Resources for Family Caregivers of Older Adults
End of Life Planning & Considerations – Wrestling with Needed Decisions

End of Life Planning & Considerations – Wrestling with Needed Decisions

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“Life is pleasant. Death is peaceful. It’s the transition that’s troublesome.” ~  Isaac Asimov

For many of us this quote hits home, for we are struggling with end of life issues for the ones about whom we care. We should also think about these options for ourselves as caregivers so that the senior loved one in your life is protected if they should lose you as caregiver.

Decisions surrounding what course to take during this difficult time may be the hardest ones we face.

Whether to remain aggressive with healthcare decisions or provide comfort and dignity for a natural course can be an overwhelming decision for many families. It is even harder for those who have not expressed any wishes about what they would like to happen when end of life is near and families are asked to make a fast choice.

Perhaps we fool ourselves into thinking that it won’t happen to us but it is inevitable that we will all face death. We may think it is not our time yet or we’ll think about putting our desires down on paper when the time comes, then the time comes without warning.  There may be those people who think that taking action to make their wishes known will jinx something into happening that they aren’t ready for yet. Sometimes a glimmer of hope from the healthcare team causes us to question even those decisions we have already made.

Views of End of Life Decisions

A recent Pew Research study examined our views, including us caregivers, about end of life decisions and the healthcare team. They found that the majority of us (66%) feel that under certain circumstances, the healthcare team should allow a person to die. At the same time, a growing minority of us (31%) state that a person should have everything done to prolong life no matter what the circumstances.

How do you feel about that question?

The research showed:

  • If you had an incurable disease with a great deal of pain, 57% would want to stop treatment and be allowed to die.
  • If you had an incurable disease and were totally dependent on a caregiver for all your needs, 52% would want to stop treatment and be allowed to die.
  • About six-in-ten adults (62%) say that a person suffering a great deal of pain with no hope of improvement has a moral right to commit suicide.
  • We remain divided down the middle, 47% approve and 49% disapprove, about whether a physician should assist with suicide.
  • Researchers found strong influencers of our opinions about death and dying were religious affiliation, race and ethnicity.

It is not surprising to most people, especially those who work closely with seniors and their family caregivers, 27% of us have given no thought to our end of life wishes and only 37% have given it a great deal of thought. Even more alarming is that 22% those aged 75 or older have neither documented nor even discussed their end of life wishes with anyone.

Only a third of all adults have documented their wishes in the form of advance directives or even merely just a letter to family.

The majority of us have known or cared for someone with a terminal diagnosis or in a coma and have firsthand experience dealing with death and dying yet few still have taken action to communicate their wishes.

While it is true that our healthcare system has become adept at prolonging our lives through medical advances and medical treatments leading to an increase in our life expectancy to 78.7 years, it is a personal decision whether or not you want to accept the treatment plan.

End of Life Considerations

If you and your senior loved ones are wrestling with how you want to chart your final years, here are a few things to think over:

  1. Goals of your treatment plan: what medication do you want or not want including chemotherapy, pain control, or other life sustaining options; what type of aggressive procedures do you want such as CPR, mechanical ventilation, artificial feeding, or palliative surgery; and what is involved in treatment such as travel, time, pain and suffering, or caregiving needs.
  2. Where do you want to spend your final days? Do you want to stay in the comfort of your home or do you want to be in a hospital or other care facility?
  3. Who do you want around you when the time comes? Do you want certain family members or do you want professional caregivers to do personal care for you?
  4. Have you lived a complete life or do you still have unfinished business? Have you made your peace with everyone or do you need to soothe old hurts?

There are many helpful tools to use to state your wishes that we encourage you and your senior to review such as Five Wishes and legal forms such as a durable power of attorney and living will.

It is also important that family caregivers make a plan in the event that something should happen to you before the person for whom you care which might leave them without a caregiver or possibly a safe place to live.

Being prepared for what is to come does not mean you have to give up hope! Enjoy each moment to the fullest, you will never know what tomorrow brings!

2 Responses to End of Life Planning & Considerations – Wrestling with Needed Decisions

  1. For any readers who are currently experiencing the transition of a loved one into end of life care, Catholic Health Services can ease your burden and aid you in providing exceptional care for the ones who mean world to you. Catholic Hospice provides compassionate care for the terminally ill and their families. We are dedicated to preserving the dignity of individuals, supporting those dealing with the challenges of death and bereavement, fostering acceptance and respect for all phases and transitions in life. We are committed to alleviating spiritual and emotional distress, as well as, physical discomfort so life may be enjoyed to the fullest.

    When going through this process of difficult decision-making, it is important to know that you are not alone and that there are many people just like you who have been in this position or are currently caring for a loved one in the same predicament. To view testimonials and experiences from the families and caregivers of a few of our patients, follow this link: http://www.catholichealthservices.org/catholic-hospice/catholic-health-services.aspx?nd=397

    For more information about Catholic Hospice or any Catholic Health Services other service lines, please visit us at http://www.catholichealthservices.org

    • Thank you for your comments Alison.
      We agree that the benefits of hospice are vast and so many times come late in end of life. There could be even more benefit if everyone knew about their options earlier in the journey.

We'd love to hear your thoughts!





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