End-of-life decisions are hard choices to make, but incredibly necessary, as they affect how a family can come to terms with the death of a loved one. Doctors play a huge role in helping families understand and deal with end-of-life decisions. They ensure peoples’ wishes are upheld as they approach their deaths. As when discussing other health topics, it’s important for doctors to make sure patients understand their disease and all the options available.
When my maternal grandfather was battling with cancer between 2006 and 2008, clear communication helped our family understand his disease and ultimately helped us to make the decision to put him into hospice as his health declined. Granddad was diagnosed with pancreatic cancer in June of 2006, shortly after he moved to Baltimore to be closer to our family. His body was relatively strong, so he decided to have surgery in August 2006. Through a procedure called a Whipple, doctors removed part of his pancreas and parts of other organs to cut out his tumors. Surgery and chemotherapy worked for a while, and he took up sailing and went on trips to Aruba with his girlfriend, focusing on enjoying his life.
In June of 2007, his cancer returned with force and his health declined significantly. He was always in and out of the hospital in critical condition. During one particularly bad hospital visit in November of 2007, Granddad was diagnosed with sepsis. This overwhelming infection was taking over his body, which was already weak from chemo and the cancer. As he laid shivering in his hospital bed, fighting to stay alive, my mother and his doctor talked about how he could die that day.
My mother confessed that she was worried about her father’s quality of life, as he was always going into the hospital with little certainty that he would make it back out again. Granddad’s doctor told her that when her own mother was terminally ill and reaching the end of her life, her family and her mother had agreed that hospice could be a good option. Hospice is an in-home care service for people who are reaching the end of their lives that allows them to spend their last weeks or months in comfort rather than in the hospital.
The doctor said hospice had been life-affirming for her mother and that the hospital had a hospice representative that she could talk to. End-of-life discussions were really difficult for my mom to have with her family, but everyone agreed that Granddad shouldn’t have to suffer for the last few months of life.
A few weeks later, a hospice nurse began regularly visiting Granddad in his apartment to give him anti-anxiety and pain medicine. He was able to see family and friends and make peace with the fact that he was at the end of his life. He went into hospice in January of 2008 and died on April 2nd.
My mom is forever grateful that Granddad’s doctor saw her as a daughter, just as she was, trying to help a parent make the best end-of-life decision.
Madison Wilson is an intern at HLM and a pre-med student at Washington University in St. Louis. She is a senior majoring in Urban Studies with a health focus.
Tips for having an end of life conversation with your doctor (AARP)
Making end-of-life decisions (American Cancer Society)