Death and despair or peace and contentment: why families need to talk about end-of-life options

Talking to your family about your end-of-life preferences will save them the pain of having to decide for you. Andy/Flickr

TALKING ABOUT DEATH AND DYING – Why don’t we talk about death and dying? A simple albeit difficult conversation could mean the difference between a peaceful and undignified death for individuals, between trauma and peace for families. Hopefully, Brian’s story will inspire people to talk about life’s greatest inevitability.

An undignified end

Brian, aged 73 years, had recently been discharged from hospital following a minor leg surgery due to poor circulation. Prior to this surgery, Brian regarded himself as “fit and healthy”, although he was diagnosed with hypertension four years earlier, and took medication for it.

Visiting his home one day, Brian’s sister found him unconscious and called an ambulance. Investigation revealed Brian had suffered a significant stroke to his frontal lobe so he was admitted to the Intensive Care Unit (ICU) and kept alive on life support. Further investigation showed recovery with intact neurological function was impossible for him.

His only relative – his sister Joan – was contacted and informed of the severity of Brian’s condition, and of the unlikely chance he’d regain consciousness. Brian hadn’t prepared an advance care plan, or discussed his preferences in the event of becoming critically ill, with his sister.

When Joan met the ICU consultant, she was informed there was little hope of any sort of meaningful recovery, and that if Brian was taken off life support, he would most surely die.

Joan was unsure about what Brian would want and pleaded for him to be given more time to improve, and for her to consider what his wishes might have been before any decisions were made. Brian remained ventilator-dependent in the ICU for nine days, his condition further complicated by the development of pneumonia and septicaemia.

Despite the continued aggressive treatment he received, he died in the ICU, never having regained consciousness. The prolonged aggressive treatment, associated suffering and loss of autonomy and dignity that Brian endured, in addition to the distress that his sister suffered, could easily have been avoided if Brian had completed an advance care plan. Or if he’d had discussions with his sister, Joan, or his GP, about how he would like to be cared for in the event of serious or life-threatening illness.

Photo courtesy of Melissa Bloomer