"She Won't Feel A Thing"
Making the decision to remove a feeding tube from a terminally ill patient will haunt you, even when it's the right thing to do.
BY: Diana Keough
The past days' controversy about Terri Schiavo, the brain-damaged Florida woman whose family has fought to keep her on a feeding tube, has reminded me of the decision my older sister and I had to make in my mom's last days. It was hard for us to believe she was near the end. There were so many times in her battle with AIDS-related lymphona when she had seemed sicker, in more pain. But I think she knew this time was different. As we filled out the extensive paperwork to check her in, she pleaded with us, "You're my advocate, right? You guys will make sure they take good care of me?"
We agreed, of course. We knew she meant we should look out for her best interests, to make the right decisions. And we knew that to my mom the "right" decision meant doing nothing to hasten her death, but not doing anything to prolong it either.
Two weeks into her stay, we were still hopeful that the staff would get her pain and the rapidly growing tumors under control, enough that we could take her home again. That is, until her doctor pulled us into his office and told us our mom wasn't going home. "She's in the final stages of this disease," he said. "She's tired and we've done all we can do for her." He advised us to remove the artificial hydration and nutrition being given to her by the IV lines in her left arm. His reason: The woman in that bed was no longer our mother.
"That is only her shell. Your mother left us two weeks ago and you need to come to terms with that and let her go," he told us, quickly looking away. As he stood, signaling to us that this meeting was over, he said, "She can’t live very long without water. . She won't feel a thing."
When we returned to mom's room her left arm was swollen with fluid. One of the nurses told us her IV had moved and was now going straight into her tissue. As the nurse pulled out her line, we asked her not to replace it. Tears were running down both of our faces. I could hardly breathe. The horrible reality of our decision hit us: We were going to starve our mother to death.
I had failed her. I had promised to be her advocate and now I felt I had just given up on her.
Mom died a week later. I had let her go, but the guilt over the decision we made was overwhelming. What if there was more we could have done?
In the years that followed, my sister went back to school to become a hospice bereavement counselor. In her training, she learned there are benefits of not using artificial hydration and nutrition in the end stages of dying patient's life. My mom's swollen arm was already telling us that she was retaining fluid--an indication that her vital organs were already shutting down. Forcing liquids into a person whose body is shutting down can create an