End of Life Choices for 95 Year Old

  • Thread starter Thread starter HolySpirit08
  • Start date Start date
Status
Not open for further replies.
H

HolySpirit08

Guest
My Godfather who is also my father’s brother suffered a stroke about 10 years ago that robbed him of about 98% of his ability to speak and express himself. He was also not always able to write to communicate if something hurt, etc. He was never married, had no children.

One of my cousins has been our uncle’s only visitor for all these years while our uncle has lived in two small privately owned group home. My cousin also took care of all of his legal matters and drove him to doctor appointsments prior to his moving into the most recent care home. While living in either of the two care homes our uncle wasn’t able to communicate much at all with the other residents. His life was quite solitary even before he suffered his stroke.

In the beginning our uncle was able to attend weekly family pot luck lunches but he’d often choke on his food. Twice my cousin had to perform the heimlich (sp) manuever on him! Since I have moved back home, I have been able to make the drive to visit him about once or twice a month taking him ice cream or other treats, burgers, that sort of thing. Still he coughs through each meal and always has so much congestion, mucus and does not have the stength to cough it out. I know that’s gross but that is the way it has been for him and the other residents did not want him at the dining table with them because it really is nauseating. I’ve gagged and almost thrown up myself while there and my uncle is eating, coughing and hacking. I can’t describe it. He can’t inhale while coughing until he’s almost ready to pass out.

I’ll go to the next page now to keep this managable.
 
HolySpirit08 said:
My Godfather who is also my father’s brother suffered a stroke about 10 years ago that robbed him of about 98% of his ability to speak and express himself. He was also not always able to write to communicate if something hurt, etc. He was never married, had no children.

One of my cousins has been our uncle’s only visitor for all these years while our uncle has lived in two small privately owned group home. My cousin also took care of all of his legal matters and drove him to doctor appointsments prior to his moving into the most recent care home. While living in either of the two care homes our uncle wasn’t able to communicate much at all with the other residents. His life was quite solitary even before he suffered his stroke.

In the beginning our uncle was able to attend weekly family pot luck lunches but he’d often choke on his food. Twice my cousin had to perform the heimlich (sp) manuever on him! Since I have moved back home, I have been able to make the drive to visit him about once or twice a month taking him ice cream or other treats, burgers, that sort of thing. Still he coughs through each meal and always has so much congestion, mucus and does not have the stength to cough it out. I know that’s gross but that is the way it has been for him and the other residents did not want him at the dining table with them because it really is nauseating. I’ve gagged and almost thrown up myself while there and my uncle is eating, coughing and hacking. I can’t describe it. He can’t inhale while coughing until he’s almost ready to pass out.

I’ll go to the next page now to keep this managable.
Click to expand...
I may be jumping the gun and assuming I know what your question is before you ask it, but you had said that you would be going “… to the next page” and there were no more pages to this post. So, allow me to respond based on my assumption of what you are going to ask.

You should continue to be there for your uncle, as should the other members of the family. I can only hope that should I reach the age of 95, someone (family) will be there to spend time with me. Even if I have handicaps such as you mentioned.

God bless and keep being there.
 
Last week he was taken to a doctor who told the care home to take him directly to the ER because his lungs were so congested with mucus that he was unable to lie down. The gurgling was very audible with each labored breath. Still, he was able to understand simple language and communication, from those he’s used to being around and could communicate back to us as he has for the past 10 years.

In the hospital his condition did not improve. His food was now minced and then pureed, liquids were thickened which he wouldn’t drink. The had him hooked up to an IV with fluid and antibiotics. If he ate too fast, he choked and even vomited his food during one meal. He was unable to get rid of all of the mucus which was way up in his trachea the doctor say and his “cough” was so weak and always exhale, exhale, exhale, exhale, exhale, exhale, exhale, exhale, exhale and not able to catch a breath to inhale always coming close to passing out. The nurses tried to stick flexible tubes down his throat and his nose but he’d panic and struggle because it hurt and terrified him. I kept giving him a little water from a plastic picnic spoon because the nurses and doctor refused to. He could eat ice cream and other soft foods but just teeny little bits off the end of the spoon. Still he choked and coughed to near passing out so they gave him morphine in low doses along with a steroid to take the swelling in his chest down and to help him breath and relax. It didn’t help.

