Quality vs. Quantity of Life

As I watched both of my Grandmothers in the final stage of their lives, one being 94 years old and the other being 90, I clearly can see that the most important thing that my family can do for them is keep them comfortable.  Even though their paths to this stage of their lives have been very different, when we visit with either one of them they both frequently express their desire for their life to be over.  You might read that and think they are just depressed and need treatment, but I can assure you that, especially for my older grandmother, this is not the case.  They both also speak frequently about how they enjoyed their life and are proud of the family that they have.  They simply are tired, their bodies are worn out, they are ready to rest.

Inevitably the decisions about their care changes because of this.  It becomes necessary to consider quality of life instead of quantity of life.  What I mean is the goal of further treatment changes from trying to keep them alive to keeping them comfortable and content for the remainder of their lives.   It means as new or continuing health issues arise, we now ask ourselves what is the best treatment to keep them comfortable.  Thankfully my family is wonderful and the decision to change the focus of their care is agreed upon without arguments or hurt feelings.  Having helped too many families to count through this change in treatment, I know that my family is very fortunate to be blessed with this cooperation. Some families are on opposite sides of this fence.  Many times when children do not live nearby it is especially hard to understand this change in focus because they have not watched the aging of their parent first hand.  If you are the sibling that is the primary caregiver, you need to make every effort you can when changes in condition begin to keep in close contact with your brothers and sisters.   Explain the changes you are seeing, ask them for suggestions, tell them what the doctors are saying, and decide on treatment plans together.   You do not want to call them up one day and try to make them understand changes that have been progressing over time in just one phone call.  It will overwhelm them and they will become defensive and feel the need to protect their parent.

Keeping the lines of communication open through the aging process with those closest to you and your loved one will hopefully make these transitions easier on everyone.  Each of you may have different ideas about what quality of life may mean to you.  Allowing each person to express their thoughts enables everyone to hear all sides but try to keep in mind that just because your loved one is old it does not always mean that they are incapable of making these decisions themselves.  It is ultimately about what they want, not what you want...

Quality of care in the last stage of life = Aging with Ease!

Share Your Stories...

Today I went with my mother to visit my grandmother.  Not the same grandmother that I have mentioned in other posts.  This is my mother's mother and she is 90 years old.  She lived with my parents for more than 10 years and recently, due to health decline, has moved into a long-term care facility.  These last few months have been very difficult to watch as my grandmother began to fail both physically and mentally.

My grandmother has always been a very strong-willed person.  When things needed to get done, you could count on her to do it.  She always kept her word and could be depended on when you needed her.  She also was directly open about telling you what she thought about things.  Most times, she would express her opinions with love, but there were several moments that I can easily think of where she told you what she thought without any regard to what the reaction might be.  Don't get me wrong, my grandmother is a wonderful person.  From her I get my strength to keep moving forward, my stubbornness, my need to always be on time, my work ethic and my confidence.  From her I also inherited the family gene to worry.  She would worry endlessly about everything.  I also inherited from her the talent to keep personal struggles to myself.  Sometimes these two traits can be good things, but sometimes, as you can imagine, they are not.

I think that those last two traits are why, as her mind begins to fail, she spends a lot of her time now paranoid that people are talking about her, worrying that they are going to throw her out of her room and suspicious that they are out to get her.  It is very difficult some days to visit her.  You never know what you are going to be walking into.  One day, she is very pleasant and speaks very highly of the staff who help her.  The next time she spends the whole visit begging us to take her home.  The strain and guilt that this puts on my mother does not go unnoticed.  I know she wonders if things would be better for my grandmother if she did take her home again, but the fact is that my grandmother needs someone with her 24 hours a day.  Watching over her medications, her health and her hygiene.  These are not things that my mother is able to provide for her.

I am never sure what to say to my mother after a visit with my grandmother.  As a nurse in geriatrics, I understand the changes that are going on with my grandmother.  I have seen this progression so many times.  That does not mean that it makes it any easier to cope with it.  It makes you feel awful to see someone that you love, who was once so strong and vibrant, now look so sad and frail.  The only comfort I can give my mother is to reassure her that my grandmother is getting good care.  That she is in a good facility where people do really care about her.  Having worked in long-term care facilities before, I know the signs of quality care and they are all present at her facility.  My mother knows this as well and that does bring her some peace of mind.

My family is very blessed to have had my grandmother in our lives for so long.  Many families are not so lucky.  My hope for her is to find some peace in her own mind as she reaches the last stage of her life.  Perhaps the anxiety she feels is actually a result of exactly that - maybe she is afraid to die?  I don't know what the right answer is to this.  What the best course of action should be.  What we should say to her when she asks us to take her home.  I just answer her honestly about why she needs to be there and hope that some day soon she will accept this stage of her life.

If you are a caregiver who has gone through this transition with your loved one, I would love to hear your stories...

Sharing your stories helps the process of Aging with Ease!

 
I originally posted this in November 2011 on my first Aging with Ease blog, my grandmother passed away in February 2012 at peace with her family at her side.  Her passing would be the first of three close family members leaving me in 2012.  Let's just say this year has been very long, sad and unending.  As the year finally draws close to the final month all I can really say is that my family knows I love them.  Death is final and there is nothing you can do to change it.  All you can do is just love them...

I am working on finding a way to regain some motivation in my life, as my grandmothers and my father taught me to do.  It has been difficult since the three people I have lost were also the three people who motivated and inspired me the most.  I hope any followers that I have are patient with me as I try get back into it.