Thanks to Wizcon.

Dad’s Death Panel

Thirty years ago, Mom and Dad came to my brothers and I with a medical directives following an extensive physical at Stanford as a requirement for his new position in the middle east.  It is several pages of very small print and very detailed. They did it at the insistence of Dad’s employer and after talking to their Dr.  Our conversations with him about that document have always centered around quality of life and what “Hope” means in medical situations. Along with that document was a power of attorney for their personal and financial affairs. When Mom died in Saudi Arabia, protests against her wishes were easily dispersed with that document.

When he was first diagnosed with Alzheimers in 2002, he was wintering in Yuma, AZ. Since his retirement in 1985, he had been living and traveling fulltime in his airstream. His first response to the news was to say he was going to walk out into the desert. Then he went on to 5 more yrs of traveling with his friends.

Dad is now 90 yrs old. He looks at his feet in bafflement when they do not respond to his brains command to move. He winces in pain during an ultrasound but says he is not in pain. Pain isn’t a definition he can communicate anymore. He has no understanding of the word. But he feels it.  Last month the battery in his pacemaker needed replacement. They were able to do it under light anesthesia and in the office. This month a gall stone was blocking a duct in his pancreas. They were able to remove that in day surgery under light anesthesia and by going down his throat. But the conversations with all the Doctors in regard to the gall bladder full of stones went as follows: “He is not a candidate for surgery because of his age. It will kill him” Or “what quality of life he has will rapidly decline if he survives”. It all seems very clinical at the time. After all, they are talking about my Dad. Would risky surgery do him any benefit at all? Would it improve or destroy the quality of his life tucked safely away in an assisted living home? To my brother and I, insisting on those surgeries ,with those odds, were cruel and inhumane.

It’s the same conversation we had about the lesions in his lungs, a souvenir from his service in WW2. He still had cognition and able to input into his care when they told him it looked like they had turned cancerous. He said, don’t treat it. Don’t biopsy it. They told him he was not a good candidate for that surgery as well.  He wanted to go on in his own terms.

Even though the POA’s have been activated, my brother has been outstanding in keeping everyone informed of what is going on. He includes Dad and me in all decisions. Decisions are made based on his comfort because that is what he can understand and feel. It is now up to our reliance on his directives and his words to guide us in decision making.

It is getting so Dad cannot talk on the phone anymore. There is no face to connect to and no ability to follow more than a sentence at a time. Questions baffle and frustrate him. He just plain doesn’t know what is going on in front of him. He doesn’t know his past. He watches the activities of those around him and often falls sideways in his chair. He is disappearing into silence. He cannot speak for himself.

I would hate to think where we would be without those directives.  We know we are honoring his wishes. Whether he knows it or not, he is going to have the closest thing possible to the kind of death he wanted.

In his time and on his terms.