Communications over advance directives is one of the toughest conversations to start. End-of-life issues literally scare most families down a path toward a needlessly painful, extended death.
Today’s New York Times Sunday Dialogue is titled Discussing Dying With Loved Ones. It’s an exchange of letters on the topic of how aging parents, their children and doctors face — or avoid — the reality of death. Some great quotes from readers:
… Except for those suffering from advanced dementia, older adults are quite capable of raising the topic of their end-of-life wishes. As functioning adults whose quality of life and experience of dying are on the line, certainly they bear equal responsibility for initiating the discussion….
… This is the elephant in the room that no politician or policy maker is willing to put out there for a rational national debate. Doctors, nurses and other caregivers do not gain anything when we pursue futile care, often in intensive care settings with extremely expensive protocols, because a patient and/or the family “wants everything done.”
Our collective answer needs to be: “We’ve already done everything, and now it’s time not for rationing, but for rational care.” We need to face the limitations of our abilities, and the need to let the life of a loved one have a natural ending.
… I suspect that a lot of our reluctance to talk about end-of-life planning has more to do with our fear of losing our parents than with their fear of death. Most elderly people have lost loved ones and are quite aware that death is the ultimate reality.
One thing my mother said that really helped me was, “I don’t want to die, but I’m not afraid to die.” Because of that, I didn’t feel as if I was deciding to kill her; I knew that I was giving her the autonomy she wanted to die with as much peace and dignity as possible.
… Conversations about end-of-life care should not be postponed until an individual’s final days. We never know when our time will come, or when a loved one may be injured or become ill. Making medical decisions ahead of time, rather than being burdensome, frees individuals to concentrate on the personal and emotional at the end….
Member of Congress, 3rd Dist., Oregon
Read the original column and all of the letters in reply in the New York Times.