As we’re coming to the end of life, it’s very important to have a time where we say, “Okay, I am dying. It’s not a question of if, it’s a question of when. How should I best do that? Do I want to be in the hospital? Do I want to be in intensive care? Do I want them pounding on my chest when my heart finally stops? Do I want to just have comfort care or do I want to be home with my family around me?”
If we don’t make that decision and choose the latter, the default of medicine will be to just keep on going, to do one more thing. And then, we don’t get into discussions with our family, we don’t have closure, and we die as a fight to the finish. We need to consider where we are spiritually. Am I ready to meet the Lord?
I think we need to make a decision at some point to say, “Okay, just keep me comfortable.” We should do that on the basis of our physical status. We need to know the diagnosis and the prognosis—what the likely outcome is going to be. We need to consider where we are spiritually. Am I ready to meet the Lord?
We need to consider where we are emotionally. Sometimes just going to the doctor, going back and forth to the hospital, taking pills, taking treatments, having one more surgery can make us tired, and we just don’t want to do it all anymore.
We need to consider where we are socially. Is our family ready? That’s particularly hard when young people and teenagers are involved, both as a patient and as family members.
We need to look at all those things and then decide not to pursue aggressive care. Then we need to have an advanced directive. We need to sign a living will that says if there’s no hope of recovery, don’t just try to keep me alive.
We also need to appoint a power of attorney: someone who can make medical decisions for us, and then instruct them what our values are. For many people, it’s appropriate to go under palliative care or even hospice. These are organizations designed to help you stay at home through your later days and weeks, and allow you to die in the presence of your family while resting and doing many things to keep you comfortable. That is the better way to die.
John Dunlop (MD, Johns Hopkins University) serves as an adjunct professor at Trinity International University and practices geriatrics in New Haven, Connecticut, where he is affiliated with Yale School of Medicine. Dunlop is the author of Finishing Well to the Glory of God: Strategies from a Christian Physician and Wellness for the Glory of God: Living Well After 40 with Joy and Contentment in All of Life.