Let me clarify: this is an elderly woman, unmarried, with no children, who has metastasized cancer. This is not somebody lost in clinical depression, but somebody facing hard choices about quality of life and a bad prognosis.
My etiquette book has nothing helpful to say. When my mother-in-law used to tell me she was wishing she could die, I said the natural thing: Oh, not yet! Oh, not you! You'll feel better tomorrow. I think now that was maybe not the best thing to answer. It's hard to know what is right, though. Our culture does not deal well with death.
Very few of us have ever really attended somebody who was dying. Hardly anybody in the U.S. now dies at home or with family. We are carted off to hospitals where the whole focus is to stave off death at any cost. We have trouble making the choice to stop treatments and go for dignity and pain-free peace at the end. I don't know what to say to my friend. How hard.
Thank you, Adrienne! What a generous and helpful comment! Very thoughtful.
ReplyDeleteI worked as a social worker with the frail elderly for 5 years and dealt with this many times. This is a very very tough issue. I have to agree with Adrienne about considering linking with Hospice if the diagnosis is imminently terminal. There is no reason to be in physical pain in addition to all the other losses this person is undoubtedly facing.
ReplyDeleteAnother issue most of us don't want to address is what we used to call "puttin' it in writing". Putting our wishes in writing while we are clear and have decision making capacity may feel a bit morbid, but if that unfortunate time comes when we may not be able to speak for ourselves, the right paperwork can make all the difference in terms of quality of life AND quality of death.
DNRs, Living Wills, and Health Care proxies are good starts. They may not be infallible (say you end up unconscious in a non-local hospital... the ER staff may not have your paperwork and will need to intervene), but they are sure better than nothing. There are various levels of detail a person may identify (say, pain management, removal of life support or feeding tube).
For example, my brother and I would like our mother to put her wishes in writing because we disagree on some things. Her doing this could spare a family dispute should the time ever come.
Also, when choosing a health care proxy, one should pick someone who'll carry out their wishes, regardless of how they themselves feel about it. This question should be asked before naming someone.
If your friend will give written permission, perhaps it's worth contacting her doctor to explain how she's feeling? A referral for counseling or medication might help, and perhaps she is just too down and dejected to do this for herself.
Sorry to be so verbose here, and I doubt I have given you any real comfort in this immediate situation. Things to think about.... but I do offer this: how blessed your friend is to have someone who cares so deeply at this time in her (and your) journey. I wish you both strength and comfort. You have my thoughts.
Thank you both for excellent advice! Your comments are very helpful, coming from true experience.
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