Saying Goodbye

Saying Goodbye
| by Kristy Dalechek

My next blog post was supposed to be about one of my favorite octogenarian clients who had the most amazing spirit. To know her was to love her. I could, and did, sit for hours with her. She never failed to put a smile on my face; her vibrant personality, her wit and her tenacity were contagious.

I was going to tell you how Ms. Janice raised six great children who loved her dearly. How at 88 years old she was starting to face some mounting health concerns. Her son, a busy professional, reached out to me for help. He was concerned that care was fragmented, and they were not getting enough information to make the most informed medical decisions. He wanted to make sure that his mom understood what was happening and was able to make the best decisions for herself.

I was going to tell you about attending appointments with her and making sure each doctor was updated on medication changes, upcoming procedures, and the general care her other doctors were providing.

I was going to tell you about keeping her large, caring family updated after each appointment and every day of her multiple hospitalizations. I was going to tell you about answering questions for Ms. Janice and her family when they needed a little more explanation.

Instead, I am going to tell you about saying goodbye to Ms. Janice.

Somewhat unexpectedly, she was admitted to the hospital with shortness of breath. She had just been at her pulmonologist the day before and while her lung function was a little diminished from her last visit, there was no major concern. She was admitted on a Tuesday. I went to visit her on Wednesday. She was sitting up in a chair with supplemental oxygen, but other than that seemed to be her normal spirited self. We talked about her hospitalization, what expectations she had and the plan moving forward. Then we talked about her family and the German deli that I needed to take my dad to because they made the best potato salad and sandwiches. The hospitalist came in before I left, and we had a thorough discussion about her care. She was to receive a few more days of IV antibiotics and then discharged home. Ms. Janice was very serious about her discharges. She told the doctor she was going home on Friday, and she meant it. Unfortunately, when Friday rolled around, she took a turn for the worse and had to be admitted to the ICU.

The ICU nurse had a great conversation with her that was direct and decisive. Ms. Janice was clear that she was not ready to give up. She was going to fight. She specifically said she wanted a breathing tube and she wanted CPR. I cannot stress enough the importance of having this conversation with loved ones. In a stressful situation families feel much more peace when they believe they are fulfilling their loved one’s wishes.

Ms. Janice spent six days fighting in the ICU. I called the nursing staff at least once a day for updates. I also called her doctors for updates. I stopped in to check on her in person. I put updates in her portal every day so family, whether near or far, could follow her care. By day six the family needed to make some decisions. Her body was failing and there was no hope for a recovery.

I spoke to her son and daughter on the phone and discussed options and what to expect moving forward. They made the decision to withdraw care and let her go peacefully.

One of the greatest honors I get as an advocate is to work with families to assure they have all the information they need to make the best decision possible. I always say, there is no wrong answer. They just need to feel confident in the choice they make, and they can only do that when they feel they are fully informed.

I met with several of her children that afternoon in the ICU waiting room. We talked again about their mother’s wishes, her current condition, and her prognosis. We also talked about their mom, and they shared some great stories. Finally, before I left, we talked about what to expect. I assured them that their mom’s comfort would be the highest priority.

I received a message later than evening that Ms. Janice had passed peacefully.

So, while I intended to share Ms. Janice’s story in a blog post, this was not the story I intended to tell, but an important story, nonetheless. I want to encourage everyone to talk to their loved ones about their healthcare wishes. I want to encourage everyone to complete the paperwork necessary to make sure your wishes are known and can be carried out by your loved ones. If you need assistance at any point in this journey, I want to encourage you to reach out to an advocate.

Saying goodbye is never easy, but you can feel a sense of peace and that peacefulness can go a long way.