The Glade 4.0

Sometimes I really really hate being in the medical profession and having any sort of conscience. Seeing what family members put their elderly loved ones through honestly gets sickening. I really wish I, a nurse, a Doctor, someone can just tell them flat out what kind of self sadists they really are.

What is pushing me over the edge is a current patient. Honest to god I find myself praying he has lung cancer, and that would be the most merciful of options. How **** far have I fallen to actively be wishing cancer on some one, and it is the most **** merciful thing!?

This gentleman is 96 years old and demented, fell and fractured his femur. The gentlemen in question had a living will for no intubation or heroic measures., but his power of attorney (his son), and his 6 other children are all adamant that "Dad has to live". Well onto the ventilator he goes to have the femur fracture fixed, where we discover it was due to bone cancer, active and stage IV (hint there is no stage V), with possible lung mets. So today he is going to catscan, if he has lung cancer the family will thankfully honor his wishes and let him go (or so they say). If not, then by golly their 96 year old, bed bound dad is going to get the joys of a feeding/peg tube and be introduced into the wonderful world of Radiation therapy. The doctors can barely keep a civil tongue to them, and the rest of the staff can not even look at these people. So all the while they sit there with a father on a ventilator, sedated to the heavens (femur fx's are painful and we had to fight them on that, because they wanted "dad" to be awake to communicate with them), with the kids showing him pictures of past things "This was Aunt So-in-So's wedding, do you remember? You were happy then? Do you remember Dad?"

I know loosing a loved one is hard, but honestly stop being so **** selfish, honor your fathers own wishes and be a damn adult and stop torturing him because you feel sad about loosing him!

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"Life isn't divided into genres. It's a horrifying, romantic, tragic, comical, science-fiction cowboy detective novel. You know, with a bit of pornography if you're lucky."
— Alan Moore

Sad that people think this way. 96 years isn't exactly a short life and they've had plenty of time to share with dear ol' dad.

They should honor his wishes and let him comfortably pass while they they are at his bedside.

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This must be Thursday. I could never get the hang of Thursdays.

I couldn't agree more.

Sorry you have to go through that. I'd have gotten myself fired by now telling the family off.

Uncle Fester:

Not having any experience with that particular field, is there any sort of position in existance, such as a hospital counselor or advisor, who can (rather, should) speak to families faced with such decisions?

Perhaps a voice who can inform of the "indignities" of such treatment? Sure, some people would balk at being offered such advice, but maybe it would help others who just don't realize what they are putting their loved ones through just to share a little more time with them.

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This must be Thursday. I could never get the hang of Thursdays.

It's very easy to see the logic behind other people's family members. Especially if you're educated on the subject.

I have not been in that situation, so I cannot judge.

Don't judge them too harshly. Do you think they don't care about him? Educate them as best you can. Help them let go.

It is a very fine line to walk legally, ethically and morally. It is made all the worse by the fact that they truly seem to love him with all their hearts. In a weird way it is easier to understand the selfish assholes who want to keep cashing a disability check on a family member. In the medical profession you see more suffering endured and inflicted out of genuine love then malice. I think we (those in medicine) to get very cynical, having watched how this show will play out over and over, but that cynicism is honestly just a self defense mechanics so we (the professional) can make it through our day.

In terms of counseling/support every hospital has different rules and practices. A doctor could refuse to do the radiation, but the family can doctor hop until they find one who will OK to their every wish. Every hospital has a spineless doctor who gives into demands. So really in the end we just try to provide the best care in the worst situation, while being angry that we can not express ourselves, who knows maybe something passionate might sway them where patient explanation fails, who can say. By our rules when the conflict is between legality and Ethics, legality will win everyday and twice on Sunday.

I am trying not to judge the family, having been on the other side of the bed when we were trying to implement my Grandfathers living will over the objection of one of his daughters (he had very strict DNR/DNI orders, even forbidding fluids). Two of his children wanted to honor his will, one did not. Thankfully the one with the Power of Attorney was for the honoring the will, but the arguments and recriminations were very ugly and strained family relationships for years. The uttering of "You just want Dad to die!" takes a long time to fade.

