|
A: Decisions regarding the end of life are some of the most
difficult we face. The fact that your father told you what he didn’t want is a
big help.
Good medical care has two parts: one part attempts to cure an illness or
injury (curative care), and the other part attempts to relieve pain and
suffering (palliative care). The machines that are supporting your father’s
breathing and his kidney functions are curative — that is, efforts to keep him
alive and get him through this episode. The medicines he gets to relieve pain,
and the physical care he gets to exercise his muscles and prevent bedsores, are
palliative.
Curative care can cause suffering. For example, chemotherapy attempting to
cure cancer can cause nausea, infections, and fatigue — all of which may seem
worthwhile when the odds for recovery are good. But at every point in medical
care, a person has the right to say what is worth it for him or her, and what
isn’t. People even have the right to say what is to happen, if like your father,
they can’t express their wishes. They can do this by completing an Advance
Directive: that is, a document that expresses their wishes and appoints someone
to make decisions in their best interest (a Durable Power of Attorney for health
care).
Your father’s doctors should be able to tell you what the odds are that he
will recover, or whether it is time to stop attempting recovery and provide him
with care that is aimed completely at his comfort.
If your father has several doctors who seem to disagree about the best thing
to be done, you have more options. The social workers and case managers working
with your father can help.
Also, Sparrow has begun a Palliative Care Service. The nurses, physicians,
social workers, case managers, pastors, and dieticians who work with this
service can help patients and families with medical decision making and
treatment options. This team can walk you through this difficult journey.
Denise Egeland, RN, BSN, OCN
Ms. Egeland is coordinator of Sparrow’s Palliative Care Service.
|