They tried giving him breathing treatments with medicine in steam but he was terrified of that too and wanted it off. It would loosen the mucus a little but that caused him to cough in that weakend way and he was unable to bring the mucus up. We tried many times to suction it from his mouth but then he’d get confused and suck on the suction which made me throw up because it just grossed me out.

Finally when I was feeding him lunch one day he choked and coughed so badly that it went on for almost two hours with the nurses trying to suction him, I tried, and nothing worked until the raised the strength of the morphine to take down the swelling, relax him and to help him sleep. Whenever the aides came in to change and clean him and turn him, they would lay the bed down and he panic trying to call out that he couldn’t breath the entire time they had him lay flat and they would have to hurry to do this for him.

That day that the choking and coughing and hacking went on for hours my cousin and I and the doctor decided that we would raise the morphine so that he could stop struggling to breath, stop choking and trying to cough up mucus that refused to come out of his trachea. The doctor took him off all water by mouth and we decided to let him die because the only thing that would help him to stop choking and coughing was high doses of morphine whenever the choking started. They closed down his fluid IV and he went to sleep until he died.

I asked the doctor first if we did not do this, would he die choking and she said that he in all likelyhood would.

Your opinions please. Did we euthanise him or should be have let him choke to death naturally?
 
It should also be clear that my cousin and I loved him very deeply. We still do. We would do anything for him. My uncle was very, very dear to us.

Our uncle wanted to die. He was so tired of suffering. He just wanted to move on. He was 95 years old. He had a pacemaker, suffered that stroke, used a walker, fell often, was now diabetic and in hospital, they were constantly poking his fingers and then injecting him in the stomach with insulin. It all seemed so cruel to try and keep an elderly man alive who was suffering from bronchitis that soon could be pneumonia if he didn’t choke to death first.

The doctor said that he now had to be fed with a feeding tube and my uncle did not want this although when he made up his will, I think he and even I assume that a feeding tube would only be used when he would be in a vegetative state…not when he would be coherent.

My cousin and mostly I spent hours and hours daily with our uncle in the hospital. The last night, I spent the night there after the priest gave him last rites. I was so exhausted from several nights of very little sleep (perhaps 3 hours) that it never occurred to me to ask for a priest’s advice. Never!!! Now I feel sick wondering if we did the right thing.

Please help me.
 
Here is the Catechism’s section on euthanasia:

Euthanasia

2276 Those whose lives are diminished or weakened deserve special respect. Sick or handicapped persons should be helped to lead lives as normal as possible.

2277 Whatever its motives and means, direct euthanasia consists in putting an end to the lives of handicapped, sick, or dying persons. It is morally unacceptable.

Thus an act or omission which, of itself or by intention, causes death in order to eliminate suffering constitutes a murder gravely contrary to the dignity of the human person and to the respect due to the living God, his Creator. The error of judgment into which one can fall in good faith does not change the nature of this murderous act, which must always be forbidden and excluded.

2278 Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of “over-zealous” treatment. Here one does not will to cause death; one’s inability to impede it is merely accepted. The decisions should be made by the patient if he is competent and able or, if not, by those legally entitled to act for the patient, whose reasonable will and legitimate interests must always be respected.

2279 Even if death is thought imminent, the ordinary care owed to a sick person cannot be legitimately interrupted. The use of painkillers to alleviate the sufferings of the dying, even at the risk of shortening their days, can be morally in conformity with human dignity if death is not willed as either an end or a means, but only foreseen and tolerated as inevitable Palliative care is a special form of disinterested charity. As such it should be encouraged.

It seems to me that we need to look at the criteria of par 2278 in particular. It seems firstly that the intent was not to do your uncle to death, rather than death in one way or another was inevitable and it was a question of making him as comfortable as possible.

