14. Palliative Care at Home Part 2
by Susan Ellis of KeyLifeJourneys
On Tuesday the home visiting palliative care doctor diagnosed Tammy to have pneumonia, caught in its early stages. I brought her the antibiotics he prescribed. He asked her first if she wanted them. She said yes, she wanted to live a little longer. Accepting palliative care gives one control of decision making, choice is power. Control is so important to people before they reach the stage of surrender and letting go. Being palliative is first processed at an intellectual level.
While in hospital Tammy made several life and death decisions firmly and confidently. Heart problems had appeared during the bowel surgery and the doctors offered her a stent to be inserted to improve cardiac function. She said no, her heart was providing her with the power she needed to walk to the bathroom. She did not need more than that. The first major decision she made when she came home was to have the DNR order written and posted on the fridge. Do not resuscitate.
Tammy had been given orders to set up an appointment with the oncologist from whom she had previously had chemo therapy. Tammy said, no more chemotherapy, don't make the appointment.
Having made all these decisions Tammy had intellectually accepted the terminal nature of her life and was choosing not to endure procedures to prolong it. Some would believe that making these decisions would lead to feelings of hopelessness and defeatism. But for some to make such decisions is empowering and elating. It also forces caregivers out of their denial - out of the get well soon - mode. It makes those around the dying person be able to walk with them honestly, openly, bravely and with fear - but together. It also provides those sending cards to offer messages or real compassion and provides people with permission to say the things so often left unsaid. There is an avenue of communication. There need be no regrets. So many cards talk of "I will always remember you because…."
Tammy has chosen to die at home. I am the leader of her care team. She said to me recently "I may be dying, but I am dying with dignity." How right she is. She may still be afraid of what is to come, but she is not denying its coming. Last Friday she appeared jaundiced, something that had gone by Saturday. "It's getting closer isn't it?" I could say yes quite freely because there is no game playing now, just honesty. Tammy does not have to dwell on the future; she is truly living in the moment. As the day ends she often says "It's been a good day today." Perhaps it is only when you are being fully present with a dying person, sharing the journey, that you know you are alive for the very first time.
On Tuesday the home visiting palliative care doctor diagnosed Tammy to have pneumonia, caught in its early stages. I brought her the antibiotics he prescribed. He asked her first if she wanted them. She said yes, she wanted to live a little longer. Accepting palliative care gives one control of decision making, choice is power. Control is so important to people before they reach the stage of surrender and letting go. Being palliative is first processed at an intellectual level.
While in hospital Tammy made several life and death decisions firmly and confidently. Heart problems had appeared during the bowel surgery and the doctors offered her a stent to be inserted to improve cardiac function. She said no, her heart was providing her with the power she needed to walk to the bathroom. She did not need more than that. The first major decision she made when she came home was to have the DNR order written and posted on the fridge. Do not resuscitate.
Tammy had been given orders to set up an appointment with the oncologist from whom she had previously had chemo therapy. Tammy said, no more chemotherapy, don't make the appointment.
Having made all these decisions Tammy had intellectually accepted the terminal nature of her life and was choosing not to endure procedures to prolong it. Some would believe that making these decisions would lead to feelings of hopelessness and defeatism. But for some to make such decisions is empowering and elating. It also forces caregivers out of their denial - out of the get well soon - mode. It makes those around the dying person be able to walk with them honestly, openly, bravely and with fear - but together. It also provides those sending cards to offer messages or real compassion and provides people with permission to say the things so often left unsaid. There is an avenue of communication. There need be no regrets. So many cards talk of "I will always remember you because…."
Tammy has chosen to die at home. I am the leader of her care team. She said to me recently "I may be dying, but I am dying with dignity." How right she is. She may still be afraid of what is to come, but she is not denying its coming. Last Friday she appeared jaundiced, something that had gone by Saturday. "It's getting closer isn't it?" I could say yes quite freely because there is no game playing now, just honesty. Tammy does not have to dwell on the future; she is truly living in the moment. As the day ends she often says "It's been a good day today." Perhaps it is only when you are being fully present with a dying person, sharing the journey, that you know you are alive for the very first time.
Posted by Key Life Journey's Blog at 9/22/2010 1:23 PM 
Categories: palliative care at home
Tags: DNR palliative care caregivers
Categories: palliative care at home
Tags: DNR palliative care caregivers
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