The hospital terms ER or emergency room and ICU or intensive care unit are part of our everyday lives. I attended a conference a few weeks ago and heard an Emergency Room doctor, Dr. Monica Williams-Murphy, share her concerns about what is happening at the end of life for many elderly folks in ER and ICU. She shared a story of a “Grandma” who is 89 years old grasping for breath when a neighbor finds her and calls 911 to have an ambulance take her to the hospital.
The Living Will and Health Care Proxy
Once in the ER Dr. Williams-Murphy asks the neighbor if Grandma has a Living Will and the identity and location of her selected health care proxy and if she has signed Do Not Resuscitate (DNR) or Do Not Intubate (DNI.) Her neighbor had no idea about those documents because nothing like that had been discussed. Dr. Williams-Murphy said 70% of Americans are not prepared to face these questions. It is likely that most of us have thought about death but have yet to make plans to meet it. Dr. Williams-Murphy said, “Trust me, ER is not the place to set your affairs in order.”
Since Grandma’s affairs were not in order Grandma will most likely be physically examined, possibly given an EKG, then a variety of other tests, medications and possibly placing a tube in her lungs, or an IV in her neck or emergency CPR attempting to shock her heart back into a life sustaining rhythm and then sent to ICU to sustain her life on machines. However, Grandma may be in the process of dying and does not want to have chest compressions but if there is nothing written doctors are trained to fight death to the bitter end. Dr. Williams-Murphy proposal is that we should not do emergency medicine on the elderly but without the indication of what a patient wants in writing emergency procedures will be automatically preformed.
These are different times
One hundred years ago families were multigenerational and children often witnessed parents caring for their dying older family members. Usually these elders would die in their own homes. Today we have moved very far away from those times. The power of advanced technology seems to have taken over our bodies with medical procedures that make it seem that it is just not OK to die anymore. There is less closure and peace with one’s family and less preparation for Grandma to end her life with dignity.
In my book, Embracing the End of Life: A Journey into Dying and Awakening, I have created a guidebook to help us prepare for our death. This guidebook is reminiscent of past years where community can be formed to share what is important to each person and to support each other when the time comes for our dying. We do not have to be like Grandma at the end of our life.
Embracing the End of Life: A Journey into Dying & Awakening to be released in September 2017. I invite you to pre-order now on Amazon.com.