ACCEPT our own mortality, and to then decide what is most important for us in our last days, whether those are years, months, weeks, or days. And if we wait too long, the decisions are often taken out of our hands.
There have been numerous reports and studies over the last few years that document how physicians often make very different choices for themselves in medical care than they recommend for their patients. There is nothing malevolent about this – it is part of human nature and even part of medical training. We (yes, I’m a dentist/doctor) usually have a far greater understanding of the real risks and side effects of various surgeries, medications, etc. It’s been found that doctors end up refusing treatment more often than the public, because those doctors know the likely outcomes and don’t want them, but they’re trained to “fix” other peoples’ problems. But it’s difficult to look a patient in the eye and say, “Yes ma’am/sir, you are dying, and everything that I’m telling you to do might not do a damn bit of good except to give you a few more months of misery and suffering before you die.” _It’s human nature and how medicine currently works._
But it doesn’t have to be that way.
I could write so much more, but hopefully I’ve simply prodded you enough to decide to read this on your own, whether because someone you love is approaching death, or perhaps because you are.
This is a book that actually deserves TEN stars IMO.
I’ve already sent the link to my parents and to my younger sister and suggested that we should read it and discuss it as a family so that we are ready when that time comes.
#mortality #dyingwell