A Managed Bereavement Process is a process of consensual withdrawal of life maintaining treatment from a patient.
Each of the patient, the care provider (in our case, a Hospice) and the family must agree to such a course of action, which naturally involves a detailed consideration process examining all possible alternatives first.
In our case, the patient was only in his mid 60s and still of youthful mindset.
It was made all the more difficult by that patient – MikeyM™’s father – being absolutely fine mentally but having suffered from a long term debilitating physical condition that rendered his physical quality of life minimal in his eyes, depriving him of much valued self esteem, confidence and sense of identity.
Having lost Mum a year earlier after almost 50 years of marriage and endured years of chemotherapy for crippling pain and dreadful breathing issues (though he had never smoked, he reported that he felt he was living life “under water”), he was very tired, weary and reflective.
He had even recently told a nurse at the Hospice happily and calmly that it was “time for him to go and be reunited with his (deceased) wife”.
Yet nothing could prepare us for the feelings we encountered as the time for withdrawal approached – it was otherworldly.
Signing the consent forms felt like committing a loved one to a death sentence – and what if they changed their minds while sedated but couldn’t communicate it to us...?
We were engulfed by a mixture of advance grief, guilt that we couldn’t make things better and (the worst part) a wholly unjustified anger that the patient, a person we loved and needed, was electing to leave us behind.
But we had to respect his wishes, full stop.
It was time to let him go.
The hardest thing to get our heads around was the fact that life had become so untenable for someone we loved that the alternative unknown without us was a more preferable prospect for him.
But the Hospice team were absolutely amazing.
The wraparound patient and family support was unflinching in its comprehensive excellence, both in the lead up to and following withdrawal.
Discussions in advance were collective and exhaustive.
There simply was no cure or effective treatment for the condition in question.
Nor any medium to long term prospect of one.
After withdrawal, both we and the Hospice team were in tears, the consent of a junior doctor attending throughout having been granted for personal development purposes as “it was probably the only time in her career she would experience it”.
And we too, together with a close family friend who's level of support was nothing short of outstanding, were there throughout.
There was no suffering, just a gradually emerging calmness and cessation of chest heaving.
A final, long overdue relief from pain and suffering as we reassured him how much we cared and encouraged him to “fly to Mum”.
We were truly humbled to have been part of this and privileged at the effort that had gone into making it happen in accordance with Dad's wishes.
As we hugged the consultant who had managed the patient programme so wonderfully and sympathetically immediately following ‘successful’ withdrawal of treatment, we offered a simple observation amidst the peace we all shared in.
Namely, that when we first arrive into the world, all we have is Hope.
And similarly, when we leave the world, all we have is that very same Hope – in Dad’s case, that of reuniting with Mum.
But slowly we started to remember Dad as he would have wanted to be remembered – as a vibrant, physical, well humoured spirited man with so much to give.
And with the course of time we also more keenly recognised the sheer bravery of his decision, no doubt seeing the impact his condition was having on those who loved him most as part of his assessment of options available (see our earlier post entitled “Identifying and Stressbusting™ Panic Attacks” for specific examples of this impact in our own case).
This helped the Grief Process immensely, a process we hope to cover in a separate dedicated post in partnership with the Hospice itself.
Now extremely rare experiences like this one ought truly to justify the reopening of a discussion on the availability of Euthanasia more widely.
We have a fundamental right to Life.
Yet our right to determine our own Death is limited to strictly defined circumstances.
Of course, there is sound fundamental reasoning behind this – the avoidance of abuse as well as some specific though decreasing religious objection.
But vastly increasing life expectancies bring with them the prospect of living to a grand old age in year terms but with zero or extremely limited quality of life.
This must surely be a catalyst for a fresh consideration programme with the interests of the individual, not social, financial or religious policy, at its core.
Making decisions and discussions relating to managed death “taboo”, simply serves to make it more traumatic for the patient and their family, as well as an administrative and legal minefield for dedicated but underfunded healthcare providers more than capable of reaching reasoned, responsible value judgments with the patient and their families on a case by case basis.
NB: If you have been affected by anything in this post, please do not hesitate to get in touch or consult our Legal Notices page for more support suggestions.
Love alongside wonderful memories,
LouLoU&MikeyM™ 😘❤💙💚 xxx xxx