Thursday, November 13, 2008

What does end of life look like?

I guess everyone, how close or distant a reality death is, can agree that given the choice they would opt to die at home surrounded by family while still having full physical and mental capabilities. This is the ideal depiction of death for most people. It wasn’t until today, when faced with the death of a close family friend that I pondered the different forms end of life takes. For this man in particular, it was in fact ideal. Being the ripe age of 93 he suffered a quick stroke and died in bed with his wife at his side. He still lived at home, drove a car, volunteered at the local elementary school, in every way was a contributor to the community and to his family. The night of his final departure he played snooker followed by mass- just to give you an idea of his independence. It can only be this conception of death that people filling out the questionnaires on end of life preferences had in mind. Juxtaposed to this image, is that of my Grandma, who for the last ten years has been significantly declining in mind and body. In her deterioration my mother felt the burden and after tremendous guilt of trying and being unable to tend to her needs. Dying can be ugly, it can be slow- and if in these circumstances most people would think twice about wishing family members take on the responsibilities of end of life care. A question framed in such an ambiguous way is guiding a certain answer. Where would you prefer to die? – few would answer amongst strangers in a hospital bed. But if asked how would you prefer to die?- few would answer slowly with a degenerative disease that requires a lot of money and labor to manage. Unfortunately we cannot dictate the form end of life will take for us, and as such we can not judge (preemptively) what form of care will be best suited to our condition at that time.

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