“A dying man needs to die, as a sleepy man needs to sleep, and there comes a time when it is wrong, as well as useless, to resist.” – Stewart Alsop
Yesterday in conversation with the woman across the street I learned that unbeknownst to me, a neighbor down the way had died a few months back, leaving his wife physically unable to care for herself despite being in full control of her mental faculties.
Being in full control of her mental faculties does not, however, ensure that you make good decisions. In her case, she had checked herself out of the nursing home she had resided in for a few months and moved herself back in to the house the night before. The rest of the family lives anywhere from 1.5 to 3.5 hrs away.
Her closest living son and daughter-in-law were present at the time with my neighbor, discussing the situation. During the course of the conversation, the son made a few off color comments, one being, “So, Doc, how much hydrocodone do I give to kill her?”
He was semi serious.
I feel for this woman. Sometimes family is too close to the matter, weighing the burden and imposition on their own lives, to really give a chance of understanding. Truly, she probably wants to die there and if it happened tomorrow, she would be at peace with that.
But how do you reconcile this fear of a loss of freedom on both sides of the coin?
They want her in a nursing home. She knows full well if she goes in, she is not ever coming out alive. She will have to condense her entire lifetime of memories and belongings into two shoeboxes and relinquish control of every aspect of her remaining life to people who care nothing for her, people who want to constantly control her peeing and pooping and eating and mood/behavior.
I have been through this countless times with my own patients. I have been the bully doctor laying down the law and the cajoling bargainer serving as go-between. Whatever it took to get the deed done. You would think I would have some profound bit of sage advice, but I had no good answers for them. None at all.