healthmedicinet

It was the week before Thanks-giving. “I just want to die,” Elsa started the conversation. “I’m suffering way too much. I’ve had enough.”
My response, as the Palliative Care Nurse consulting with Elsa, was “Have you talked to your family about this?”
She was afraid to talk to her family. Her husband had early onset dementia, so she felt he would not understand. However, he was still listed as her primary agent on her Advance Directive for Healthcare. Her daughter would be heartsick, she explained. They had a very close relationship. Her son would understand but not like the idea, although his wife, Maria, was the one person in the family who might understand all the levels of pain that were at play here. Maria was one who understood that Palliative Care was about addressing the emotional, spiritual, and psychosocial realms of human suffering.
Elsa had a serious end-stage illness, complicated by other medical issues. Her pain had not been well managed. She had been a very strong and independent and public figure in her community all her life. She felt that she still needed to take care of everyone else before she could take care of herself. She admitted feeling “guilty” for wanted to be out of her misery.
At the end of our consultation Elsa had a “to do” list, which she had requested and was happy to read. Number one on her list was to talk to her family.