It also appears that the medical procedure of IV fluids plus morphine was likely extraordinary, burdensome and disproportionate, to use the Catechism’s terms. What might be called ‘heroic measures’, which it is legitimate to refuse. And that their discontinuance was thus a legitimate option.

Discuss it with your priest if you still feel any concerns - but bear in mind that mortal sin requires full knowledge and consent, so even if your doctor and I are wrong on this, it’s not a question of you having sinned or anything.

Clearly if you were in such a state of mental and emotional exhaustion that it didn’t even occur to you to ask the priest’s advice, then you weren’t in a state to be held culpable for the decision you made.

My prayers for you and for the repose of his soul.
 
Lilly, I can honestly tell you that I wanted my uncle to die to end his suffering. That is what was foremost in my mind. He also wanted to die. That does not make it right for either of us but I have to wonder if the doctor would have encouraged us to try more aggressive treatment if he would not still be alive. I was so distraught that all I wanted was for all of his years of suffering to end.

In retrospect, I wish we had had more help so that we could have gotten some rest and perspective. All I could think about was to stop my uncle’s suffering and lack of the level of care he needed in the nursing home.
 
HolySpirit08 said:
Lilly, I can honestly tell you that I wanted my uncle to die to end his suffering. That is what was foremost in my mind. He also wanted to die. That does not make it right for either of us but I have to wonder if the doctor would have encouraged us to try more aggressive treatment if he would not still be alive. I was so distraught that all I wanted was for all of his years of suffering to end.

In retrospect, I wish we had had more help so that we could have gotten some rest and perspective. All I could think about was to stop my uncle’s suffering and lack of the level of care he needed in the nursing home.
Click to expand...
Regardless, it does sound like the options were pretty much die with choking or die without. Doesn’t sound like there was much else you or the doctor could’ve done.

For sure you need to talk to your priest, for your own peace of mind. He can better advise you on the ins and outs of the situation than we can. It seems clear enough, though, that you were NOT in a position to think straight, and thus are not culpable for your decision in any event.

It is a sad but true fact that all such decisions and situations are accompanied by unimaginable levels of physical and psychological stress that can cloud our thinking. However, God is merciful and knows that we humans are weak and fragile vessels at the best of times.
 
God bless you, Lilly. I have been beside myself with doubt, guilt, regret, sadness. And even though my dear uncle is gone and no longer suffering in this life which is what I prayed for for him for years, I miss him so much and wish I had done more for him while he was here on earth. I will always pray from him and have masses said for him.

Thank you so much for your understanding and enlightenment. I desperately want to discuss all the details with a priest. If I did wrong, I desperately need to be forgiven. I also influenced my cousin so I am responsible for that as well. Over the years I felt that he did not place my uncle in the best available living environments so this was on my mind during the hospitalization and I wanted my uncle to finally have a safe place to reside…HEAVEN.
 
I’m sorry, this may be painful, but I am curious about how much morphine they gave him. It seems they may have been aggressive. Then again, he could have died from the pneumonia. He obviously had a very bad case of it.

Obviously, he could not tolerate oral food. He did not appear to want a feeding tube, and it would have been inappropriate at that time to introduce one. He probably could have used it much earlier, but, no one, apparently, suggested that.

My only concern with what you have said is your attempt to explain that his “quality of life” was less than ideal. I’m not even sure you realized you did that. I’m not saying you did this, but, people’s lives are being judged on someone else’s idea of what is acceptable and good, as opposed to bad. This is not your fault. We are slowly being indoctrinated to think in these terms. People themselves are being trained up to want to end it, rather than being a burden, or suffering even temporarily.

It sounds as though you tried all avenues. Had they cured the pneumonia, he would have choked again, and again. He would eventually have starved to death, or died of the pneumonia.

Be at peace.

Ceil.
 
Your Uncle R I P needed to be in a Hospital in his condition. My wife has been in a Nursing home for over three years. They are not equiped to handle a patient as sick as your uncle was.
When a patient is that Ill you need a Nursing Staff round the Clock to take care of them. When he choked he needed to be suctioned every time to ease his suffering and help him breathe.
I dont know if the Doctor said anything to you about sending him to a hospital or if there was a reason he could not be sent.
When he died it was his time to go. God called him home. His purpose on this Earth was over. He had suffered enough.
We do not live one minute longer or shorter of the time God gives us.
He went to sleep and died a natural death.
If you feel you need to talk to a priest do so.
Since he was not in a Hospital there was nothing more could be done.

