To Withhold Medical Treatment or Not....

I can’t give you that answer. Thirteen years ago, Jerry and I both made out Living Wills.  Living Wills state the type of treatment you elect to receive or not receive in the end of life stage.   It is a way for loved ones to be able to carry out the patient’s wishes.  It can be specific even down to the details of administering antibiotics.  Not fearing death (a subject for a later date), neither Jerry, nor I, wish to be kept alive by extraordinary means. We both decided that we wanted to go  naturally with the patient as comfortable and pain free as possible.

As Jerry’s condition has declined, I realize that “end of life” decisions will be a part of the decision making process.  Jerry does not have the capablility to decide these things anymore, so I will be the one who makes the decision as to when and when not to administer medical treatments.  In North Carolina, a living will is not enough.  A DNR order has to be signed.  If not, in the event of an emergency, the paramedics or hospital would be legally required to take all measures to resuscitate.   After all, their job is to save lives.

The leading cause of death in Alzheimer patients are stroke, pneumonia, aspirations, and infections.

Stroke.  I suppose not much can be done about that.  I’m not a doctor.

Aspiration, means, the patient does not have the ability to swallow anymore.  Jerry goes through spells when he chokes on this food, but most of the time, he is still able to swallow.

So, what about pneumonia or urinary tract infections?  Do we treat them or do we act as if these conditions were the natural  side effects of the disease?  It get’s pretty complicated.

An untreated urinary tract infection can lead to serious complications.  Untreated UTI’s can lead to sepsis, or septic shock.  This can result in death.

Last Thursday, hospice left me a message stating that Jerry had symptoms of a UTI and they were taking urine samples to check for infection.  They stated it would take a few days to get the lab results.  It was the first time I was actually faced with making a decision like this.  I was like a deer in headlights, “Oh no.  What do I do?  We said no antibiotics...but, I’m not ready yet.”  I can’t make that decision.  Not yet!

My thoughts were that I couldn’t withhold anything, knowing that withholding that treatment might result in death.  Yet, I do not want to prolong his condition either.  But, I don’t want Jerry to be uncomfortable.  It will burn when he pees, won’t it?  He’ll be up and down needing to pee, he’ll be more confused.  What to do...what to do.  Do I withhold or do I not?  Can you see the tossing back and forth?

Today, when I arrived to see Jerry, I was told that Jerry, in fact, did have a UTI and that the doctor ordered an antibiotic.  They didn’t ask.  It wasn’t written down. Whew!  I didn’t have to make that decision.  Hospice made that decision for me.

I’ll take this as a dry run.  A precursor for the future.  I’d better get myself prepared.  I’ll be talking to my hospice counselor soon.