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BY CAROL ABAYA
NEWJERSEYNEWSROOM.COM
SANDWICH GENERATION
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.
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 are "curative" rather than "palliative" care. Both 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 make appropriate decisions.
The Sandwich Generation is reader interactive. Questions are welcome.
Contact Carol Abaya via her web site www.sandwichgeneration.com or directly
via e-mail sandwchgen@aol.
