Overtreatment, the River Styx and End-of-Life Conversations 

8 thoughts on “Overtreatment, the River Styx and End-of-Life Conversations ”

  1. Rebecca, thank you for expressing this so clearly. I will definitely explore the concept of “Sense of Coherence, Salutogenesis (the source of well-being) and end-of-life for older people may very well be a developmental phase worthy of examination independent of other life phases. ” we see too many at the end of life that have unknowingly reached that point and are ill-prepared for the end. Preparing the patient and their families is why palliative care is so important and why it is my mission

  2. I could not agree more with this article. Thank you for saying this out loud and in such an articulate way! As an educator in palliative care for aged care workers, and a passionate death literacy educator, I try and bring this message of “prolonged dying” rather than prolonged life to as many as I can. I will be sharing this!

  3. I can only echo your advice here. I was fortunate enough to have had such a conversation with my Dad when he was “young”. My Mom thought we were strange for being so comfortable about discussing end of life, etc. He passed very unexpectedly from a massive MI whilst out picking up the potato salad for dinner. What might have been paralyzing questions in the ER – intubate or not, continue efforts to revive, etc – overwhelming to my Mom, I was able to answer knowing what my Dad really wanted.
    Fast forward 3 decades, and my Mom, having become more comfortable over the years with mortality, and knowing that a bout of viral encephalitis which should have killed her had left her with scarring that would inevitably bring on dementia, agreed to preparing several legal documents to allow me to carry out her wishes.
    She passed on 36 years, to the day, after my Dad. No artificial sustaining means, kept as comfortable as possible in hospice.
    The sad thing is that so many “health care professionals” are not on board with respecting patients’ wishes. They worry about being sued, or want to impose their beliefs on patients (the problem of taking faith out of the public square but that’s another story).
    My Mom was a victim of “pump and dump” — the dementia care unit where she resided called an ambulance to say she was having a “psychotic episode” and needed an in-patient admission versus simply admitting that her dementia had progressed to where she was beyond their capacity to care for, and guide us to possible next steps. The in-patient psych unit staff were compassionate and caring first and foremost to my Mom but also in working with me to bring Mom to a place where she could pass on in a way that honored her life and wishes.

  4. Wow Rebecca…I could not agree more! If we had less FEAR (programmed) of death…I too believe it could be more of a natural family experience at home, than we have been led to believe. Bless you for your work! You inspire me to take a course in becoming a DEATH DOULA so that I too can support those making their transition more easily! I was holding the hand of my mother at 93 when she took her last breath, and at her request and our discussion had her taken off the 9 “prophylactic” drugs she was on in the nursing home when she was 88. I was not popular with the doctor there when I said that the drugs for cholesterol and blood pressure medication were no longer required. (you can only imagine the trauma an old person goes through there their arm is SQUEEZED to have their pressure taken?) Many of the other meds were for the side effects of the other drugs, like the diuretics to stop the swelling of her ankles, which stopped suddenly after we only kept her on daily aspirin to think her blood a bit and relieve the aches and pain in the morning from not moving much during sleep anymore. People need to be proactive on the care given to their elders and their wishes as well. My mom THRIVED for another 5 years without the meds and had a peaceful death with me by her side. The nursed there were SUPER and turned her…creamed and powdered her body and just put ice slivers on her lips to keep her mouth moist. It was truly a MAGICAL experience I had with her!!!

Leave a Reply