Recently I saw a photo of a gentle man with Lewy Body Dementia. He was in final stages, in a hospital bed in a hospital shared room. I won’t use the photo out of respect but I will try to describe the scene to you.
The photo shows an elderly man in his mid-80s. He is ravaged by the disease and his body shows muscle wasting. He is very frail physically. He is unconscious and in final stages of LBD.
This gentle man is hooked up to a number of medical apparatus. He has an IV to deliver fluids and medication. He is being monitored for heart rate, temp and blood pressure and blood gasses. He has a urinary catheter in place, a nasogastric tube for feeding and his neck is encased in a brace to allow for the ventilator, to assist his breathing and for suctioning to remove any phlegm or assist if he should aspirate.
The decision was made to remove the ventilator and less than 12 hours later this gentle man had passed away. He passed away still hooked up to all the monitoring equipment and the neck brace under the glare of bright hospital lights.
My question is why?
This man was also suffering from an incurable and terminal disease, Lewy Body Dementia. He was in his 80s. Why was all this high tech equipment put in place? For what purpose? The precept of medicine is First Do No Harm, not to extend life at any cost, simply because we can.
The alternative – in a home care / care facility or palliative care /hospice situation.
In the bed lies an elderly man in his 80s. He is physically frail. He is in the final stages of Lewy Body Disease. His body shows signs of muscle wasting and the other symptoms of LBD. This is a terminal disease. He is unconscious but is resting quietly.
The room is a single bedroom, the curtains are drawn to control the light, there is soft lighting, unobtrusive background music, the temperature of the room allows for a light blanket but not freezing air-conditioning. There are no monitoring devices, a sub-cutaneous morphine pump is in place for regulated pain relief. No nasogastric tubes, no bright lights and noise, no neck braces and ventilators, no catheters as urinary out-put is minimal.
At 8.00am the care staff care staff repositioned him, this is done regularly and the pump is checked. He appeared to be resting comfortably on his side, well supported by pillows. He passed away quietly.
This man passed with as much comfort and dignity and peace as could be provided. He was not hooked up to beeping machines and flat on his back which would have added to his discomfort and pain levels.
Which scenario would you prefer for yourself or your loved one?
Make your wishes known and do not allow those who should know better to persuade you that a hospital with all the interventions they offer is the best option. In the case of long-term terminal disease, hospital is not always the answer.