by Joan Blumenfeld, MS, LPC
Eli wanted to die, and he wanted to die at home.
He had no children and no siblings. His wife of more than 60 years, who meant everything to him, had died a few years before. He had some distant cousins scattered around the world, but he had not been in contact with them for more than half a century.
Eli had congestive heart failure and refused his medication. He refused to eat or drink. He had a bed sore the size of a saucer and as deep as a cup. Eli, who had been a smart, cultured, feisty, interesting and handsome man, was now frail in the extreme and approaching the end of his life.
He had lost the will to live.
I was called in by his lawyer, a good friend who held Eli’s medical power of attorney. Eli was to be discharged from the hospital the very next day. He had been there for a week being treated for the bed sore and dehydration. Not surprisingly, the lawyer was at his wits’ end. He had no idea what kind of help Eli needed or where to find it. That’s why he called me — this specialized knowledge is the purview of a Geriatric Care Manager, not a lawyer.
The goal of my work with Eli was to orchestrate his care such that he could die a natural death peacefully at home. To that end, we hired a live-in aide and a Registered Nurse to be on duty 12 hours a day. They turned out to be a fabulous team! With great sensitivity they provided exactly the “tender loving care” that Eli requested. They knew to back off when Eli was combative and to move in with compassionate care when he would allow it. They kept him clean, safe and comfortable. When he had an appetite, they made him gourmet meals. When he refused food or medication, they left him alone.
Sometimes it was really hard for them to back off and “let go.” After all, their training was aimed at fixing and curing, and prolonging life whenever possible.
Since Eli was bedridden, his personal doctor agreed to make a house call — an extraordinary event in my experience. He noted that Eli was getting very good end-of-life care at home and helped outline a plan in case Eli experienced discomfort when the time came for him to pass.
In fact, Eli died a peaceful, natural death early in the morning of the 15th day that he was home from the hospital. He was the beneficiary of gentle, compassionate, skillful care that made it possible for him to have a good death at home, just as he wished.
Pearl of wisdom: End-of-life care and decisions are difficult for family, as well as for professional, caregivers. Hard Choices for Loving People, by Hank Dunn, a chaplain, is a remarkably informative and compassionate guide for this time of life.
Joan Blumenfeld, MS, LPC is a Geriatric Care Manager in private practice in Fairfield County, CT. For information visit www.joanblumenfeld.com. © Joan Blumenfeld 2012