Grandfather has severe emphysema, and says he is tired of suffering. He keeps getting admitted to hospital and prescribed more pills. How do we know he is suffering and what can we do to help?
What is suffering?
Webster’s Dictionary defines it as: pain (physical, mental, or emotional) that is caused by injury, illness, loss, etc. Some writers have simplified this to, “distress with no end in sight”.
For example, someone who has surgery expects pain requiring rehab and medication; they are not usually described as ‘suffering’, because there is an ‘end in sight’. Whereas, someone with a life-limiting disease, such as advanced cancer, dementia, or end-stage heart disease, may be having severe pain or shortness of breath, accompanied by emotional distress because repeated treatments bring no relief, and so feels distressed that there is no hope; they would likely describe themselves as ‘suffering’.
What may cause suffering?
The traditional goal of medicine has been to always provide comfort and to relieve suffering, but our society and medical sub-specialization has lost sight of this. Now, in our attempt to cure the incurable and prolong life at all costs, we must accept responsibility for adding to the burden of suffering as our patients approach the end of life [EOL], instead of helping relieve it, allowing them to live more comfortably and die peacefully, with dignity.
Many families and doctors have significant ‘death anxiety’: they are uncomfortable talking about EOL issues and avoid such discussions. Families often feel guilty because they think they haven’t done enough or haven’t ‘been there’ for support, triggering unrealistic expectations to keep mom or dad alive longer. Unfortunately, doctors often oblige them: their own discomfort with this, not knowing what else to do, drives them to prescribe more drugs, tests, and procedures. Put all this together, and suffering is not only being prolonged, it’s often made worse.
How do we know he is suffering?
By observation and honest conversations. Does he look like he is enjoying life? Has he sacrificed doing the things he enjoyed just to stay alive and keep the kids happy? Many folks tell me they’d rather die peacefully than have to be looked after and take a handful of pills every day. So ask him what’s important to him. Do you and he know he has several options he can choose from?
Next time: I’ll discuss some options.