One of my favorite characters in Jurassic Park was Dr. Ian Malcolm (aptly played by Jeff Goldblum) and one of his best lines was, “Life … uh, finds a way.” He, of course, was referring to the eventual naturally occurring reproduction of dinosaurs created by man who foolishly contended to also have control over their creatures’ ability to reproduce. In many aspects of life, we humans attempt to assert control. Still, life (nature) finds a way, to thwart our plans.
I once had a conversation with an elderly lady about quality of life. She shared her thoughts about having to be fed by someone else. Being fed was undignified to her and she said she would feel like a burden. Despite my best effort to assure her that people would feel honored to help her if her ability to feed herself changed, she was adamant. She was very clear in telling me that she would not want to live if she couldn’t feed herself. In her healthcare documents, she opted not to have a feeding tube inserted. Feeding herself was a measure of control and independence through which she determined her quality of life.
She recently went through some life changes that I will not divulge here, but they have taken a toll on her physical and mental health. She is declining cognitively. She has lost the ability to feed herself – her worst fear. Because she now needs to be fed, she is refusing to eat, losing weight, and “failing to thrive.”
Now, there are choices to be faced and decisions to be made by her family (since she is no longer cognitively able to do so for herself):
- Do they want the doctor to prescribe an appetite stimulant?
- Do they want to have a feeding tube inserted? (Living Wills have been ignored in favor of preventing “starvation”, which is a myth at end of life.)
- Can she be re-trained to feed herself with adaptive utensils?
- Will occupational or speech therapy be able to “fix” her self-feeding capability?
- Is hospice care more appropriate now?
Whatever her family decides, the choices seem to be: (1) intervene in some way or (2) allow nature to “find a way.”
Caring Choices understands that these kinds of decisions are personal. They are emotionally challenging to consider about ourselves and those we love. Conversations with loved ones and our healthcare team are the best way to prepare for allowing nature to find its way.
© 2015 Caring Choices