Antrim
 
Dear Friend,
I’m truly sorry you had to go through this, but am glad your uncle is now at peace.
I would not add my 2 cents except that I wouldn’t want others to be left wondering as you have been.
I participated in a similar event in the hospital some years ago. When I realized what had been done I went to my priest in confession, and he absolved me but also recommended I go to a right to life seminar, which was very informative. I’ve been forgiven but I still feel bad about my part in those events.
It seems like your uncle’s medical care was not optimal. Antrim is right, he should have been in a hospital. Seems like he should have been “nothing by mouth” much earlier, to avoid choking. He could have had a feeding tube if it were explained to him clearly, they are not that bad. Or maybe been fed intravenously only. People who tend to choke should not have sips of water, though sometimes the doctor will order ice chips to suck on.
The part that concerns me is: “the doctor decided that we would raise the morphine so that he could stop struggling to breathe.” That is euthanasia,and is not permitted by the church. It’s ok to give morphine to relieve pain or anxiety, but not to stop someone from breathing or to bring about his death. If you are giving morphine for pain and the person dies as an unintended result, that is not euthanasia.
It’s a fine line, and it seems that more could have been done - by the medical staff, not by you his relative, who obviously did everything you could. I think you did the best you could with the advice you were given, but everyone should know that giving pain killers to relieve suffering by putting an end to the sufferer is wrong.
I recommend you talk it over with a wise priest, who will be able to relieve your mind.
For the rest of us, if we find ourselves in that situation, get a second medical opinion, and talk it over with the priest. Pain and suffering can usually be alleviated.
 
He was in the hospital when all of this took place. I too think it is euthanasia and I cannot believe that I brought it about. The doctor offered to increase the morphine whenever he struggled to cough up the stubborn mucus and he didn’t have the strength. He hasn’t had the strength to cough it up for a very long time. But I don’t think he was at death’s door. I really think we pushed him through it quickly.

I was so focused on relieving him of his lonely existence and his suffering with all of this coughing. It has been such a struggle for him. His two roommates at the care home mentioned to me several times that he coughs all night long and he’s lying flat in bed. They did not have him in a hospital bed although he actually purchased one for himself a few years ago. They would not allow him to bring it with him to the care home.

He was on no liquids by mouth on the fourth day of his hospital stay. Prior to that we were feeding him the minced then pureed food and sometimes he tollerated it in small teaspoons full at a time. Other than that, he’d be happy when we would walk into his room and he could communicate with us in his normal fashion but we could understand perhaps half of what he was trying to say because of the stroke.

I can’t imagine how someone can live with no water by mouth. Wouldn’t his throat become terribly dry? How would he cough up the mucus in his trachea? I asked for ice chips and they ignored me. They said he could only have thickened liquids and that was disgusting.

The only joy he had out of life was eating and our visits but we couldn’t continue to be with him daily. If they put him on feeding tubes, what would he have to live for? I was at a point where I just couldn’t imagine that for him. He has already been through so much. He’s 95, incontinent.

Oh my God. When is enough enough? Why must be hold on to this life so tightly? Isn’t being with God in Heaven our ultimate goal? I guess I shouldn’t even be asking these questions. It’s all up to God. I need to talk with a priest. I think I made a very bad choice and influenced my cousin to go along with me. That last afternoon my uncle was going through so much but I wish we had really consulted a priest and asked for more information about the feeding tube and a move into long term care at the hospital. My uncle was just so tired of it all. He kept say “hard” meaning that it was so difficult to be so going through this for so long.
 
“It’s ok to give morphine to relieve pain or anxiety, but not to stop someone from breathing or to bring about his death.”

I am not a doctor but I know they will use morphine to help with breathing. I don’t know why it helps but it does. As morphine doses get too high, it can overly suppress breathing. This is a common balancing act when treating these patients. The objective is too keep them as comfortable as possible. Death is inevitable.

