Blog post by Paul Quinlivan / hospice volunteer /
In the summer of 2010 my mother, nearing end-stage congestive heart failure, received a left ventricular assist device (LVAD). The implanted device extended her life expectancy by more than three years. Barely ambulatory prior to the surgery, she resumed a lifestyle and activity level that one would expect for a person in their mid-eighties following a short period for recovery and rehabilitation. She interacted daily with friends and family, engaged in moderate physical activity and perhaps most importantly witnessed the birth of three great grandchildren.
The cardiologist was careful to explain that the LVAD was not a miracle device or a ticket to immortality. He told us frankly that he expected that the LVAD would allow my mother to live an additional three or four years. As with any complex medical procedure, there are many potential complications with the implantation of an LVAD. There is an especially high risk of infection for patients using it as a destination device due to the necessity of an external power supply to drive the implanted pump. In the spring of 2013, my mother developed an infection which grew progressively more serious over the summer. In August, the doctors informed us that although there were additional measures that might be taken, they felt they had lost the battle and that palliative care was the best alternative under the circumstances My mother entered hospice immediately and passed away in early October.
Reflecting on the experience in the three years since her passing I am struck by how well her experience illustrates how much living and dying has changed with the progress of modern medicine. Advanced treatments and therapies allow those suffering from diseases or conditions that once brought an abrupt end to life can now live something like normal lives for an extended period. Living – and dying – often becomes a choice, or more accurately a series of choices, that a person must make. In my mother’s case, she chose at an advanced age to undergo a complex and risky surgical procedure followed by rigorous rehabilitation in exchange for a few more years of life. But it was also her decision to refuse further treatment, choosing instead the palliative care available in a hospice setting.
In my view, hospice programs are an essential component of a health care environment where choice plays an ever larger role in how we live and how we die. We will all draw our last breath someday to be sure. But I suspect that many of us will never hear those words once dreaded by patients and their families: “there’s nothing more that we can do.” Rather, we will more often choose the appropriate time to give up the fight and elect to spend our last days in the peace and comfort afforded by hospice care.
As a hospice volunteer, I feel privileged to play a small part in a program which I know from personal experience offers an invaluable service to patients, families, and care-givers. For individuals like my mother who often have carried on nothing short of heroic struggles against illness and disease, hospice provides the opportunity to spend the last and in some ways the most meaningful phase of life in the peace and comfort they so richly deserve. For volunteers hospice offers the unique privilege of being present for those who have lived full and often remarkable lives. I look forward to a deeply rewarding as well as a challenging experience serving hospice patients and their families and encourage others to consider it as well.