Monday, November 10, 2014

Becoming the Oldest Living Generation

My father in law died yesterday.   His final days were surrounded by family, without pain, and guided by his wishes.   He spent 1 day in the ICU, 1 day in a hospital ward, and 1 day in hospice.   The journey from eating dinner with the family to death was 1 week.   His neuroendocrine pancreatic tumor was highly aggressive, and caused rapid weight loss, muscle wasting, and the inability to swallow without aspirating.    His path from life to death was just as I would want for my own - basic hydration, antibiotics for reversible infections, and a comfortable/caring environment with those closest to you standing by.

His death follows my father’s death a year and half ago.   That leaves only my mother as the living link to prior generations.   It means that I’m the oldest living male in the family.    In your 50’s it is common for you  to manage the declining health of parents.   It does feel early in life to become the oldest living generation.

Having worked with the transition of two fathers in two years, there is much I have learned about preparing for death

*Clearly document your wishes/preferences for physician orders for life sustaining treatment
*Ensure financial resources are well documented and understood by family members - bank accounts, retirement plans/pensions, and trusts
*If bills are unpaid, tax returns unsubmitted, or decisions unmade, ensure that a box of “to do” items is centralized.
*Making decisions about funeral arrangements is key
*Hospice is a good thing

My father and my father in law both benefited from caring/compassionate care in a hospice setting.    Hospice staff place the patient’s comfort first, reducing pain, alleviating anxiety, and providing a soothing environment.      We all die.   Spirituality aside, we’re a collection of biological systems that fail.   As walking fails, then eating fails, then thinking fails, vulnerability increases and control is lost.

A unified family, guided by the wishes of the patient and supported by a hospice setting brings a dignified, respectful death.  

All the emotion I expected was easier as the living members of the family gathered together for support.   Group hugs and gentle conversation helped calm the tears.

Over the next few weeks, there will be infinite details as accounts are closed, legal documents are executed, and the physical items associated with life are disbursed.   The death of a parent is never easy, but I am confident that the experience of my father’s death and the preparation for my father in law’s death will make the process as manageable as possible.


Unknown said...

So deeply sorry for your loss, John and Kathy.
John - your value to the world goes wayyyy beyond your open-access gifts of wisdom to the informatics community. Thanks again for your dedication to this blog.

David said...

Beautiful post, John

Medical Quack said...

Sorry to hear about your father in law, it's never easy, lost my mother last year and you are correct in getting things together as it does help to be organized and we had her advanced directive available at both the hospital and the hospice home, which was excellent. I had her information stored in a PHR which we both had access to and I lived out of state so I was able to easily get the information available before I could physically arrive. It helped a lot but and it's not that hard to do but it was interesting as even her doctors were not real familiar with what I was doing ahead of time and the PHR records, but it worked.

Sharon Wentz, RN said...

Very sorry for the loss of your father in law Dr. H. Being in our 50's brings a new realization to the chapters of our lives- helping focus what is truly important, where to spend our time. Hospice care is a wonderful thing and thank you for sharing a private experience in your life with others. Death is a reality and when we have loved ones that take the time to put affairs in order- well that is a huge gift. My parents, particularly my dad did that for us girls. I can't tell you how thankful we all were that we knew what to do at a very emotional time.

Mattpenning said...

My sincere condolences to you, your wife and family. I'm glad that you were able to assist and be with your father-in-law. Thank you for this post which will help others in planning for the path that we all must take.

Anonymous said...

Hi John

So sorry for yours and Kathy's loss. Good fathers are our anchors at times and the wind in our sails at others. Even as adults, we still look to them for guidance and consul.
My Dad died at 92 almost 20 years ago and I still ask the question, "What would Dad think about this?"
Peace and Love
Bill Atkinson

Anonymous said...

John and Kathy,

My thoughts with you. May his soul rest in peace.


Anonymous said...

So very sorry to hear you lost another loved one. Sincere condolences to you, Kathy and your family. Tho expected, it is not easy. May you find comfort and treasure the memories you have of him...especially the last few years when he lived with your family.
God bless, Hannah Chong