End of Life Discussion

This week we have a guest blogger. Thanks to Phyllis Nixon for writing this, and to Dr. John Ross for  his talk in Bridgetown. 

An interesting presentation of ‘how to talk about death and mortality as a natural function’ took place at the Bridgetown and Area Library on October 18, 2015.  Dr. John Ross, Emergency Medicine Professor at Dalhousie University presided, sharing his views about end-of-life options.  The roomful of inquisitive attendees, asking questions and providing their own outlook, set the tone of the evening’s discussion.

Dr. Ross stated his opinion that death represents the ending of ‘life’s circle’; that death and mortality are natural functions.  He reminded us that hospice and palliative care are available in Nova Scotia to offer dignity and acceptance in death, peace, and easing of pain.  Talking about our death and mortality with our children or friends is good for us and is less injurious than keeping these feelings inside.

Dr. Ross mentioned that ‘Death Cafes’ are becoming more familiar.  These are places where concerned people can meet together and talk about death and dying.  He thinks that these places can be better termed as ‘Sharing Circles’, and they can help us to care for each other and be of assistance to those who need it.

Questions arising from the discussion

DNR – Do Not Resuscitate.  This request should be witnessed by two people.  Make sure you talk to your family or a friend about your death wishes and let these people know where you keep this information as this request is usually carried out in a medical emergency situation.

Power of Attorney.  This document can include a legal acknowledgement of your request to `not resuscitate` and any other end-of life-options agreed upon.

Doctor Assisted Death.  This HIGHLY controversial proposal is expected to become formal legislation in 2016.  A few scenarios were generally discussed, such as:

• What happens if a doctor refuses a request for assisted death due to religious or ethical objections?
• What are the requirements for assisted death?
• Should a person with dementia be eligible to request assisted death?  

As yet, official conditions and restrictions have not yet been laid out and clarified, and the College of Physicians and Surgeons has not put out their attempt at defining or responding to the issues.  

Neuroplasticity.  This term refers to changes in the neural pathway synapses of the brain due to changes in behaviour, the environment, the neural processes of thinking and emotions, as well as changes resulting from body injury.  The concept of neuroplasticity has replaced the formerly held position that the brain is a psychologically static organ, and explores how the brain changes in the course of a lifetime, thereby negating the idea that our brain is static and unchangeable.  Dr. Ross said that the brain continues to grow and our muscle mass maintains itself with exercise, keeping the muscles active as we age, giving us a quality of life for a longer period of time.

Dr. Ross:  `Words of Wisdom`

• Make sure you discuss your death wishes with your family or friends, and state exactly what you want.  This is very important.
• Make use of hospice and palliative care in your area.  These offer help to die with dignity, a sense of peace, easing of pain and the acceptance of death as part of the life cycle.
• Educate yourself and others.  Most people don`t know enough about their own bodies and therefore we should take more responsibility to learn more about our physical self.  Do your own research to increase this knowledge.

• Get rid of the word elderly`.  Knock off the `ly`at the end of this word and you are left with elder`, a word signifying a collective wisdom which can be shared and engaged by living fully, being productive, and having a sense of purpose.

• If you were told you had a year left to live, name what you would like to do with that time allotted to you.  Then ask yourself this question: Why not do them now.

• Recommended reading about the subject of death and dying:  Being Mortal by Atul Gawande.