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April 30, 2008

Final decisions

Many of you already have done this. I have been through this once before too. But that doesn't make it any easier. Nearly two weeks ago my siblings and I made the tough decision to begin hospice care for our 96-year-old mother. She'd fallen in early February, fractured her humerus and ended up permanently in a care center (she'd been at home with my brother as care-giver prior to that). She has barely been eating or drinking and has lost a lot of weight. She's been refusing her meds. The signs were there.

So last week I made a trip to Iowa where we could spend time with Mom and where we could meet with hospice staff to start the process. They'll manage her care and she can stay right at the care center, so her life won't be disrupted any further—something that really creates difficulties for people who suffer from dementia as she does. Something that was so emotional for us took on a comforting tone when we met with the wonderful folks who work in hospice care. Our father died in a hospice facility almost seven years ago so we knew what an amazing experience this could be. And now the hospice social worker we had for Dad will be the same one we have for Mom. What a lovely bit of grace amid a difficult day! Our family can't say enough good things about hospice care and the dedicated, compassionate staff and volunteers who make it all happen. After Dad died, one of my sons spoke for all of us when he said, "I'd like to die this way."

Now the focus can change for Mom: from a staff whose orientation had been to help her get well (that wasn't going to happen anyway, given all her challenges at this age) to a staff that's into comfort care. Under hospice direction, what Mom wants will be the guiding factor. Hospice is all about caring for people with respect and dignity and making them comfortable for whatever time remains for their lives. We know she'll be in good hands. That makes this highly emotional decision and these next days, weeks or months much more bearable. This is a holy, precious time—and we don't want to spend it in regret that we didn't do what Mom needed or wanted. We want this final journey to be as peaceful and good as it can be.

Now we are glad we took the time several years ago when Mom was healthier and lucid to fill out advance directives, forms such as the "Five Wishes" document (which hospice staff called "the Cadillac of advance directives" because it tells medical staff personal wishes as well as medical desires). We are glad we had conversations with Mom about what she wanted in her final days. We are grateful that we siblings can talk openly about difficult matters such as facing the loss of our last parent—and that we agree on the direction we should go.

The Lutheran has had many articles through the years about making final decisions, about death and dying. You're invited to do a search on our home page to look up some. Meanwhile, here are a few to get you started:

With just one word

Can we talk?

Questions on death's way

The uncharted journey

Imprint for eternity

Great days in the face of loss

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