“I’m not afraid of death – I just don’t want to be there when it happens.” – Woody Allen

I think that if we are really, really being honest, most of us would say that we fear death, or the pain and debilitation sometimes associated with death. This is especially true in our culture – as death has become something as far removed from our lives as possible. The dying patient is placed in a hospital or nursing home – somewhere we believe they are receiving the “best” medical care possible. Back in the “old days” family members were born at home and died at home…not that this should be our absolute goal, but I do believe there should be a middle ground somewhere – a wisdom to be found, so to speak, in where we choose to end our days – if there is an opportunity of choice.

The medical community is helping us along in that direction – by providing end-of-life care, called hospice, in the patient’s home, where he or she can be in familiar surroundings, with family and friends in attendance, if so desired, and with appropriate medical care. Often, the problem lies with the term, “appropriate.” We may have very different opinions as to what the term means, with regard to care for a dying loved one. And if we haven’t had the, “what-if” conversation with our loved one before the health crisis comes, then, we are apt to “do everything” possible to “save” our loved one from death. It’s just human nature.

The “what-if” conversation is one that we all should have – with our parents, with our adult children. Even better yet, would be multiple conversations – that would provide answers to questions such as: “If you were in an accident and the doctors agreed that you would not recover, would you want to be placed on a machine that would breathe for you?” Another question might be, “What if the doctor said you would probably recover, but it would be a long haul, and you might need to be on that machine for only a few days? How would you feel about that?”

The answers gleaned from these and like questions are appropriately called “Advance Directives,” that give our loved ones an idea of how we feel about aggressive life-saving medical interventions. It lets our wishes be known regarding end-of-life care, and relieves our loved ones of (possibly) having to make some very difficult decisions on our behalf – compounded by the crisis at hand. How many of us make our best decisions in the midst of a crisis? In my work as a Chaplain I see these scenes play out so very often. A spouse says, “I just wish we had talked about this. I don’t know what she would want!” Or, adult children gather at the bedside of a terminally ill parent and say, “We don’t know what he would want; he never said, and we never asked.”

Another medical issue that should be addressed regards CPR – Cardio-Pulmonary Resuscitation. We see it all the time on television. A person collapses and a bystander provides CPR (chest compressions) and all of a sudden the victim jumps up and everything is fine. People don’t realize that CPR was invented to revive otherwise healthy, young people from a sudden cardiovascular event. And it’s very effective for doing so in that particular population. Not nearly so much, for frail and elderly individuals suffering from multiple (or long-term) medical problems. But we still have that incorrect perception in our minds – the one that television presents, that CPR almost always saves the victim.

The bottom line is this: death comes to us all, and it is so very helpful to our loved ones if we have had the talk/s – have addressed the “what-ifs” that could occur. It prevents our family members from being placed in the difficult, heartbreaking position of having to make end-of-life decisions for us. And when we take steps to make our wishes known, in the form of *Advance Directives, we can be more confident that our end-of-life medical care will be done according to our wishes.

Just this past week, in my role as a Chaplain, I was called to the bedside of a middle-aged woman who was at the hospital for a fairly routine procedure, when everything took a turn for the worse and she was placed on a ventilator. The doctors said there was no chance of recovery. The family had no information regarding an advance directive on the part of their loved one and they struggled with what to do next. Shift to another bedside.  This time I wasn’t there as a Chaplain, but as a friend. My friend was recovering from a serious medical procedure, but seemed to be progressing. Something happened and she collapsed, surprising everyone, including her physician, who happened to be there at the time. He performed CPR for half an hour. The staff came out and reported what they thought had happened, a “terminal event,” meaning she would not recover, or if she did survive the CPR, she would most likely be on a ventilator. Her loved ones knew that this was not what she would want, and the decision was made to stop CPR and to allow a natural death to occur without further intervention. While it was a difficult decision for her family to make, it was the right decision for her, as it respected her desire regarding end-of-life care.  They had discussed the “what-ifs” beforehand.

Later this week her friends and family will gather at our church to say a final goodbye to our friend. There will be laughter and tears and according to my faith tradition, lots of fried chicken after the service. I will take comfort in their fellowship and I will continue to be grateful that her end-of-life wishes were known and respected. It’s something she deserved – something we all deserve.

Kim W. Chafee
July, 2013

*Advance Directives are often available online, or through hospitals and physician’s offices.

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Kim Chafee

I am a lover of the God who sings! I am a Christ-follower and an ordained minister married to the other Rev. Chafee (Scott), with two grown children and a multitude of pets. And, I love chocolate. Read more about me and the reason for this blog on my ABOUT page.

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