Palliative care refers to the medical care of patients in the final hours or days of their lives. In 2010 a study by the New England Journal of Medicine found that patients who received palliative care for a terminal illness (like lung cancer for example) were happier and in less pain than those not in the palliative program.
End of Life Care has been a passion of mine from the early days of my career as a critical care nurse. I worked in a surgical-trauma ICU. The most tragic part of my job was talking with family members in the ICU waiting room who were suddenly faced with end-of-life decisions. The families who suffered the most were the ones who had never discussed these issues before that day.
But, the issue became very personal when my father was diagnosed with renal cancer. He fought the good fight for two years. During that time, we had many discussions about how he wanted the end of his life to be. We discussed it as a family and all agreed to support his wishes, when the time came.
That’s the really hard part, when do you know “the time has come”? My dad was a fighter. He faced the pain and indignities of his disease with tremendous grace. We felt the time had come during his third round of chemotherapy, when the medications were sapping all his strength and preventing him from enjoying any activities. The last few months of his life were free from medical procedures and nauseating medications. We let go of all the diet restrictions. He did whatever he felt like doing, whenever he felt like doing it. We saw some of his old personality re-emerge.
Still, when he woke up in the middle of the night with sudden, severe pain, we took him to the Emergency Department. Luckily, we were met by a care team that asked the right questions. We declined emergency surgery, opting instead for palliative care. Greenview Hospital, in Bowling Green, Kentucky provided amazing palliative care for my father and our entire family.
They gave us a room at the end of the hall with some extra chairs. They arranged a daily care routine for my dad that focused on keeping him comfortable with pain medication, oral care, skin care, and providing time with family. The nursing staff came in every two hours to turn and reposition him. As important as their physical ministrations was their discussion with the family. They asked for stories about the man in the bed. They seemed to want to know him. They joined us in remembering and honoring my father. The hospitalist team made sure there were no “routine” lab tests or imaging studies. The physicians evaluated my father’s status by listening to his lungs, touching his skin, talking to the family members who were watching him continuously.
My father died peacefully with his wife, children and grandchildren in the room. His beloved WKU Hilltoppers were on TV, winning! I wish all of our patients could have such a wonderful death. I am determined that every member of my family will!
Because we knew what my dad’s wishes were and the hospital staff was on the same page with us, my dad was able to die the way he wanted. And in the end, isn’t that what we all hope for?