But is it what she would want?

Thank you for your kindness and compassion!

What a beautiful and fitting story, and what a gift you gave to your patient. Bless you. :heartbeat

Thank you for allowing 'your Little Old Lady' to die with dignity and respect. You and the hospitalist are to be commended for advocating for your patient.

Working in Long Term Care I encounter this scenario quite often! Regardless of what the patient wants, the family members can not let go. I have had the "hard conversation" many times and apologize for the bluntness while as delicately as possible explain exactly what is going to happen if they insist I send their loved one to the hospital. The tests, pokes, machines, all in a sea of confusion because they barely know what is happening in the familiar facility let alone a scary strange hospital. I paint a picture of the comfort we can provide ensuring they are as pain free as possible and cared for an loved in thier familiar surroundings allowing nature to take its course. Usually I succeed in getting them to come to grips with the reality of the situation and make good on my promise to do whatever it takes to ensure the end is as comfortable and loving as possible but once in a while the family member just can't let go and for that I am sorry for all parties involved! The hospital who puts resources towards a futile attempt of maybe buying a little more time for the family member's sake, the agony the family will go through as this will occur again and again until they are convinced to let go or the patient hopefully goes in their sleep before any "interventions" are possible and most of all to the patient who is put through useless transport, tests, restless nights, and agony. Nobody likes to have that conversation but it is for the good of the patient! I always ask are we keeping them going for them or for you, what is the quality of life we are hoping for? Unfortunately as much as we are our patients advocates we do not have the final say....

Stargazer, Thank You for writing this article. I see this situation every week on my neuro/tele and step down unit. I get so very sad when my little old people come in with strokes, advanced infection or failure to thrive, and the family wants "Everything Done" to get their loved one better. If the family would just talk to their love ones and open their eyes, they could see that their elderly parent is trying to die with dignity. Not eating at an advanced age is common, and occurs right before someone passes. It is a peaceful and painless way to die. But what I see over and over again is the patients that have a DNR, are frail and at the end of the road, their families decided to put a feeding tube in their abdomen and tube feed them , and continue with the endless lab draws and painful tests. I also see that most of the doctors in my facility leave the heart to heart about end of life issues, to the nurses. This is a subject that the doctors need to be discussing with famiies, and they need to emphasize that their loved one is at the end of their life and encourage families to let their love ones die without pain or suffering. This subject saddens me the most as a nurse. People want their loved ones with them at any cost. It doesn't matter that they are confined to a bed in a nursing home, incontinent of bowel and bladder, have alzheimers, or are aphasic and paralyzed from a CVA, can't tolerate food by mouth and have a feeding tube. They want their mom and dad to be in that bed waiting for them alive each time they come to visit. How as a society have we got to this point that we allow our elderly to suffer like this?

I wondered this the one Christmas day I had to run a full code on a 101 year old man with end stage Alzheimer's. His ribs were like twigs and broke. He was covered in feces and urine. We worked on him for an hour because the family couldn't let go. They were screaming in the halls when we had to call it quits.I still have nightmares about that. It's awful.