On Aging

Working temporarily on a medical-surgical unit at Bristol Regional Medical Center, I am developing some firm ideas about aging and the care that I would like to receive. One of my favorite soapboxes is related to advance directives – my advice to each one of you is to seriously think about the care that you want and the treatments that you do not want, and to complete some advance directives while you are still healthy and in your right mind. I do not intend to be an elderly person hanging onto the last shred of human life through any sort of artificial means or medical treatments. Should I live to a certain age when things start to seriously deteriorate, either mentally or physically, I would like for my terminal illness be allowed to run its course and carry me  off before I become either a burden to my family or find myself the victim of my own deteriorating body. I realize that some suffering may be inevitable, with possible loss of various functions before my time may come. If, however, I am found living in a nursing home with a very poor quality of life and I develop pneumonia, I would like to receive no other treatments beyond oxygen (to ease breathing) and pain medication. Rather than viewing the pneumonia as something that should be aggressively treated, perhaps it  might be the friend that ends my full life, saving me further debilitation and loss of dignity. Too many older adults are not allowed to die but are subjected to treatment after treatment, staving off death when their quality of life is very poor indeed. It may raise ethical questions to make judgements about someone’s quality of life, but I firmly believe that were these adults able to voice their sentiments on the issue, they would prefer to be allowed to pass on. Often patients will express this desire, but families step in and insist that everything be done. I know I would want to be allowed to die. Truthfully, once my mind has gone, I see no reason to linger. Legally speaking, the medical profession is obligated to treat until no further benefit can be gained. If the family insists, the medical profession can (and often does) give futile medical care. If you do not want these treatments as you age, you must indicate so on legally binding documents – advance directives – and let your wishes be known to your family and those who might become responsible for you in the event that you become incapacitated in any way. Advance directive forms can be found on the internet, and should be filled out while you are healthy, not once you become sick. Your families should also be notified of your wishes and the location of your advance directive papers. Too many times, this has not been done, leaving the families with decisions they are ill-prepared to face in crisis. Many families do not discuss these sort of topics, and those are most ignorant of wishes when dilemmas arise. Let your family know and sign those documents!

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