05 March 2008

Well, this sucks....

My 89 year old grandpa has graciously decided to allow me to put my several years of dilettantism with the pain sciences into practice. He's entered the hospital in pretty dire straights. I'm trying to help my parents be involved with decisions about his palliative care (without getting in the real clinicians way).

So, I'll be posting some reflections about his/my experiences with pain care, ethical issues, and other topics, as we go. I'm sure much of this will be naive; especially compared with many of your experiences and backgrounds. But perhaps I'll stumble across something interesting or useful to you.

Also, from time to time I'll probably be soliciting advice on where to find information on certain specialized topics. I'll really appreciate any help I can get.

1 comment:

Keith said...

I was involved with my 101 year old grandmother’s end of life care. She did not want to leave the home she had lived in since 1927. Then she fell. Into the hospital she went. While there, she crawled over the foot of the bed and fell again, this time breaking her pelvis. My, and my father’s, feelings about hospital negligence aside, into the hospice she went. A 101 year old woman with a broken pelvis has no chance of healing and she was in constant pain. The end was clearly near.
Under current medical thinking, the only treatment for my grandmother was to make her as comfortable as possible. This meant as much morphine as she wanted. With someone who has no chance of recovery, what is the problem with this? Nothing in my book. I was amazed at some folk’s comments on the horrors of morphine. My point was “she’s 101 with no chance of recovery”. One so called friend thought it immoral and un-Christian to medicate a woman of her age. I thought how clueless. And even more cruel to suggest my grandmother should spend her last days in terrible pain.
In age, there is a huge difference between your grandfather of 89 and my grandmother of 101. Some very hard questions you might want to answer: Is he in chronic pain? Is he going to survive? If not, how much time does he have? Does he have two weeks or two years? This makes a huge difference in the type of pain management he may want. And the really big question, what kind of shape is his mind in?
Having watched many friends die of AIDS, and one friend die of colon cancer at the tender age of 27, I feel that chronic, high level end of life pain needs to be medicated. It’s not appropriate to worry about addiction or moral or religious issues at this time. The patient’s comfort is paramount. Great Aunt Sadie, who has a wing-ding over morphine use in your grandfather ought to be politely told to take a hike.