Other than trying the drugs (which unfortunately rarely help) mentioned in the previous column, there is another option that more patients/families are choosing.
An elderly man was dying from his Alzheimer’s and his daughter, his caregiver, was worn out. She knew that family members have an increased risk of Alzheimer’s, and I asked her what she would want if she developed it.
“Only two things” she said. One, no antibiotics. If she caught pneumonia, let it be her ‘old person’s friend’: in the days before antibiotics, pneumonia was the most common cause of death. She didn’t want to be a burden to her family nor interfere in a natural event which may offer an escape from additional suffering.
And two, “M&M’s”. I thought she meant the candies, but she said “no, Morphine and Margarita’s”. She wanted everyone to know that if she had pain, she wanted whatever it took to alleviate it—including morphine; and since she really enjoyed having a Margarita with her family and friends, she wanted to continue to have that ‘happy hour’ every day.
The point she was making is that since we can’t cure this tragedy, her goal was to improve her remaining quality of life by being comfortable and sociable. She didn’t want to prolong her own or her family’s suffering; rather, enjoy every day as much as possible and leave the rest to God and nature.
To help ensure that, I reminded her to have an Advance Directive outlining her wishes and to talk with her family.
Next time: “letting go” versus “giving up”.