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Planning for a good death

  • 26 May 2014

--> My 88-year-old mother has been taken by ambulance to the Accident and Emergency ward at the local public hospital. I arrive twenty minutes later. That's enough time for the young doctor who has scrupulously read my mother's extensive medical history, to call me aside. (He's realised I'm Mum's Medical Power of Attorney or Medical Substitute Decision Maker.)

The doctor is concerned that the newly-arrived patient with plummeting oxygen levels, who was diagnosed six months ago with early stage Alzheimer's, has deteriorated quickly. 'If your mother continues to deteriorate, would she want to be resuscitated?'

'No resuscitation,' I respond almost automatically, and then explain. 'Years ago, not long after Mum made me her Medical Power of Attorney, we went to see her trusted general practitioner to discuss what her future health-care wishes would be if she were unable to communicate due to illness or injury. Mum said she didn't want to be resuscitated, particularly if her quality of life would be severely compromised, or if she'd end up in a vegetative state.'

In retrospect, it was only at the insistence of friends in the medical fraternity in Queensland, where 'Advance Health Directives' have been common for some years, that my mother and I visited her general practitioner in Melbourne to discuss her future preferences for medical treatment. (At the time Mum was well, in her early 80s, and still working as a school crossing supervisor.)

In answering the Emergency doctor's question about resuscitation, I'm so thankful that my mother's wishes have been made clear and documented by her general practitioner. Not only does it mean that the medical team at the hospital have clear instructions, but it's also a personal reassurance for me; I am in no doubt that I am acting as my mother would want.

The Emergency doctor seems pleased with my response — not to resuscitate. I'm not sure if that's because he has clear instructions, or because it's a view he personally shares. (What he doesn't see are the tears welling as I walk back towards my mother who is wondering about all the beeps and blips on the machine she is hooked up to.)

Five weeks later, my mother still has not left hospital. After weeks in coronary care, followed by a stint in a general ward, and a fall, she is moved to rehabilitation. 

One day while visiting Mum in rehabilitation, I find pamphlets on her bedside table — for brain-tissue donation.