May 152012

“What’s it like to die?” He sat in his wheelchair in the middle of the kitchen, looking to me as if I had all the answers. His wife sat nearby and gave a soft gasp of astonishment at his question. He had cirrhosis of the liver or liver cancer, I cannot remember which now. I do not remember the disease, but I remember him and his wife. And I remember that day and that question.

When I first went out to the home I knew his diagnosis was terminal. His wife and kids knew it too. But no one had told him. I was a bit surprised to find his family that naive. But it was too early in the relationship for me to explain to her that he had the right to know. When you are in someone’s home, especially in a professional capacity, it is a balancing act to earn trust.

In the United States, talk of death is traditionally avoided, as if by ignoring it, we can defeat it. And our desire to defeat it is evidenced in our constant battle to raise awareness about every terminal illness and find a cure. I would like to think it is because we love life so much but I suspect the truth is our fear of death. And we perpetuate that fear by not talking about it. It is not looked at as a part of the natural order of things but an enemy to be fought against.

When I first started nursing 29 years ago, I had never heard of living wills and advance directives; the right to die idea was just starting to take hold. I wish I could say that we are more enlightened now, but that is far from the truth.

People are brought in to the hospitals every day, with nothing in writing and no one appointed to make decisions for them. They have not told anyone whether or not they wish to be hooked up to machines or fed through a tube if there is no hope of recovery. And the burden then falls to the family to make that decision and many of them feel guilty, as if they are being asked to kill their loved one. Even though they may know intellectually that it is the right thing to do, it tears them apart.

On the other hand, there are those who have discussed it with their family, who have made it explicitly clear what they want done and do not want done. They have put it in writing, made their own funeral arrangements, done everything they can think of to prepare for the inevitable. When their time comes, the family is still sad, but they can grieve the loss of their loved one rather than wrestle with decisions, uncertain what to do. If a decision is left to be made they are fairly certain what their loved one wanted and they do not suffer from guilt.

As you learned from yesterday’s blog, even with everything discussed, a nurse who has seen the ugly side of prolonging life in terminal cases, the decision was still a hard one to make. If your elderly parents have not filled out their own Advanced Directives, perhaps it is time to have a conversation with them. They may find it a relief to talk about it.

Tomorrow my answer to the question, “What’s it like to die?”


  15 Responses to “The Question”

  1. Tough question. To have a good conversation to find a relief is indeed a good advice.
    Memorias Flash

  2. My mother voluteered at a hospice. She said the gift she gave her dying patients was that she was willing to discuss death with them. Often their families would not talk about it with them.
    Sonya Lenzo

  3. Suzanne,
    Dying is a one time experience. Like birth. We all prepare to the best of our abilities and spiritual growth. I have heard that Tibetan monks invite friends over to witness their separation from the body when they decide it is time.

    Covert Hypnosis: 3 Magic Word Patterns

  4. for many the decision making process concerning death isn’t something they can do or want to do.

  5. It’s very interesting viewing the different attitudes to death amongst different cultures. But it’s never easy. And your recent posts have shown the importance of advance discussion and planning, not matter how uncomfortable.

  6. Excellent points you make in your post. My dad died unexpectedly at 51 and it was a nightmare going through all the legalities of probate court, which took over a year of time. I’m always encouraging people to have the discussions now before it’s too late.

    MGM films

  7. Thank you for pointing out the importance of putting final wishes in writing. I was surprised to learn that it happens so much, even in this day and age.

    Cherie Miranda
    When To Meditate

  8. I am always amazed at people who have “prepared” for death. Even though I would like to put my head in the sand about the topic, talking about all aspects is the right thing to do.

    With Passion & Conviction,

    Wendy Schauer: Author – Speaker – Chiropractor – Kettlebell Trainer

  9. I was not aware that this problem still occurs … Hospital Admitting is strict on Living Wills in my experience.

    Lyle R. Johnson

    Sales Access to Non-Conscious

  10. It is odd that people think that by ignoring death, they can avoid it. I admire this man, asking about it. I am curious to hear the answer.

    Mark Hogan

  11. Hi Nurse Suzanne,
    Simply important information for every parent.
    Thank you so much
    Looking forward to tomorrow!
    Would you like to stop feeling guilty about caregiving?

  12. It is still a subject we all avoid discussing for fear of the hurt it might cause. Sad but a fact of life.

  13. Hi Nurse Suzanne,

    My late husband and I discussed extensively what he wanted and what his wishes were. We made out a medical power of attorney (POA) which I highly recommend people do with any possibly terminal illness because there are always high emotions when all of this is going on and it could be a challenge to do what they want when it comes down to it.

    Happy Dating and Relationships,

    April Braswell – Internet Matchmaker
    Top 3 Common First Date Dressing Errors Single Women

  14. I don’t think I would be prepared to handle that question…my wife and I dont talk about that very much, but we should

    Sales Expert

  15. I would like to say that directives are common and followed but they are not. Many times they are unclear, with no specific guidelines. The family is put in a very awkward position-they have to decide what’s best, and what would their loved one want, and what SHOULD they do, what is the right thing to do, etc etc.
    The questions are tough and go on and on.
    Be Well.

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