End Of Life Issues

August 13, 2008

This morning my mother emailed me and asked me to pray for the family of Buddy Wagner, a 63 year-old man from her church who suddenly died this week. He went to his dentist for a root canal and developed a serious infection which required hospitalization for five days. They sent him home with a prescription for antibiotics, and once he completed the antibiotics they put him on a blood-thinner to prevent clotting. He apparently then suffered a stroke, and because he was on blood-thinners, he bled out and went to meet His Savior Jesus. This request reminded me of the complexity of issues grieving family members are confronted with when their loved ones become seriously ill or die.

Interestingly, today I also received a “Fresh Words” email from Desiring God that offered some very helpful advice about how family members can plan for these complicated end of life issues. While very few of us like to talk about death, it is important that we thoughtfully consider how to care for our loved ones during the sufferings of serious illness, as well as how best to meet our obligations to them, since Scripture clearly states that the way we care for our suffering loved ones is an indicator of the legitimacy of our faith in Jesus (1Tim 5:8). Check out John Ensor’s advice below. He offers nine questions which his family recently asked his aging mother, first gauging her preference then responding as caring sons and daughters.

1. What can be done to prolong her independence?

Since she lives alone and the nearest of her children is an hour away, we discussed maid service, delivery of meals and groceries, and, for our peace of mind, a personal alarm for her wrist. This was a difficult discussion. My mother does not spend money on such things. But we got them on the table.

2. What measures should be considered when total independence is not possible?

Here we introduced the idea of her staying with one of us during periods of treatment and recovery or during the winter months, when isolation is a real danger and getting around is more difficult and dangerous. We also heard her views about moving to a community village where independent living is possible but help is nearby. (Not interested.)

3. What is our “family care plan” when living independently is no longer possible?

She expressed a desire to live with family, and we agreed. We discussed her options and how to prepare for it.

4. What conditions or indicators will trigger the family care plan?

My mother listed some of the things that would indicate it was time to move in with one of us (like going blind). We listed about 6-8 others. Hopefully this will help us all recognize the time.

5. How are costs related to her safety, ongoing medical care, and living expenses to be covered?

My older sister is spending extra time understanding our mother’s assets, her insurance plans, and business affairs. She will also advise her on when to spend her money on herself, since we know she will not do so without encouragement. We also introduced sharing expenses when necessary.

6. If a nursing home setting is required for her care, where will that be?

We talked about researching quality care and understanding the costs and the need for it to be close to family.

7. What medical directives should be in place in her last days, and what principles should guide our health care proxy decisions?

This was the most difficult discussion we had. Avoidance of suffering seems to be the great determinate in our culture. But this is not so biblically. God has long worked good through suffering. We sought to appreciate that. We discussed discerning what measures promote life versus what measures merely prolong death. We reviewed real cases of other relatives and what seemed appropriate and what seemed excessive. We also talked about food and water as not an extreme measure. And we reviewed the medical power of attorney assigned to my younger sister.

8. What funeral instructions and burial wishes do you want us to observe? And what prearrangements have been made or should be made?

We listened to my mom pour out her heart’s desire to make her funeral a final testament of the grace and glory of Christ and the resurrection. I’ll be preaching. And out of a biblical respect for the human body, she will not be cremated.

9. What do you want us to know regarding the disposition of your assets?

My mother seemed most concerned about this question (in fact, she wanted to start with this question). She is mindful of how families have been torn apart fighting over money and goods. But we have two things going for us. First, she hasn’t collected a lot of stuff and is a woman of modest means. And second, we her children are going to pray that God keep us from falling back into this world. “All that is in the world—the desires of the flesh and the desires of the eyes and pride in possessions—is not from the Father but is from the world” (1 John 2:16).

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