Be at peace with your decision. You did not euthanize him. He was dying. You could not stop that.

To others in a similar situation, I recommend that you contact hospice specialists. Our local hospice groups have a teams that visits your hospital or home with doctors, nurses, social workers, and clergy.
 
You should be careful what hospice you use. Sometimes they are the worst culprits.

No doubt the Morphine hastens the inevitable. Just so long as the dose starts small and is increased gradually, just enough to keep respirations b/w 20-30. Ativan should be given to keep the patient from being restless and anxious. It should not be administered to deliberately sedate them. That should come about naturally, through the disease process, not be induced artificially through medication. This is a common mistake.

Our tendency is to want to hasten this stage, as it is very upsetting to us. But, we must remember that there are activities going on at the level of the soul that we know nothing about. It is the most important moment of our lives. We should be genlty encouraging them to embrace the Lord. We should be praying for them in their presence, reading Scripture, playing soothing, preferably religious music, etc. They can hear right up to the last moment.

Death should be a natural progression of the disease, eased by the benefits of the medication God, in HIs mercy, has given us.

The world tries to tell us to hurry it up because the patient is suffering. Especially in this stage, it is we who are suffering. Once they lose consciousness, they are not aware of this physical state. They are very much active on another level, however. I believe this push to rush things is a temptation of the devil, who does not want this “work of the soul” to be played out. Please, please remember this. There is a right way to go about these things.
 
HolySpirit08 said:
Last week he was taken to a doctor who told the care home to take him directly to the ER because his lungs were so congested with mucus that he was unable to lie down. The gurgling was very audible with each labored breath. Still, he was able to understand simple language and communication, from those he’s used to being around and could communicate back to us as he has for the past 10 years.

In the hospital his condition did not improve. His food was now minced and then pureed, liquids were thickened which he wouldn’t drink. The had him hooked up to an IV with fluid and antibiotics. If he ate too fast, he choked and even vomited his food during one meal. He was unable to get rid of all of the mucus which was way up in his trachea the doctor say and his “cough” was so weak and always exhale, exhale, exhale, exhale, exhale, exhale, exhale, exhale, exhale and not able to catch a breath to inhale always coming close to passing out. The nurses tried to stick flexible tubes down his throat and his nose but he’d panic and struggle because it hurt and terrified him. I kept giving him a little water from a plastic picnic spoon because the nurses and doctor refused to. He could eat ice cream and other soft foods but just teeny little bits off the end of the spoon. Still he choked and coughed to near passing out so they gave him morphine in low doses along with a steroid to take the swelling in his chest down and to help him breath and relax. It didn’t help.

They tried giving him breathing treatments with medicine in steam but he was terrified of that too and wanted it off. It would loosen the mucus a little but that caused him to cough in that weakend way and he was unable to bring the mucus up. We tried many times to suction it from his mouth but then he’d get confused and suck on the suction which made me throw up because it just grossed me out.

Finally when I was feeding him lunch one day he choked and coughed so badly that it went on for almost two hours with the nurses trying to suction him, I tried, and nothing worked until the raised the strength of the morphine to take down the swelling, relax him and to help him sleep. Whenever the aides came in to change and clean him and turn him, they would lay the bed down and he panic trying to call out that he couldn’t breath the entire time they had him lay flat and they would have to hurry to do this for him.

That day that the choking and coughing and hacking went on for hours my cousin and I and the doctor decided that we would raise the morphine so that he could stop struggling to breath, stop choking and trying to cough up mucus that refused to come out of his trachea. The doctor took him off all water by mouth and we decided to let him die because the only thing that would help him to stop choking and coughing was high doses of morphine whenever the choking started. They closed down his fluid IV and he went to sleep until he died.

I asked the doctor first if we did not do this, would he die choking and she said that he in all likelyhood would.

Your opinions please. Did we euthanise him or should be have let him choke to death naturally?
Click to expand...
The IV fluid would not in my opinion have been an extraordinary means of medical treatment. I would have consulted a Pulmonologist to see if there was any other options to ease his breathing.
 
