Terminology around death and dying is always difficult. For patients in hospitals who are terminally ill, the advance directive called “Do Not Resuscitate” instructs hospital personnel not to resuscitate these patients if they stop breathing or their heart stops. Recently, hospitals have started calling this advance directive “Allow Natural Death.” For a terminally ill patient, resuscitation efforts are almost invariably futile anyway, dreadful for everyone, and even if successful, serve only to prolong a sufferer’s pain. These hospital orders are widely seen as appropriate.
However, allowing seniors to pass away naturally under other circumstances is almost unheard of. Rules and regulations at nursing homes focus on extending peoples’ lives, instead of allowing them to decline in a way that would be more natural. While it is sad to see a loved one slipping away, I would argue – from personal experience – that it can actually feel cruel to take steps to prolong the person’s life, long after he or she is truly ready to go.
This does not have to be a depressing topic. Taking control of how you live can and should be empowering. Some people want to stay alive as long as they possibly can, and of course that’s their right. But if a competent person who sees advanced disease or dementia approaching decides that is not how he wants to die, should it not be his decision, for example, to stop taking his heart medication?
That is the case with my father. He is not depressed, but he’s more than ready to “go.” He mentions it approximately every 15 minutes, each time my sister or I visit him. It finally occurred to us that if he went off his heart medication, “It would be God’s decision when it would be his time.” (He’s quite religious). He embraced the idea wholeheartedly. Nobody had ever presented it to him as an option.
His doctor was shocked and opposed when we broached the subject. She eventually came around, when my father made it clear that it was what he wanted. Here is a senior who feels strongly that he made the right decision about the rest of his life, based on the principles that are important to him. It is his life and he should live it the way he wants to. I believe that, if seniors are taking medications (and what senior isn’t?), a doctor should regularly discuss with them the medications they are taking and why, and the impact these medications are having on their life and life expectancy.
So much about the end of life is difficult, for adult children as well as their aging parents. In my case, as I age, it will make me happy to keep control over how I live my life, while I am still competent to make decisions. And if I lose all mental capacity, I want my caretakers to know that my wishes are to pass out of this life naturally and expeditiously. Preventing every germ from reaching me, treating me for infections, making great efforts to keep me fed and hydrated – look at it objectively. If my body is trying to go, all any of these measures do is to prevent that from happening. That is simply not natural.
People may be shocked at this idea, but I believe there are seniors who would be happy to make decisions similar to mine. Encouraging the health care community to promote these discussions and embrace the wishes and decisions of seniors and their health care agents would go a long way toward making the end of life a more humane experience.