Suicide, a DNR and a Dilemma

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Hey, wanna solve a mystery?
Say, for example, you know someone that is sick and dying (could be 6 weeks, could be 6 years).

This person is old enough to die without raising suspicion, so to do so would not be unusual (dying that is). But there is no active disease process present to cause death – just the disintegration of the mind, the necessity to wear diapers and the inability to swallow appropriately to eat.

This person has been in a rehab/nursing facility for about 8 yes.

A DNR is in place and this was the disabled person’s choice since 1999, when the stroke occurred. (whaszza DNR? look it up!!!!)

About a week ago, this individual decided to stop eating (nigh a tiny piece of dark chocolate with raspberry), stop drinking fluids. Two days later, medicines are refused; held in the mouth and then spit out, or forcibly knocked out of the nurses’ hand (how ruuudddde!)

OK. Here is the hard part. Do we (me and the medical team) honor the DNR verbatim  (no “heroic intervention: comfort measures only) and allow the patient to basically off themselves via starvation?

Do we force nutrition by installing a central or PIC and an NG tube (there’s another abbreviation for you to Google)?

Or do we start an IV for a route through which we can safely administer meds?

Does an IV violate the terms of the DNR??? Does the feeding tube? The DNR states no heroic measures – is a feeding tube a heroic measure – as it would ease  discomfort from malnutrition.


On Death and Dying


I am facing the death of a parent right now.

Our society (in da USA) does nothing to prepare us to handle the death of someone important (human or otherwise).

We are shown many ways to celebrate life, enjoy life, create life, save life. Not even God’s many fan clubs give us a clue how to handle death, or how to handle the dying process.

(I can vouch for the fact that one certain organization used the threat of death to make people believe their way, and of course, get your money. I know firsthand,  was an 8-yr old child brought to many a tent revival. To this day, I still have a moment of panic when I hear a horn from an unknown source blare – or a storm comes up suddenly a darkens the sky. But that is the subject of another post.)

Sadness. Grieving. Loss.

Instantly, that is what we Americans think about when someone dies. We rarely prepare for death in any way, and even if a loved one (again, human or otherwise) is ill, we submerse ourselves in a bath of denial  – that they will somehow miraculously get better or that science will come up with that miracle cure just in time.we use words that try to ease the impact of what is actually happening.  Some people say someone “passed on (what, they didn’t want to breathe  anymore and decided to pass on it, just like passing on Brussels sprouts at Wednesday dinner),” “taken by angels (are angels like the FBI, they can just come and take us away? Do they need warrants?), “is no longer with us ” (yes, the person found a family he or she liked better) or “has moved on (All those commercials about planned communities in Florida were just impossible to resist!).

Animals are often said to “cross the Rainbow Bridge” and will be waiting us to join them. Sweet sentiment.

Yes, all of these platitudes are created to make us feel better, but I believe that they just make the grieving process longer and more difficult to  move through. But, guilt can often becomes a stage in which a survivor gets stuck. They constantly berate themselves for things they “shoulda, woulda or coulda” done that may have altered the course of events.

In some communities, long periods of mourning are required and expected. Those that are able to accept a death quicker than the social norms dictate are looked upon as being disrespectful to the memory of the dead person, and are chastized – often publically. How evil is this? Who are these insensitive asses, telling others else how to proces personal feelings and memories, how to conduct themselves in the community, what to wear. Grief, mourning, and processing the myriad of feelings accompanying a death of someone close is unique to each individual.

Social norms and behavioral expectations  have changed in the past 20 years or so in some communities, with the advent of the hospice movement, which is now actally paid for by most, if not all insurances. But again, those people, who feel as if they have to tell others how to behave and process personal feelings imply that to get hospice involved to help the ill individual (sorry, no hospice for pets yet – that I know of) is to condemn that person to death – that death it will be hastened – or that somehow, it is a sign of the caregivers’ weakness or selfishness,  just giving up and giving in to death.

In other societies, death is a part of life.  It is talked about, prepared for, and celebrated For example, Dia de los Muertos – The Day of the Dead – a celebration in Mexico celebrates the life of the departed – including beloved animals!

Why can’t the U.S. catch on, and save its population from the horror of denial, grief, pain, hopelessness.  Sometimes, we cannot imagine our life without the beloved and take their own lives. More death.  Leaving more behind to grieve.

Lacking the spiritual strength that immersion in the aforementioned fan clubs of the Almighty seems to bring, I feel isolated.  Of course, this feelingof being an island is greatly enhanced by the facts that I am an only child, estranged from extended family, and thus lack a true feeling of “community” I can burden with the complexity of the feelings I have. So, I called Hospice. This is the best thing I could ahve done, and I wish I had done it about 6 months ago. If you are thinking – “gee, how awful!” – stop it. Lest you have a squemish stomach about all things medical, I will spare you the intricacies.  Bringing Hospice into the situation earlier that I did would have prevented lots of agonizing pain and unpleasant medical procedures, which led to a couple of painful medical errors, creating more suffering for not only my parent, but for me, and in turn my husband. The four recent hospitalizations which occurred in quick succession stole the last bits of dignity and  humanity from an already weak and broken individual. That aspect, and the sceams that occurred even in a coma-esque state that echoed down the long corridor leading to the ICU broke my spirit and ripped my remaining strength.

The Hospice workers have become my “community,” and focus upon keeping my parent comfortable. They work to preserve simple human dignity, provide comforting care and pure lovingkindness. These are special people. They also provide support for me, my anxieties, my feelings and my confusion. I imagine that this is how the dying are cared for in societies that embrace death as part of the life experience, and do not pretend it never happens, as is the societal standard here is the US.

Thusly, I really wish I could ask, “Do you feel you want to die?”

An answer would make life – everyone’s life –  simpler. We could all work toward a common goal, in harmony, together.  We do not have an answer to thia query. We do’t know if we should encourage activity and eating and drinking and participation in ice cream socials. We don’t know if my parent is tired, and feels that it is “time.”

Providing a good transition – when the essence of my loved one will leaves it’s tired, worn vessel and becomes free – that is my solitary goal right now. Comfort and peace is our sole intention.

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