Prepare for the end

January 22, 1998|By Elise T. Chisolm

THERE is no good way to die, is there?

My mother found a merciful one. At 79, she went to bed one night happily planning for the next day and died in her sleep. I was not prepared, of course, nor was she.

I was rattled because she had refused to talk about funeral arrangements, including whether she wanted to be buried or cremated; so those decisions were left to me. That was 35 years ago, but there are still many people who refuse to plan for their eventual demise.

When my husband of 54 years died two years ago after a long bout with bone cancer, I regretted that we had not made funeral arrangements early on or even talked about what type of care we wanted in the event of grave illness. Sometimes I think maybe there should be a rule that after a couple has been married 20 years or so, they have to make such plans.

Youth culture

Part of the reason for not making them is our obsession with the whole process of living healthy and forever. When we become ill, we are dismissive or intrepid.

A friend told me after her husband died: ''It was awful because we never discused the mechanics of death, what kind of funeral he wanted and who should do the service, or what kind of nursing care -- at home, in a facility or in hospice? And worst of all, he didn't have a will.''

As a teacher at senior citizen centers, I regularly hear such comments.

So, many married people don't want to contemplate each other's deaths. Why? Men and women share the most intimate details of their lives. They make love, they go places together, they argue, but they don't talk about something we're all going to experience?

Alternative care

One thing to consider in making such plans is home hospice care, which allows a terminally ill person to die in relative comfort and without intervention to prolong a life that's clearly at its end. The patient may have some of the trappings of a hospital, like a hospital bed, but they have familiar surroundings. However, there is a caution.

When my husband became terminally ill, we signed up for home hospice care at the behest of our doctor, but we didn't understand the limits of hospice care.

His time in home hospice was the most grueling 18 months of my life and our children's.

Home hospice care has caring nurses and is far less costly than expensive hospital stays. But the hospice nurses only visited twice a week for an hour. For overnight help, you have to contract with a nursing agency -- an expense that many families can't bear.

So, the family has much of the responsibility for the ill person. During my husband's illness, I administered morphine every four hours and other medication at varying intervals. Sometimes, mostly at night, I became overwhelmed with exhaustion.

Our children, some of whom live out of town, suffered from incredible worry. If I had known how much work I would have to do, I am not sure we would have elected home hospice care.

According to a poll by the National Hospice Organization, some 88 percent of respondents would prefer to be cared for at home or the home of a relative in the event of terminal illness. However, some 40 percent said they did not want to be a burden to their families.

Study all of the options of out-of-hospital care before deciding. Also, find out if you can afford a nursing-care policy, a form of investment for long-term illness.

I urge couples to explore the resources out there for illness and dying. Then write up your plans and file them with love and hope.

Someone said death is part of life. Of course. But life also begets death eventually.

Elise T. Chisolm is a former Evening Sun columnist.

Pub Date: 1/22/98

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