It is often the case that ninety-five year-old, absolutely decrepit and demented elderly people come through accident and emergency and end up in some ward or another.

Generally, this person will absolutely not be in a position to take any comprehensible decisions so the medical staff turns to the relatives, usually in a large group, huddled around said elderly person. And they nod and say benignly ‘Do everything that can be done, poor thing, and then if she/he has to go, at least we know we have tried everything.’

I hear this so often that I cannot help but question ‘tried everything’ for who exactly? Is this to put the relatives’ minds at rest that they did not commit some kind of back-door euthanasia or do they honestly think they are acting in the best interests of the elderly person?

Because I most definitely do not think so. Nowadays we keep elderly people alive who most often would much rather be dead because modern medicine and power of attorney gives us the power to do so.

If you only knew how many times I have seen relatives allow their elderly to be pumped with intravenous antibiotics, fed through naso-gastric tubes and when they do eventually stop breathing, make the nurses perform CPR, compressing this poor person’s chest, only to perhaps find an erratic heartbeat and prolong the suffering by admitting the patient to ITU. All on the insistence of the relatives.

Now I am not some mercy-killing, angel-of-death kind of nurse. But when someone’s time is up, I am most certainly ok with letting go. If you are 98, in a care facility, dependent on someone else for all activities of daily living, often claim how you wish to die and basically have a pretty crap quality of life, it is time to say goodbye. Allow that person to go in peace. I think anything else is just selfish: keeping your loved one alive and suffering just so you can visit them once a week and feel like a good Samaritan, is abhorrent.

I’m not saying that this should happen to everyone of a certain age. But those who are honestly in a bad state with no hope of ever getting at least the basics back, I think we should just let them be. I am not saying actively terminating their lives. But not aggressively saving them either.

I speak like this because I have a trained eye. I can tell when a patient’s life is being prolonged unnaturally with no hope of change. And I am sure that some people are reading this and thinking about how cruel and unfeeling I am. And it is precisely because I am not cruel and unfeeling that I do speak this way.

Each situation is unique and it is never clear cut. But there is a time to say good-bye and I do believe that relatives know it. But due to fear, and perhaps family pressure, they do not dare speak up.

I have yet never been in a situation where such decisions needed to be taken for loved ones, but when it does happen, I hope I make the right decision.

Whatever that may be.

 

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