Yesterday I cited an article from an AgingCare.com newsletter about Daylight Savings Time. The newsletter had another article by the same author, Anne-Marie Botek, titled “Why a Nurse Refused to Give a Dying Woman CPR.” It was about the controversy surrounding the death of an 87-year-old woman who was a resident of Glenwood Gardens, an “independent living facility” in Bakersfield, California. When the woman collapsed, a staff member called 911. The staff member was a nurse, and the 911 operator pleaded with her to administer CPR until the paramedics arrived, but the nurse refused, citing facility policy against doing so. The ambulance arrived within minutes and transported the patient to the hospital where she was later pronounced dead. Shocking, right? When I first heard the story on the O’Reilly Factor last week, I thought so, but after reading this article and thinking about Mom and Dad’s situations, I’m not so sure.
The executive director of Glenwood Gardens issued a statement outlining facility policy. The quote in the article made it sound like a cold, heartless bureaucratic decision, but I wonder how much of it was based on the tangle of red tape that surrounds both our medical and legal systems. Southridge Village is the assisted living facility Mom and Dad called home for the last months of their lives. A doctor visits the residents once a week, and there is a registered nurse on duty during the day, but based on the operating licenses of the facility, there are limits to what kind of care can be provided when the doctor is not present.
Mom and Dad had living wills, advanced directives and do-not-resuscitate orders in place long before they gave up living independently, but there comes a time when choices still have to be made. Dad became a fall risk several years before he died. He insisted he didn’t need his cane or his walker, but he moved around the house like a child on roller skates, tottering from table to counter to chair, sometimes hitting the floor when the next handhold was a few inches further away than he thought it was. Most of his falls hurt nothing but his dignity, but when he fell for the last time, he hit the corner of a table leaving a huge knot on his forehead. Southridge called an ambulance, and my brother Jim met them at the emergency room. Scans and X-rays showed no permanent damage, so Dad was sent back home. The next day, he couldn’t stand or communicate very well, and he was having trouble swallowing, so he was sent back to the ER to check for signs of a stroke. Nothing definitive showed up, and no one actually said “this is the end,” but that was the message. We were told he could stay in the hospital where they would insert a feeding tube or he could go back to Southridge where they would arrange for hospice to come in and make him comfortable. After much prayer and many tears, we chose to let him spend his last days in his home without tubes and monitors and with the woman he had loved for over 70 years.
He didn’t linger long. His swallowing improved a little, and he took sips of water and juice and bites of Jell-o, but his interest in food was gone. He slept most of the time, sharing his hospital bed with Mom at night, and during the day he communicated with single words or nods. We were told he might last weeks or months, so we weren’t there at the end, but it was a gentle passing. A staff member was getting Mom dressed for the day when she noticed Dad was struggling for breath. She went over and held his hand until he stopped breathing.
The next year we had to make similar decisions for Mom. A few months before she died, she developed a skin condition with an unpronounceable name that caused painful eruptions and constant infections all over her body. She spent five weeks in the hospital and rehab and got steadily weaker. Her arms were black and blue from the attempts to find a vein that would support another IV, and she wore mittens to keep her from pulling out the pick line – again. Once more, after investigating all the options, we moved her back to Southridge and called in hospice. The hospice workers dressed her wounds, fed her, made her comfortable and loved on her. They also loved on us when we came to visit. We were not there at her passing either, in fact, no one was. That last evening she laughed at the antics of a therapy dog brought in by one of the nurses, ate a good dinner and was put to bed. When they checked on her a couple of hours later, she was gone. Her earthly body lay still and her face had a peaceful expression that said “Don’t worry about me. I’m home with Jesus now.”
In her article, Botek quotes Carole Lieberman, M.D., a psychiatrist and best-selling author, who says, “It is totally unethical for anyone, no less medical personnel, to stand by and watch a person die.” I understand what she’s saying, but eventually that is our only choice. There comes a time when our human efforts are exhausted, the fighting is over, and all we can do is stand by and watch a person die.
I’m glad Mom and Dad gave us their last wishes in advance, and I’m glad we made the decisions we did. I’m glad that Dad’s last sight on earth was the familiar face of a caring staff member and his loving wife instead of strangers armed with oxygen masks and defibrillators. And I’m glad Mom’s last waking moments were filled with familiar, positive experiences instead of sterile hospital routines. I have all the end-of-life documents in place, and I’ve told my loved ones that when my time comes, don’t fight it. Just let me go.
Hebrews 9: 27-28 (The Message) Everyone has to die once, then face the consequences. Christ’s death was also a one-time event, but it was a sacrifice that took care of sins forever. And so, when he next appears , the outcome for those eager to greet him is, precisely, salvation.
- One Good Things About Daylight Savings Time | by Linda Brendle (lifeaftercaregiving.wordpress.com)
- The Stress Doesn’t Always Go Away When a Loved One Dies | by Linda Brendle (lifeaftercaregiving.wordpress.com)
- Caregiving: It’s Not for Sissies | by Linda Brendle (lifeaftercaregiving.wordpress.com)