Thank you all so much for your advice, comforting words, informative and inspiration. I just learned that the soul is so alive and preparing us to meet our Savior during the dying process. I did not know this. I did everything wrong.

I should not have been making decisions as emotionally involved as I was. For years and years I have been worried about my uncle because he had emotional problems and was such an isolator. His health problems and being placed in facilities that were very lacking in care when I was helpless to change them were very frustrating and stressful for me. I prayed a lot of him but other than that, I was unable to change anything.

And then he ended up in the hospital and I was the first one there with him and got acquainted with the doctor so I was more influential than my cousin was and i was also able to influence him in the decisions we made on my uncle’s behalf. My uncle was not a very spiritual man although he was a regular church goer. His understanding was a bit limited. He wanted to die but had probably never heard of euthanasia. I should have known better. I was too hasty. I too think the devil was not just whispering but SHOUTING in my ear and I did not stop him.

I did not know about pulmonologists. That makes me angry with the hospital but i think they did what they did because I kept telling them that my uncle wants to die and is tired of suffering and we do not want them to do anything to prolong his life or to make him suffer any more. The increased doses of morphine were given to actually allow him to die. I think it killed him along with the fact that we agreed to have all IV fluids stopped and his kidneys failed. In a word, we killed him. I have to live with the fact that I ended my uncle’s life. I feel sick. In fact yesterday I was sick to my stomach.

I must talk to a priest. I have so many regrets. I hope God forgives me. I don’t think that I can ever forgive myself.
 
You are being WAY too hard on yourself. You made the correct decision, in terms of removing extraordinary care. The onus was on the hospital and medical people if there was anything inappropriate done. In the end, it is all a matter of opinion, anyway.

I am not sure I agree with Br. Rich, with all due respect, about the fluids. I have been in hospice for three years and oncology for several more. IV fluids during the dying process is not only painful, it worsens the respiratory symptoms. Most people who are conscious
during the end stage choose not to take many fluids, and especially no solids. This causes a dehydration that eases symptoms during what we call the active dying phase.
The difficulty comes in determining whether or not the patient is end stage or actively dying.

During active dying, the body organs begin to slowly shut down. Fluids at that time are not processed properly. It goes into the lungs and causes severe respiratory symptoms. It also goes into the tissues, and prolongs the whole process by reversing the circulatory shut down. I hope I am not being too graphic, here.

Your uncle, God rest his soul, was in dire straits regardless of what you did. He is with God, now. Do not beat yourself up about this situation, please. If it should ever happen again, seek out a good hospice, preferably a Catholic one, if they are still available, and
see what they say. If they seem too eager to end it without due process, keep looking.

I deal with this anytime someone is in the hospital. It is a situation in which, short of giving them something to stop their heart, there is no sure way to manage.

Be at peace.
 
I don’t think that is remotely like “euthanasia”. When I think of euthanasia, I think of people who learn they have 3 months to live, so they decided to end their life rather than face the fact that they are confronted with something out of their control, or people who arbitrarily decide that somebody’s life is not worth living.

What does the Catholic Church teach about “wanting to die?” I think on some level, dying people accept that death is inevitable, its one of those stages, and they let go of living. I know in my grandfather’s case, he stopped eating, drinking, or even taking painkillers. We had a family relative that died very slowly from complications from diabetes, my mom helped take care of her, and she gave up at the end too, she just didn’t want to live anymore and accepted what was happening.
 
Sorry about your loss. No matter what you would have done, we always question after with what if this or that.

The person can not die from dehydration or starvation as the result of intervention. Like a Terry Shievo situation. ( Just a few miles from my home )

However, the dosage of a pain killing drug may be increased to the amount needed for pain relief but not beyond. If the person dies at that threshold, there is no wrong doing.

A have a sneaky feeling that at the VA, if your not going to make it in a no hope situation, they don’t let things drag on and on. They crank it up and cross that threshold and let the person slip away.

Everyone should just go the bed one night feeling fine and wake up in Heaven.
 
Status
Not open for further replies.
Back
Top