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SALT LAKE CITY — I have worked in critical-care areas for most of my career, and I know firsthand how difficult it is for families to face the end of life in any situation. While deciding whether to continue life-sustaining treatments or allow nature to take its course is hard for anyone to do, there are ways to make the decision a bit easier.
As a nurse, I find it frustrating and somewhat worrisome that most people have not accepted the idea of a life span and its inevitable end in death. No one lives forever. In many countries death is a welcome guest — not an avoided enemy.
When making the life-and-death decision for an incapacitated loved one, the quality of life must be addressed. Living is when your heart beats and your lungs breath with or without help; having a good quality of life is something entirely different. Leading a productive life means participating in daily activities, being able to make decisions, being able to care for yourself, etc.
When making an end-of-life decision for yourself or a loved one, consider the following advice:
- Talk about your wishes openly with your family members before the situation arises. When you're very ill your mind will not be able to clearly understand any choices that are given you. You are in survival mode only and cannot foresee the future or its limitations.
- Consider financial, emotional, spiritual, physical, mental, environmental, social and medical outcomes to your decision.
- Remember who makes the final decision and support that person. When it comes to the end of life, medical personnel will seek direction from the patient, then spouse, then children, then parents. Do not overstep your role during this difficult time. Doing so will only leave the decision-maker feeling more confused or guilty than they already do.
Related:
Decisions to consider when beginning the end-of-life discussion
Death is a somber subject to tackle, and there are several challenges surrounding decision making for end-of-life care.- Listen to all medical personnel who are trying to help you understand what is happening. When you talk with many different caregivers and doctors, their views may only be on their specialty — not on the whole situation. For example, if a doctor who works on the kidneys gives you his consult, he mainly focuses on the kidneys. A doctor who works on your lungs may only give you a outcome for the lungs, not the entire situation. This is not on purpose — just the process. Most nurses are better at putting the picture together because they are working with the whole person. Remember, seek information from the medical team, not one team member; use logic, not feelings.
- A pat**ient's age should not matter when an end-of-life decision has to be made.** It is true that young people seem to recover better in any situation, and older people are more likely to have complications and permanent disabilities, but age alone should never be the deciding factor.
- No one hasthe right to overrule the decision maker, no matter what the decision is.
- Understand you are not playing God by turning off life support. We are acting in a manner like God with life support, because otherwise the person would not be alive. The life-saving machines are great when used for a brief time, but there is no sense necessarily in using them for extended periods of time.
- Monitor daily progress. When deciding whether a family member is improving, consider a three-day span. Ask yourself: Is the patient better off than they were three days ago? Or has the patient either not improved or gotten worse? This is an easy way to help you mark the possible outcomes of the situation.
- Living wills can b**e ignored if there is a question on family agreement.** Power of attorney cannot be not be ignored. Remember, there is not a right or wrong answer when you find yourself dealing with this type of situation. You just need to make sure you're educated and do the best you can.
Suzanne Carlile, "Nurse Suzy," has been a nurse since 1982. Her main focus is critical care and nursing education. She holds a master's degree in nursing, is a Certified Emergency Nurse, and a member of NNSDO Intermountain West Chapter.
