At What Point Do We Stop Battling To Keep People Alive?

[RATTER15]

I work with people with dementia, some of the people are quite happy in their own worlds some are not. I quite often here people say "I wish I could die" and I often have to agree that their life is so miserable that they should be allowed to die. The problem with dementia is, can they make that an informed decision? generally not!

How do we decide?

[sandyRoe]

Thou shall not kill
But need not strive
Officiously to keep alive.

[237SJ]

Maybe it should be compulsory to file a health and welfare Lasting Power of Attorney (Living Will in Scotland) when people get to a certain age or when first diagnosed with dementia. I see really elderly people being wheeled in to the CT unit at the local hospital and they are barely conscious - that`s not living.

[RATTER15]

I look after people that can no longer feed themselves, more due to age than their dementia, where they can no longer stay awake long enough to have a cup of tea or to eat, where we have to keep rousing them from sleep just to be able to get them to eat a few morsels and drink enough just to keep them alive. If we don't do this we are guilty of neglect, these people often have no quality of life and just want to be able to fade away naturally, but no, we keep them going for many months in this state, how can this be good for anybody!

[sandyRoe]

I can't see how it's neglect to let nature take its course.

[ummmm]

Doctors do withdraw treatment though.

CT scans etc could be so they know what pain relief to give. You don't see cancer suffers being fed intravenously.

[andy-hughes]

It's a massively complex ethical question, and there is no simple across-the-board answer in my view.

The most manageable solution is the one we have now, where no-one's life is cut short, despite the fact that observers may believe it is the best thing for them. This is the only sure way of maintaining life for those who would wish to carry on living, were they able to communicate that wish.

The downside is that many people appear to suffer with no disernable quality of life.

It is such a difficult situation, and I am very grateful that I don't have to try and make those decisions, or live with the consequences if I did.

[RATTER15]

237, we also have a Living Will here in England and Wales, the problem with dementia is many people live a long and happy life with dementia without a care in the world. Where I work is generally a very happy place, most of my ladies have a lovely content life with no worries, others are very different and quite distressing.

[237SJ]

I think my sister`s husband (cancer sufferer) was fed intravenously at the end ummmm. People living until a great age is the product of a civilised society with good health care but withdrawing food to starve them to death (I know it happens in some cases) just seems so barbaric.

[Sqad]

\\\\\It is such a difficult situation, and I am very grateful that I don't have to try and make those decisions, or live with the consequences if I did.\\\

Quite a-h.....a very good point.

Presumably you would want the medical fraternity to make these decisions?

However, in the last week or so we have had ABers describe doctors ( some doctors) as arrogant, imagining themselves as "God like figures" and playing the role of God.

You can't have it both ways.

[RATTER15]

ummmm, //Doctors do withdraw treatment though.// in my experience in care homes, Dr will only withdraw treatment if a person can no longer swallow medication or would at danger of swallowing it or the patient is not going to get any benefit, this is only usually when death is inevitable in the next few days, we then stop food and just moisten lips to keep the person comfortable.

[237SJ]

My both my Grans lived until their late 90s and were relatively well but one of them got ill and had gangrene in her leg. She was on shed loads of morphine and they always used to say that the doctors gave people a little bit extra. My Mum always said it was the morphine that killed her. I was quite happy with that but if doctor`s did that now, they would have the family on their backs with threatened lawsuits. You can`t win sometimes.

[RATTER15]

Sqad //However, in the last week or so we have had ABers describe doctors ( some doctors) as arrogant, imagining themselves as "God like figures" and playing the role of God.//

I dont think it should be just down to the Dr, I think a decision from all quarters should be a part of allowing a person to die, including social services, family, Gp's and a solicitor. and if a living will is in place that would a great help.

[RATTER15]

We have one guy, with dementia and blind, we have a good laugh with him on a daily basis, he has a great sense of humour but on a bad day he would kill himself if he could and tells staff that he wants to die quite regularly. These cases are never easy to deal with.

[Cloverjo]

When my mum was near the end of her life, she wasn't fed any more. I worried that we were starving her to death, and I was very upset, but I guess her body was shutting down and she didn't need or want food.
I wouldn't have wanted her to have been kept alive with aggressive treatment. She was in a terrible state, mentally. She didn't have dementia, but her cancer had a similar effect on her brain. She wouldn't have been allowed to make a decision about dying as she wasn't mentally well enough.

[Sqad]

RAtter.....quite correct, but the doctor will be the one that (pulls the trigger.).........turning off the ventilator or giving an "extra" dose of drug as described by 237SJ.

[sandyRoe]

I think that's the last merciful service a doctor can perform for their patient. ^

[Prudie]

This is such a difficult topic I agree and making the decision not to maintain someone's life is probably too heavy a burden for anyone to bear. Doctors can only advise. Thank God neither of my parents had dementia but popped off really quickly. I have a friend whose mother has been in care with dementia for about 7 years now. She recognises no-one, she's blind and deaf and spends all day in bed and shouting out for her own mother. My friend wants her to stay alive because she can't face losing her mum but what a dreadful dreadful 'life' that woman is living.

[Cloverjo]

That's very sad, Prudie. When the time comes for your friend's mum, perhaps she'll be relieved she's not suffering any more. I was when my mum went. She also used to shout for her own parents, who had died 15 years before. It was heart-breaking.

[RATTER15]

I would gladly give a fatal injection to relieve some from the torment they go through daily or for the ones that we are keeping alive when they really have no quality of life at all. I would genuinely see it as the next and final step in my care of the people I look after.

[Cloverjo]

I agree with you Ratter. I hope someone can help me on my way if I'm ever in a similar situation.