From Chaos to Calm - Decision Making in Time of Crisis

By Linda Thompson


During the last five years, I’ve given workshops and lectures about life planning across Phoenix. And while I say it isn’t all about death and dying, that’s certainly a part of it. Even though I thought I had all of my ducks in a row, this is the latest chapter in a very long learning curve. In 1994, my then 79-year-old mother came to live with me. We’ve always had an easy, open way of communicating both the important and unimportant. We are planners; we like everything organized and in order.
Right after the death of my father in 1969, Mom purchased a funeral plan that matched exactly what we had done for her soul mate. At that time, a dollar bought a whole lot more and for the large sum of $1,900; she paid for this plan over a period of 18 months. Although she’s now in Phoenix with me, it is and always has been her wish to return to Denver to rest beside Dad. A few years ago, she wanted to make sure everything was in place for what was to come. We met with a local mortuary and found that there were some things that we were still missing to make a complete plan. For an additional $5,000, those things were taken care of. All I have to do now is pay for transport back to Denver when the time comes. But the real shocker of the meeting was when the mortuary representative told us her $6,900 investment was now worth approximately $26,000.
Over the last couple of months, Mom has had a few mini-strokes. Although the residual effects are slight, each one gets a bit worse. Last week, Mom had another one and was comatose for three days. I thought I knew what to do, but I was in for the surprise of my life. A friend told me I had to contact Mom’s primary care physician to get orders for hospice care. When I called her doctor, I was told that since she had not seen my mother for six months, she could not diagnose her as terminal; therefore, she would not issue hospice orders. Wow, the first roadblock. I then called one of the largest hospice organizations in Phoenix, only to be told that they couldn’t help me without her doctor’s orders. Another roadblock.
Okay, here I am, at home alone with a comatose mother – what do I do? For the past four years, I have worked with the most marvelous non-medical home care group I could find. After one phone call and within two hours, I had a Visiting Angel here to help with Mom and stay with her while I was on the phone. Thank heaven for my Angels. They also gave me the name of a local hospice physician who, when I talked with him, told me to call Hospice of Arizona and they would take the case. Within another two hours, an assessment nurse was at my door. During the course of the day, we invoked Powers of Attorney, issued DNR orders in accordance with Mom’s written wishes, another nurse brought supplies, and appointments were set for a social worker and spiritual counselor to visit later. What a turnaround. From chaos to calm, all because someone knew the right people to contact. Obviously, my plan was missing a few pieces.
Fortunately, Mom has bounced back from this episode; but we both know the end is near. She’s now lucid. With a lot of help, she can get to a wheelchair and out of the bedroom. She’s eating, but getting weaker every day. She’s old, she’s worn out, she’s ready to go. She’s talked with me about what dress she wants to wear and how she wants her hair done. In other words, it’s time and I will honor her wishes. I have been blessed with her presence for over 10 years and it’s time to let her go on to the next stage of her journey.
All of this has occurred partly because we had planned for it, and partly because I did not anticipate the roadblocks that were put before me. During the four hours of almost frantic phone calls and waiting for call-backs, I kept thinking about others in this same position and how frustrating, panicking and emotionally draining it must be for them. At least I had part of the puzzle in place. But no one told me what might happen when I tried to invoke care that was badly needed, but unobtainable. Her physician, or should I say former physician, couldn’t seem to grasp the concept of her being comatose in her bed, not wanting to go to a hospital – meaning a call to 911 was not an option – and was totally unwilling to offer assistance of any kind. I wasn’t prepared for a hospice agency to refuse care for any reason. In other words, I hadn’t completed my homework.
My passion for the past five years has been elder care education and, with this experience, I have even more information to share. The medical community needs to get a grip on what’s happening with our elder loved ones. They need to bend the rules a little, they need to learn how to spell “compassion” so they can look up its meaning. In other words, they need re-educating on the purpose of their profession. It is to help – not to hinder. Some hospice organizations need to educate their staff on the same thing – think out of the box a little and try to help someone in need. Not everyone wants to be hospitalized, kept alive artificially, and fed every pill available in the pharmacy. Not everyone wants to be drugged, in a strange place, being bothered by people they don’t know. In fact, I’d bet that a lot do not. What ever happened to personal dignity? Are we so afraid of the dreaded lawsuit that we can no longer help those in need without first checking the rule book?
I keep wondering what would have happened if this case had been of an elderly couple and one of them was trying to get help. Who would they have called? Would they have panicked, called 911, and started the process of quantity over quality? Times of emotional and mental crisis are not when we make sound, logical decisions that are in the best interest of our loved one. It is my sole purpose in life right now to ensure that my precious Mother passes with as much dignity as possible, in her own bed, in the comfort of her own home, with people who love her close at hand.
But had I panicked and called 911, she would now be hospitalized and subject to a very undignified and degrading process. That will not happen in our family. But it could happen to you if you are not educated, informed, and emotionally prepared to follow the previously determined wishes of your loved one.
There are 78 million of us Baby Boomers waiting in the wings and none of us are getting any younger. Isn’t it time you start planning for end of life realities? Don’t put the burden on your family and friends to make choices for you. Know your and their rights. Know what things need to be in place. Make sure your wishes are in writing and that a family member, trusted advisor or friend knows what those wishes are. If you haven’t already done so, now is the time to talk with your family and start the planning process. It’s not easy, not comfortable, and certainly not a fun conversation, but it could be the greatest gift you will ever give. Once your plans are in place, get on with life, knowing you are prepared for the eventuality of end of life. You and your family will have a sense of security, balance and peace of mind. You should know that decisions made in time of emotional crisis are almost always regretted later. Don’t, as Scarlett O’Hara in Gone With the Wind used to say, “Think about it tomorrow.” Your tomorrow is here today; do something!


Linda Thompson is founder and President of Life Path Solutions, specializing in intellectual wellness. She is author of Planning for Tomorrow, Your Passport to a Confident Future, a common sense approach to life planning. Linda can be reached through her Web site


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