To hospice or not to hospice...

There comes a time in most alcoholic’s journey when they get sick and it appears that the end is near. Questions come up about liver function, brain atrophy, and other such ailments. Usually the alcoholic is hospitalized and sometimes, comatose. Eventually, the question will come up that goes something like this, “Would you like to have hospice step in with his care?” What they are asking is do you want to prolong this life no matter what that life may be? Or, do you want to remove yourself from the life cycle and let nature take its course?

It’s hard to say “Just let him/her die” no matter what the situation or who the alcoholic is in relationship to you. No one wants to feel that they’ve turned a blind eye and essentially killed a person as a result. Our basic instinct is to survive at all costs. Prolonging life is an inherent part of our being. To go against that can sometimes be impossible.

I believe there are several questions that must be answered before making such a life-altering decision.

First, what does the patient want? Do you know? Can he tell you and if he can, is he in a clear frame of mind when answering? Has this person ever stated what his wishes would be if the situation was to present itself?

Riley often said that he should have been left to die long ago. In fact, he was angry with me because he was still alive. While I did nothing to prevent him from leaving earth, I would not simply ignore his screams for help. Because he survived so many near-death experiences (I believe the count was up to nine.) he believed I was responsible for taking care of him – managing his life. I, on the other hand, didn’t buy into his theory that I had kept him from dying.

Riley didn’t really want to die. He wanted to live, but only if he could stay drunk all the days of his life. He never believed that drinking would end his life. In his eyes, there was no danger inside that bottle of vodka. He vowed he would be shot by a jealous husband as he jumped over a fence at the age of 103. Well… I suppose we all have our fantasies.

Second, has the medical community done everything they can to restore the patient to good health. Along with that is the question of is the life restorable to a point of quality living? If a life can be saved and the patient is able to care for himself in a fairly independent manner, maybe now would not be the time to call in hospice. But, if even a drastic surgically procedure will not change the current condition, then is when to talk to your doctor about hospice services.

The liver can regenerate itself if there are enough healthy cells from which to draw the regeneration. By the time the question of hospice comes up, there are most likely not enough healthy cells to regenerate. Once the liver stops functioning properly, a series of other organ shut-downs occur and there is no “do-over” button to be pushed.

Liver and other organ transplants are not viewed favorably when the recipient is an alcoholic. I’m not saying it can’t be done. I’m just saying that those instances are rare. The criterion that must be met is very difficult for an alcoholic to achieve. Most don’t have enough time on the life cycle to reach the goal. In reality, transplantation is not a very viable option. Riley told me that he wanted to get well enough to go on the transplant list, get a new liver, and then…. Start drinking again!

Third, is there anything more that you, as a caregiver, can do for the patient to prolong a quality life? Of course the answer is always, YES. It’s true, you can bring the alcoholic home, spoon feed his meals, change his soiled diaper, turn him in the bed so not to get bed sores, read to him, and do all those other things that will destroy any possibility of having a life of your own. How long do you think it will take before you burn out and start looking for help? I’d say the normal person can hang in there for about two to six months. When you start looking for help, where will you look? Believe me, when I say help is very expensive. It is worth it, but you may have to live without lights for a while. Or you could give up your car – after all, you won’t be using it because you’ll be chained his hospital bed.

Please remember I’m not a professional medical, therapist, doctor, lawyer or Indian chief, I’m just a woman who has been there. When it gets that close to the end, hospice will save your life and make the passing of the patient far easier. Their goal is to make the patient as comfortable as possible as his life reaches its conclusion. They are also there for the caregiver providing support in every possible way.

If I should ever get to the place where my quality of life will be dependent on someone else giving up their quality of life, I want to have things end as quickly and peacefully as possible. There’s no point in my hanging around waiting for a miracle cure. Rip off the bandage and just let nature take its course