CBS' 60 Minutes ran a report recently on the high cost of health care at the end of life.  As a health care provider, I was aware of the costs and the seeming futility of some of the care, but it also reminded me that many families haven't discussed end of life decisions.

It is hard for us as providers to see a family wrestling with these most difficult decisions in this most difficult time. 

 If only they had talked about it before.....

The holidays, when the family is together, might just be the best time to have that conversation.  If your family is like most, it is when there are often more generations at home.  It is a good time for everyone to understand each other's feelings on this most difficult subject.

I didn't realize the full emotional impact of end of life decisions until I had to make decisions regarding my own parents.  Fortunately, we had discussed their feelings in detail.  My parents were a bit unique and even had us over for dinner before trips out of the country to review these issues and where all those stupid papers were.

I had an understanding, but the decisions were still difficult.  It was then I realized that there are two parts to the end of life decision making, the emotional and intellectual decision.

There are two parts to the end of life decisions, one is objective/intellectual, the other is emotional.

The emotional decision can be distilled to the question, "do I want everything possible done to treat my loved one?"

I would assume that the answer is yes.  From an emotional perspective, to not want everything done for your loved one is unfathomable.  As a child, your parent has nurtured you.  When you become the adult caregiver for your parent, you have an opportunity to do the same.  As my mother said, it is return for all those poopy diapers she changed.  If you are a parent in the horrible position of caring for a dying child, you are facing issues I can't even imagine.

The intellectual decision is entirely different, however.  The question here is an objective decision regarding, "does this make sense?"  This part of the decision that your health care provider can add expertise in answering the objective questions about prognosis and appropriate application of care.

These are all difficult decisions, but something that gives both the person and the family some comfort in knowing what decisions to make.

Tomorrow we'll look at some of the resources to help people with decision making and reducing the decisions to paper.

Like it?  Hate it?  Have questions?  Leave a comment.

If you are interested in this or other subjects about health, you can SUBSCRIBE using the button above.  It's free -- it will help you keep up.