End of life

I grew up in a very traditional Mexican family having a difficult time acculturating to the American values and lifestyle. In America, it seems almost customary to have a living willor an advanced directive completed before a loved one is at their life’s end, however in Mexico, this is not necessarily the case. The family (i.e. husband, children, etc.) routinely make the difficult decisions about end of life care because death and dying are not normally discussed within families. In Mexico we celebrate el Dia de los Muertos (Day of the Dead), a day that honors the dead with festivities, lively celebrations, food, drinks, and activities that the deceased enjoyed, however this remembrance only focuses on the deceased and does not consider those who are at their life’s end. In our family, we never brought up death and dying. My mother was very adamant against having this conversation even when her parents were very sick.

Because of this resistance, I had never stopped and thought about what I want for my own end of life care until I started nursing school. As I become more knowledgeable about the death and dying process though theory and clinical experience, I know I do not what to be in a situation where machines, tubes, and wires are prolonging my life if the life I would have with these interventions is not worth living (quality of life is poor). In clinical I see this dilemma time and time again where the family is not ready to let their loved one pass. They continue to prolong life when there is no hope or possibility of ever recovering. I feel that this selfishness only adds to the pain/suffering, hospital cost, delays the grieving process making it much harder to let go. I think my younger sister would be the person that would be able to make the hard decisions for me. My family is very supportive but they all would have a hard time letting go.

I sat with my family over the weekend to discuss these issues and they were not very receptive as expected however opened up as I provided them with more knowledge. I think my best approach was to give examples and possible consequences for end of life care. Although my mother thought it was grim even talking about it she expressed that she dis not want to be suffering or have her life prolonged by artificial means if they have a poor quality of life to live. Poor quality of life to her meant she would be in a vegetative state not able to participate in daily activities. My mother agreed that my sisters would have a hard time making life choices and though my youngest sister and I would be able to make them for her. My eldest sister on the other hand was not very receptive. She thought that there was no need to talk about death and dying. I tried the same approach as I did with my mother, but she would not discuss the topic further. I think she needs time to process the information before approaching her. I was glad she listen to me to some extend because I can see that it made her think about it.