I guess the best way to express it is like watching a similar show over and over again, like Law & Order, the specific details may change but the ending very rarely surprises you. In the end this gentleman will be dead either on comfort care with a big bottle of morphine hanging or in a code, with a room full of hospital staff pushing drugs, compressing his chest and artificially inflating his lungs, all secretly praying they we are not successful because it will be more merciful. If the children honor his will the first way is the probable one. If they go for the longer route then the second is probable, or the first, but only after many radiation treatments, a feeding tube due to no longer being able to eat, another ventilator and possible a tracheotomy.

This actually brings up a topic I kept wanting to start in general, but always put off. I wanted to hear from other families, mine is odd so many of us work in medicine so death is a common topic of conversation, a old aquatince. But in your own families how often has the topic come up? Do you know a persons wishes, desires and fears? I see so often patients in their 70's+ and their children who have never discussed end of life, and f reverently do not want to talk about it, denies it ever as a possibility for their loved one.

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"Life isn't divided into genres. It's a horrifying, romantic, tragic, comical, science-fiction cowboy detective novel. You know, with a bit of pornography if you're lucky."
— Alan Moore

Never discussed. I'm one of four kids, 3 of whom are very emotional-based. I will be given power of attorney (I have not yet, but will be once one of the parents passes). Anyway, I predict that it will not be pretty. I'll be executor of will also, I'm guessing.

I have POA with my mom, and she has a living will. When she had a stroke and was on death's door about 9 years ago, the instructions were to not prolong life. I honored those as much as I could. The last thing they wanted to do was a feeding tube, and I decided to give that a try. She was unresponsive up until that point, but when they tried to put it in she clamped her mouth shut and weakly shook her head. Didn't get the tube, but after that, she recovered.

So, yeah, I do know what my mom wants. Right now, she doesn't want to die alone, but she also doesn't want to linger. Her life has been one long series of medical problems pretty much as long as I can remember (40+ years). I'm also an only child, so this is all on me.

Speaking of which, I need to renew all the POA and living will, etc., so I make sure I have it when I need it.

_________________
This cold and dark tormented hell
Is all I`ll ever know
So when you get to heaven
May the devil be the judge

My grandfather was 96 when he passed. At his last birthday party, my dad asked him how he felt.

He only said this. Don't live this long.

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Raell Kromwell

Ouch. That's both discomforting yet revealing. It sickens me when people claim to know the truth of life to the extent that they try to tell others what they can or can't do to either extend life, or end their own life, or alleviate their own suffering.

My mom survived ovarian cancer, and was on the road to fully becoming herself again after five years, when she started having pains in her back. Her doctor told her it was all in her head and sent her to a phsychiatrist, who prescribed drugs. They found the liver cancer a bit too late. Chemo was making Mom sick so she said enough! Dad rented a hospital bed, the doctors gave her morphine, and the hospice nurse started coming to the house a few times a week. Mom died June 2, 1989, as she wished...at home in her own bedroom with her family around her.

My mother-in-law fell and broke her hip. During her recovery she started showing signs of dementia to the point that her sons took her car away from her. They set up home visits from nurses and home care assistants to help her with her meds, exercises, and housework, etc. When she finally went to hospital, she told her sons what she wanted and that was what was done, no questions asked. She died on her own terms. My mother-in-law was a pistol! A manipulative and demanding and very loving and caring woman that I miss every day.

My dad has already told me what he wants to happen when he dies...and I will fight tooth and nail anyone who opposes his wishes, and I mean anyone!

And yes, my husband knows what I want when my time comes and I know what he wants when his time comes...whichever goes first will do the bidding of the other.

Uncle Fester I'm sorry for what you and your co-workers are going through with this family. I cannot fathom that kind of disrespect for one's parent that they are showing. If they truly loved their father they would let him go!

