Ruth, age 67, had been bedridden
due to multiple sclerosis and colon cancer for two years. Complicating matters, she was prone to urinary infections and sepsis. Her body was ravaged by IV lines, breathing and feeding tubes, colostomy and a bladder catheter. While Ruth appeared to be an ICU patient, she was not. Her husband, Bill, cared for Ruth in their home. She had never been denied medical treatment.
Bill called 911 when Ruth had become feverish and less responsive. In the emergency department, the physician clarified Ruth’s "care status," which is similar to determining a patient’s code status. Was Ruth to be resuscitated and treated aggressively or made comfortable? Bill had never considered this question and choice. He only wanted his wife to get better. After two years of Ruth
being on a respirator, Bill’s goal was to have her breathe on her own.
Ruth appeared to be aware of her surroundings, but was despondent. She was either afraid to speak or had given up on having her say. Her eyes seemed to be telling the physician to let her rest in peace. The physician was surprised to
learn that Ruth had been receiving palliative care. Bill scoffed, saying this service was all talk and no action. His idea of a team approach meant round-the-clock care for his wife.
Bill shut the conversation down with the poignant question, "Are you suggesting that I shouldn’t have called the ambulance?" The
physician felt as powerless as Ruth, realizing that speaking the truth might be malpractice.
Loved ones are even more precious near the end of life, and family caregivers need to think twice before calling 911.
Keep these considerations in mind as you shoulder the burden of helping a loved one
transition from life to death: