Oppenhagen Column: End-of-life discussion a must

It is simply a matter of my age, I suppose, that I feel a strange sense of loss when I open the newspaper and read of the death of a person that I feel like I know. It was only a short couple of weeks ago that I wrote of Eunice Shriver; today, my mind wanders a bit in the wake of the death of her brother, Senator Edward Kennedy.
Love him or hate him — and for most people it was an either or situation, Edward Kennedy was an impressive individual who, when all things are considered, did more for the United States than either of
his brothers. He will be remembered for different things, depending on who you are and what humanitarian issues are most important to you. What I take from his governmental service is his dedication to
the less fortunate, especially in the arena of health care.

Kennedy spent his last remaining time in government focused on health care reform. It is a fitting testimony that we are right now engaged in perhaps the most meaningful discussion of health care reform
in decades. What is ironic is that the biggest outcry against the proposed plan is the very issue that Kennedy was dealing with — end-of-life care.

The debate over health care access — because that is, after all, what we are fighting for — has come down to an emotional debate over so-called “death panels.” I put the term in quotations because the
term “death panels” appears nowhere in the proposed legislation. I have read the section of the legislation that lays out discussion of end-of-life care and nowhere in there does it mention that care will be
terminated or that a panel will decide if you should live or die. Nowhere. Nowhere.

What the legislation does provide for is discussion of end-of-life care. It does specifically mention “the use of artificial administration of nutrition and hydration,” which may be what the fear mongers are
using to drum up opposition to this legislation. But, if you read the legislation dispassionately, you will find that the discussions of “life-sustaining” (yep — that’s the phrase they use) are basic. And if you
have had any experience with close friends or family dying after a long illness, you will recognize how important this discussion is. Families don’t like to talk about it; doctors don’t like to talk about it;
patients don’t like to talk about it. We are scared of dying and talking about it seems to be bad luck. But it needs to be talked about.

I thought I was OK with the topic. How to interact with patients and their families was covered in nursing school. Living wills, advanced directives, powers of attorney — all of these things make sense.
Even basic wills that cover what will happen to living children — important. But how many of us have wills? Or have these other documents?

When I think of the end of life, I see clear movies of my last visit with my grandmother Pleviak. She had been diagnosed too late with the autoimmune disease that would take her life. It was October and I
saw how difficult it was for her to walk, to talk, even to get up out of a chair. But in the brief spurts of time that we had to talk, she told my mom and me about the plans she had made — the dress for the
funeral, the songs to be played, the funeral home to handle the arrangements. I knew this was good information and important to have, but I was very uncomfortable listening to her talk about it. This was
my grandma — she had always been there and would always be there. Two months later, she wasn’t there anymore.

The discomfort I felt during that discussion was minimal when I compare it to the discussions my mother had with me during her last visit in March. She and my father joined the Neptune Society. In my
mom’s opinion, it is the best way to handle things. When either of them pass, the group will pick up the body, handle the paperwork, cremate them, and in a blink of an eye, I and my sisters will get
possession of ashes. No memorial service, no wake, no funeral. As she, in her ever practical way, put it, “this way you and your sisters can get together when it is convenient for all of you to have a
service.” It makes sense; she’s made plans. And yet, I still have not been able to tell her how I feel. I don’t like it at all. It’s not what I want to happen.

But you see, this is exactly why this conversation needs to take place. I know so many people who agonize over these decisions when they are least able to think rationally. It becomes an internal battle
between what we want and what the patient wants. Having this discussion with your doctor, getting these things in writing, makes it less devastating for the family. And makes it less likely to end up in
court.

It is easier to rail against “death panels” than to accept the reality that life ends. How we want to be sustained at the end — physically, emotionally, spiritually — is our decision to make. If we need the
government to put it into law so that we make those plans, then so be it.

Better than having the government involved in a battle between our family members at the end.

Denise Oppenhagen is a longtime resident of Prince William County and can be reached at DenOp1@comcast.net.