My take on ‘Being Mortal’
Happened to read this book recently ‘Being Mortal’ and made me think of ‘End of life care’ or ‘Hospice care’ as people in the US call it. We seldom see that here. Most people in palliative care either end up in a ICU hospital bed and succumb to complications there or if lucky as in if the family cares enough, get EOL care at home with round the clock nurses.
Pain management is still an evolving field here, the knowledge yet to percolate to general physicians. Accessibility to opioid analgesics is restricted here(good in a way) as against opioid abuse that is so rampant in the west. The concept of ‘Assisted Living Facility’ being a multi million dollar enterprise was something new to me.
In India, as rightly mentioned in the book, the onus of taking care of one’s aged parents often fall on the children. It is a common practice here for one child to act as the care giver even if it meant compromising a little of their own goals and aspirations. The trend is slowly changing today with parents being more accommodating and adjusting and altering as per the choices of their kids.
I personally think EOL for people beyond a certain age group or in cases of terminally ill is a welcome option as against selling them the idea of a last ditch attempt with novel therapies and under trial drugs which seldom prove fruitful. It exhausts the patient physically, the family monetarily along with the added conundrum of the patient not getting enough quality time with his near and dear ones during the final days of his life and instead having to spend it secluded in an ICU bed somewhere surrounded by complete strangers, attached to numerous machines and tubes which often leaves the patient feeling totally disoriented and agitated.
I recently had one of my relatives pass away from Stage 4 Stomach Cancer. He refused treatment flatly. Even though he wasn’t informed about the full enormity of his health condition, he had a hunch and chose not to spend the last few weeks of his life in a hospital bed. He had lived a happy and fulfilling life and at the age of 89 when he passed away, it was at home surrounded by his family with nursing support. A very wise choice in my opinion.
I am all for recent advances in medicine and hail Mary treatment options as long as it is for a young patient with a promising life ahead or at least someone who has a fair chance of recovery. Prolonging life for the sake of prolonging life with a vegetative existence is not something I advocate. I think for people who can afford the time and money, I would prefer at home hospice care to institutionalizing an elderly. It is akin to a child growing up in an orphanage with a set timetable for his life surrounded by care givers who do have their best interests at heart but lack the connection that perhaps only a close knit family can give.
In the case of institutionalized elderly people it is way worse because they know that they have a family somewhere outside who for reasons plenty either do not wish to or are genuinely unable to care for them. Somewhere they give up on a psychological level before the physical deterioration kicks in.
Just the way our parents owe us a happy, encouraging and peaceful childhood, we owe them a peaceful and contented end of life. This is just my take on what a family should be like and what end of life care should look like. That said, to each his own.
