End of Life Care Issues
On a freezing cold day in January, we were called to the hospital on behalf of my mother’s older sister, Helen. Our family stood around her bedside, helplessly gazing at her tiny body hoping for some sign she would regain consciousness. We were told she would not likely recognize us or return from wherever her mind was due to her advance age. At ninety-four, her chances for recovery were slim.
As she wrestled with the oxygen tubes in her nose, her arms thrashed against the bed-rails, moaning in her restless sleep. Her eyes remained closed despite all attempts to rouse her. Standing beside the bed, I wished that I could gaze into those electric blue eyes one more time. For now, she was in the hands of caregivers in whose care her existence was measured out one moment at a time.
Pacing the quiet corridors of the hospital, it occurred to me that any material possessions Helen gathered after working eighty years were suddenly insignificant in the grand scheme of things. It became clear that no bank account, no piece of jewelry, expensive designer dress or item of furniture would ever be of use to her again.
Nothing else seemed as important that day as spending a few hours with a loved one.
Swift & Company
Children in Factories
Helen started working at age twelve at the Armour meat packing plant. In was necessary to support the family after her father passed away at thirty-five, leaving behind a wife and three young children. Helen's mother (my Grandmother) arrived to the United States in 1904 on a ship from Bremen, Germany. Her journey started from her family home in Vienna, Austria after her own father passed away. She was fourteen and began working for her uncle and aunt in their boarding house.
Helen worked at Swift Dairy and Poultry Company for over thirty four years from 1941 to 1975. After retiring at age sixty-five, she took a job in bookkeeping at Saint Joseph's Hospital. As a single mother in the days when being divorced was uncommon, she continued to support her mother, sister and her own child, often holding down two jobs.
In the seventies and eighties, she and her younger sister, Louise, took dance lessons at the Fred Astaire Studios in Fort Worth. Together, they traveled to Spain and other countries, dancing their way across the country competing in ballroom dance tournaments, taking home many trophies.
Helen worked well into her eighties, running the snack shop at a downtown bank in Fort Worth, Texas. She was a single mother who often worked two jobs.
Back in the hospital room, the specialist finally arrived to evaluate Helen's future dietary needs, taking into consideration her inability to swallow food on her own. After a brief examination that lasted less than ten minutes, she hastily left the room. I chased after her, running down the hall to ask the painful question, the one we dreaded. Yes, they would be withdrawing any food given by mouth.
In those brief moments, this young woman determined that my aunt would never eat food again. We were left to decide if she should be intubated since she would likely aspirate any food given orally. Unfamiliar with medical terms, I asked for more explanation. This meant she would likely inhale food into her lungs causing respiratory infection or choking. They suggested surgically inserting a feeding tube into her stomach. It was up to us to make that decision for her.
Living Wills and Advance Directives
We held a grim family conference speaking in hushed tones about what she would have wanted. There was no living will to advise us of her wishes, no clue as to her preferences. We had only our own conscience to guide our decision concerning the grim sentence of the therapist whose ten minute analysis would set the course of Helen’s existence.
We reached the consensus that she would not have wanted her life to be prolonged artificially if there were no hope for recovery, no quality of life remaining. We informed the doctor of our desires not to force feed this body that could no longer sustain the functions of daily life on its own.
Reflecting on Wasted Moments
When I thought about the countless hours squandered staring at a computer screen, on the telephone or commuting to another faceless workday, I saw my life in a different light. I wondered about the strangers with whom I had shared a chunk of my life if any would even remember my name these years later. I considered the times I’d lost my temper or let road rage overwhelm me in the insufferable city traffic of my daily commute to work.
I wondered if I could be forgiven for the wasted moments that I would now gladly pass along to my dear aunt if only it were possible. The many times she’d invited me for a visit when my career, travel or idle pastimes kept me away flashed as videos through my mind. I began to recall the few precious hours when we spent time together. There were so many things I should have asked, so many things about her life that would now and forever be lost.
Making It Count from the Movie Titanic
The hospital released her back to the nursing home where she had spent the previous two years after suffering a stroke that left her mostly unable to talk or tend to her own needs. She was in the care of underpaid angels whose duties encompass caring for those in her condition.
The nursing home’s compassion policy would not allow her to fade away by starvation. They patiently set her upright in a wheelchair and began to offer her pureed food. Amazingly, she began to eat and drink again, surprising us with her determination to survive for an additional five months. Her death sentence was overturned giving us more time to look into her beautiful eyes and feel her kiss on our hands.
Helen knew we were there with her when, as midnight approached, the priest administered last rites on the final day we would ever spend with her. She passed quietly in the night, ready to begin her new life on the other side where she's happily dancing with the stars.
After this experience I realized the importance of thinking about my personal health decisions and making sure I created an advanced directive or living will. These decisions are ones you'll want your family to know in the event you become critically ill. Do you wish to be kept alive by artificial means if there is no hope for a cure to your illness? Who will take care of your pet? Where do you want your savings account and personal possessions to go? What charities do you wish to give your belongings to?
No one wants to think about their mortality, at least not to dwell on it. But leaving these important questions unanswered might not be a good idea. Make it easier on your loved ones and make your wishes known by putting them in writing, then, hope for the best.
© 2015 Peg Cole
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