Our guest presenter at our last Alzheimer's Support Group, Olyna Hughes, shared many ideas for making end-of-life easier, calmer, less painful, and meeting the requests and desires of the one who is passing away. With discussions in advance, especially during the early stages of Alzheimer's disease and other dementias when cognition is fairly stable and engaged, family members, friends and neighbors, physicians and first responder, can ease one into death without unnecessary drama, arguments, or confusion.
The first step is completing a POLST. This legal document works in every state and takes over for advance directives when the individual is no longer able to make medical decisions. Completed and then signed by a physician, PA, or APN (and sometimes RNs), this hot pink paper cannot be reproduced, is binding, and lasts until the end of life. Have I completed one? No, not yet. My excuse is that I rarely visit a doctor; my promise is to add it right now to my "to do" list right now. (I just did!)
As someone dies from Alzheimer's disease or other dementias, the trail may long, confusing and treacherous as the loved one melts away day by day over what may be many, many years. When this person can no longer speak for him/herself, it is gratifying to know that wishes have already been stated - orally and in writing - which along with the POLST insures that heroic measures such as unnecessary surgery and medications, intubation and other mechanicals, can be halted before they happen for making the end of life better.
Why the concern? When EMTs and emergency room staff are called, their job is to save a life - regardless of the wishes of a life-threatening disease. Once they start, it is difficult to put an end to medical procedures. Then even more heart-wrenching decisions may ensue as a loved determines to stop a breathing machine or other medical apparatus. Being wise in advance is terrific!
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