Plan ahead, die with dignity

By JORDAN WILSON

VIEW ON HEALTH

It's one of the most gut-wrenching scenarios imaginable.

Your loved one is sitting in the hospital on the brink of death. Her suffering intensifies daily, she is non-responsive and her quality of life is next to zero.

It's in this situation that a family may decide to remove her from life support. Such a decision is life-changing for anyone involved.

End-of-life care doesn't have to be as horrifying as the aforementioned scenario. As uncomfortable as it may be, having a conversation with your family members before it's too late is the most important step to take, said Jeffery Kline, the executive director of Nevada Seniors Services.

"Starting to plan saves an enormous amount of pain," Klein said.

Having to make decisions on the fly when it comes to care options for an elderly loved one can be rattling.

The best thing to do is to act early.

"Especially while your loved one is cognitive so you can do it together," Klein said. "You don't want to miss that curve. It can be emotionally draining to go through your mom's assets or your spouse's assets and worry about placement.

"It's better to see stuff coming and get a foundation in place."

Nevada, like many other states, gives the patient the ultimate call through a directives decision, Klein said. A patient signs a set of documents and they remained sealed until end-of-life care becomes a factor. People can trust their own judgment or relinquish that to a family member or spouse.

If a person becomes incapacitated, family members may have to seek legal action. A power of attorney can especially help if a family member has dementia or some other disease that takes their sense of reason.

"You have to get comfortable with that idea and head into that direction," Klein said. "If someone with Alzheimer's is not confident, you might need to take control over certain things."

Klein said knowing a family member is on his death bed can actually be a good thing. That way, you have time to right wrongs and to get on good terms with everyone.

"I hate using the word comfortable, so it's a time to get acclimated," Klein said. "It's a horrible adjustment you have to make with this disease. You have to make them comfortable as best you can and accept that your loved one has something that cannot be cured only slowed."

In addition, it gives patients time to deal with any issues they face.

For example, Klein said this is a good time for people to deal with psychological or spiritual issues.

"If the person is of a faith that has a belief system, you can find whatever solutions to have them comfortable within that belief system."

This usually includes enlisting the help of a pastor, priest or Rabi to connect with the person spiritually.

Spiritual or psychological help isn't just for the elderly. Extreme emotions often overtake the family members of a person who is dying. In fact, the family may be in worse shape than even the patient in some cases.

Guilt is common, especially if a person on his deathbed isn't too old.

"You might say, 'Why is it not me who is sick,'" Klein said. "'Why does it have to be Charlie. Charlie is the best. I'm a crummy person.' But as we grieve we start to deal with these issues."

Dealing with the issues can make death less painful. There are simple, yet challenging, plans to be made.

"You have to have a plan -- do we want to be buried or cremated," Klein said. "What plot? What kind of ceremony. It's a great opportunity for social work and mental health and spiritual leaders to help deal with these things. It does give them comfort that there's not this big knife hanging over their head anymore."

Even if you think you know best when it comes to end-of-life care, you could be in for a surprise. Case in point was Klein's own mother. He said she battled cancer for years. Family members sought for her to relocate closer to them so they could care for her.

In the end, Klein's mother stayed put and didn't relocate. Instead, she called her family to her side.

"She took my hand and looked me in the eye," Klein recalled. "She said, 'We had a good life together, didn't we?' Then at 4 a.m. she passed away. My mother knew the end was coming. She made her own decisions rather than what we wanted.

"She called her children and said goodbye and then let herself go. We would have liked to see her last 20 more years. But mother didn't feel like that was the best thing for her."