End of Life discussion

[AutumnLeaves61]

This isn't a rant. Just something I want to share - if you have a similar discussion one day, you could be better prepared. My very elderly father died last week after a short and swift decline. His LPA was still with the OPG so wasn't in force, but we knew he didn't want to be resuscitated. He also wanted us consulted, but that was not yet official. He was in hospital and I understood his condition was deteriorating and he would not survive. So far so good.

What I didn't keep distinct in my mind while I was having The Discussion with the consultant's team was the difference between him not being resuscitated and them withdrawing the treatment he was on (I wanted my sister to hear about the latter, and she was due in 1-2 hours). Because I didn't distinguish the two, there was an unnecessary conversation about intensive care procedures and priorities and how it wasn't appropriate. This created a tense atmosphere in which the consultant said, as he had the right to, they were going to withdraw treatment he was on immediately. Had I kept my wits about me, I could have stopped the resuscitation discussion, and got focus on the only actual decision: when to stop treatment. I might (or might not) have got them to wait to explain this until my sister was also there - and if not explain to me why they wanted to act now. Maybe they knew he was in distress that was not obvious to me. The hospital as a whole was excellent, my sister and I don't have a problem with what was done, but this conversation could have been better. Re-reading this, I sound rather precious to me, but at the time I felt rushed and railroaded and I could have handled it better.

[whataboutbob]

I don't think you sound precious and if it was presented as a "we don't think it would be sensible to resuscitate/ escalate to ITU" and then they virtually smuggle in the bit about withdrawing treatment, that's rather underhand. But doctors have strategies for steering decisions the way they want so I am not entirely surprised by your description. It must be frustrating to feel that you were finessed into agreeing when you did not have all the facts. Having said that, they may well have been protecting you from the burden of all the facts and acting entirely in your father's best interests.

[AutumnLeaves61]

Thanks for replying Bob. I agree with what you say and have no doubt my father's interests were best served. I guess the lesson is: try not to be the only family member present. It's a lonely place.

[whataboutbob]

Yes, agreed, it's much better to have another person to share the all this with, with the proviso of course that you get on well and that the other person is strong enough to cope. I found making a multitude of decisions about my father very draining, carrying the moral responsibility all the time really tired me out. No one prepares you for having to make these decisions about a parent, someone who had control over you for all those years and is now utterly vulnerable and incapacitated.

[AutumnLeaves61]

Spot on again, Bob - he was a tough man with a lively mind. Maybe that's why I'm shattered, I hadn't thought of that. It's not grief as such - his life came to a natural end for which I shall be eternally grateful. [Heads off for coffee break with less than usual guilt...] Thank you so much for understanding and sharing your thoughts.

[whataboutbob]

You're most welcome, glad I could help a little.