I know pixelated hugs don't mean a whole lot, but.../hugs to you and your co-workers for your compassion and hard work doing what you need to do under the circumstances.

_________________
"Said I never had much use for one, never said I didn't know how to use one!"~ Matthew Quigley

"nothing like a little meow in bed at night" ~ Bruskey

"I gotta float my stick same as you" Hondo Lane

"Fill your hand you son of a *****!"

I've got a ways to go yet, and my sister, who will be my executor if she doesn't work herself into an early grave, knows what I want.

My wishes are for the doctors to take anything usable and use it to help someone else, then burn whats left over and let my ashes blow in the wind to scatter where they may.

No grave, no tombstone, no visible reminder of my passing. I don't need it.

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The U. S. Constitution doesn't guarantee happiness, only the pursuit of it. You have to catch up with it yourself. B. Franklin

"A mind needs books like a sword needs a whetstone." -- Tyrion Lannister, A Game of Thrones

I will let my children decide what to do with my remains. They will be more important to my kids than me.

Although, I would prefer not to be embalmed and sealed in a glass coffee table.

What if you're given to Chuck Testa and kept in the car so they can drive in HOV lanes?

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Memento Vivere

I have local knowledge.
That sandbar was not there yesterday!

I'll take the Veteran's cemetary. Next to my grandpa would be ideal, but it's most likely already spoken for.

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"Hysterical children shrieking about right-wing anything need to go sit in the corner and be quiet while the adults are talking."

On the opposite end of the spectrum, I had two centenarians in my family (both great grandmothers of mine) that were healthy and active well past 100 years old. Another grandmother of mine lived a productive life into her mid 90s, and another is still alive and active and enjoying life at 96 without any major health issues (other than that she just broke her wrist). Quality of life varies a great deal in one's old age.

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Well Ali Baba had them forty thieves, Scheherezade had a thousand tales
But master you in luck 'cause up your sleeves you got a brand of magic never fails...
...Mister Aladdin, sir, What will your pleasure be?
Let me take your order, Jot it down -You ain't never had a friend like me
█ ♣ █

It's probably your evil witch magic and deals with Satan giving them longevity.

/ducks

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This must be Thursday. I could never get the hang of Thursdays.

They were/are all Christian.

_________________
Well Ali Baba had them forty thieves, Scheherezade had a thousand tales
But master you in luck 'cause up your sleeves you got a brand of magic never fails...
...Mister Aladdin, sir, What will your pleasure be?
Let me take your order, Jot it down -You ain't never had a friend like me
█ ♣ █

Jasmy, it's funny - my mom had ovarian cancer, too. Before she started chemo, they assured her that she'd lose her hair. She assured them she would not. Guess who was right?! Probably the same kind of willpower that made her clench her mouth against the feeding tube.

And, yes, my wife and I have living wills, so we both know our wishes. They're gonna cremate me and feed the fishes.

_________________
This cold and dark tormented hell
Is all I`ll ever know
So when you get to heaven
May the devil be the judge

I don't know...a glass coffin might be kinda cool. Just stand me up in a corner so I can still watch TV.

_________________
Raell Kromwell

_________________
"Said I never had much use for one, never said I didn't know how to use one!"~ Matthew Quigley

"nothing like a little meow in bed at night" ~ Bruskey

"I gotta float my stick same as you" Hondo Lane

"Fill your hand you son of a *****!"

A bit of an update, the elderly patient in question does have bone Cancer with Lung mets. The family had decided to force him to undergo radiation treatment, but made him a DNR. Not a good situation overall.

_________________
"Life isn't divided into genres. It's a horrifying, romantic, tragic, comical, science-fiction cowboy detective novel. You know, with a bit of pornography if you're lucky."
— Alan Moore

This sounds more like torture than medical treatment. Maybe there is something in the Geneva Convention?

I couldn't do that kind of work.

Ugh.