Globe Syndicate

 

For release Friday May 20, 2005

 

 

The Sandwich Generation . . . Helping Your Aging Parents

 

by Carol Abaya, M.A.

 

 

END OF LIFE:  CURATIVE OR PALLIATIVE?

 

Question:  My father, 88, has been in a nursing home for three years.  Mini-strokes over a ten year period have decreased his physical capabilities.  Although mentally alert, he can’t even feed himself or speak more than a few words at a time.  The home wants to put in a feeding tube, and my father says “no.”  The staff is getting nasty and says he’ll die without the tube.  We’re torn.

 

Answer:  My first reaction is that the staff is lazy or that the home itself is way understaffed.  This reaction because you did not say that your father could not eat if fed by someone else.

 

The home should provide an aide to feed him.  Or you can hire someone to come in at meal times to feed him.

 

If he can’t chew and swallow and a tube is the only alternative, you need to know that all mentally alert people have a right to refuse treatment, even if it means death will result.  If your father understands this, then you should abide by his decision.

 

Unfortunately, medical models of treatment emphasize keeping a person alive and ‘curative’ rather than ‘palliative’ care.  Both SNF staff and many families misunderstand the difference.  Confusion -- the kind expressed in your letter -- is common.  Families tend to want to “do something.”  Often the “doing something” only increases the physical and emotional stress of the elder.

 

In your case, if your father cannot chew and swallow even if fed by someone else, he  is never going to get better, much less “well.”  Palliative/hospice care should be brought in.  Then your father can die with the little dignity he has left.

 

At the end, both my parents made their own decisions. At 94, my father’s kidneys were going, and he refused dialysis.  Then he had a major stroke, which paralyzed him.  He died the way he wanted to, at home, three days later.  My mother, 92, refused a heart procedure, because it would not guarantee her the ability to get around by herself.

 

Question:  My father, 72, had a moderate (whatever that is) heart attack.  The doctor refuses to tell us when my father will be well.  We’re angry at the doctor.

 

Answer:  I don’t know why you are so angry.  No human being can predict how long it will take another human being to get well.  Any doctor who gives a definitive time table is only fooling you.

 

There are too many variables, medically, and each person responds to treatment differently.  How well your father follows through with diet and exercises are more important than a doctor’s guesstimate.

 

Question:  my mother is only 67, but very ill.  She is bed-ridden, has various life-saving tubes, and needs help to do everything.  She wants to be left alone to die.  Various doctors say she will never “get out of bed.”  I can’t just let her go.

 

Answer.  You should respect her wishes and decisions.

 

 

Are you juggling doing errands for your aging parents, your children, yourself and working at the same time?  Are you tired, stressed out and upset that your once vibrant parent is now frail and needy?

 

Do you feel alone?  Rest assured you are not alone!  The Sandwich Generation is dedicated to the 50 million Americans who may have elder/parent care concerns and/or responsibilities.

 

 

 

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Do you have a question? Send it in. Although letters cannot be answered individually, appropriate letters will be answered in this column whenever possible. Letters may be edited. Send letters to Ms. Carol Abaya, mail direct to her at PO Box 132, Wickatunk, NJ 07765-0132 or contact her through her web site: thesandwichgeneration.com.

 

Carol Abaya is an international-award-winning journalist and creator of the unique magazine The Sandwich Generation: You & Your Aging Parents.

 

NOTES TO EDITORS: text = 558 words; other material = 160 words

 

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