Monday, July 19, 2004

Help Her Die

Last night, the son of one of my hospice patients asked me to give his mother more morphine so she would die. His mother appeared to be comfortable, despite clearly being within hours of her death. This is not the first time I have received this request. In the past year, I have been asked to do the same with three different patients and their families. My response is always the same.

"I will make sure your mother is not in any pain. I will not hesitate to give her more medication if you or I see any indication that she might be uncomfortable." I make it clear I know what they are asking by explaining, "If I give her too much medication, she would quite possibly die immediately."

I then explain my rationale for witholding the medication. "Your mother is probably sticking around because she either has unfinished emotional business or because she is waiting for her grandchildren to arrive tomorrow. [People often wait to say goodbye to loved ones before letting go.] Your mother has her own agenda and her own time frame for letting go of this life; I don't want to interfere with the process she is working through by forcing her to let go too soon." This son then revealed his true fears. He had already said goodbye to his mother and couldn't bear to spend more time with her. The doctors had said they might transfer her to another hospice facility if she lived much longer. The family was happy where they were and did not want to have to move their mother. By uncovering the true issues, I was able to address them specifically. I assured him that I would do everything within my power to ensure that his mother didn't get moved. And assured him that she was so close to death that she would not likely last long enough for the doctors to even make those types of arrangements. He seemed content with this answer.

This son's siblings were distressed by his request. They thanked me profusely for intervening on their mother's behalf and began to berate their brother. In response to their outrage, I told them, "Your mother is having trouble letting go. I imagine it would be even harder for her to leave if she senses that her children are not getting along well. This time is very difficult for each of you. Try to be patient and understanding of one another." Their anxiety quickly dissipated into calm.

I then brought in a print-out of the four tasks of living and dying and went over each of the steps with them. I explained how they could help their mother address these tasks and thus help her to let go of this life, which is something that all of the children reported feeling ready to let her do. They were all very receptive and quickly shared stories about their mother, exemplifying these four areas without even having been told the specifics of the tasks before.

After a bad month of work, having such a positive influence on this family's experience with the death of their mother made me remember why I love nursing.

1 comment:

Jennynyc said...

You were obviously so helpful to this family that it makes me tear up. It is such a good suggestion for all involved that it would be easier for the mother to not have discord amongst the children.