IN THE END

Sixty-eight year old “Christy” was diagnosed with pancreatic cancer six months ago. She came onto hospice shortly afterwards. Christy lives with her significant other of twenty years, “Bob”. Bob has his own health issues, but is able to care for Christy at this time because she is still up and about. She tires easily and takes several naps each day. Bob helps with meals and household chores.

I went out to do a visit today and our initial discussion was related to Bob’s health issues and his limitations. It was then, I asked about their long term care plan for Christy. I have concerns about Bob being able to care for Christy when she starts to decline and needing more help.

Christy said they do not have a plan. She has no family, but has a large network of friends. Unfortunately, many of her friends live out of state or, due to busy schedules, are not available. Her friends are there for her emotionally, but the hands-on care will fall onto Bob. Christy said that she has fears of becoming dependent. She told Bob and I that she would do whatever she needs to do to avoid becoming dependent.

I asked her if she knew where that fear came from. She then shared the story about her grandmother and the many shut-ins they visited when she was a child. Those visits have left vivid memories with Christy. We talked at length about the end-of-life process and options available. She would have nothing to do with it.

I believe that if someone wants to commit suicide, there isn’t much anyone can do to prevent them from following through with that choice. I asked Bob what his thoughts were about Christy’s plan. He shared that he wanted her to talk with him first. She was quick to add that she didn’t want him to be involved as she feared he would be arrested for aiding in a suicide.

Christy asked me about other patients and their dying experience. I shared the truth being that, quite often, patients find peace in their final weeks, days and hours. I have made a referral for our psych nurse to make a visit to assess Christy. Our hospice nurse will monitor her medicine and, if needed, her pills can be locked up in a lock box. But in the end, I believe, if Christy is steadfast about her decision, there isn’t much anyone can do to prevent her from taking her life. I wish her peace.


IN THE END

She comes from a small village
where everyone lent a hand.
She has memories being with her grandmother
visiting those dependent in their homes.

She remembers clearly those long ago times.
Mixed emotions arise from those memories.
Having seen things she will never forget;
dependency, struggles, vulnerability.

She has fears of becoming dependent herself.
She would never want to be that way.
“I will do what I have to do,
to avoid ever going through something like that”.

She talks of taking her life before dependency comes.
She has many pills within easy reach.
She is not stressed, but rather at peace.
It is a natural option for her to choose.

In the end, no one can stop her, I suppose.
In the end, it really is her choice to make.
Whether a wise decision or not,
she likely will do what she needs to do.

She has always lived her life her way.
I suspect she will die her way as well.
Somehow I know it will be what it will be.
One way or another,
      it will end.