The Goals of Palliative Care: Beyond Symptom Control

Extract

My father died a basically “good death.” He died, comfortably, at home, in his own bed, clean shaven, surrounded and embraced by his family. My father lived with widely metastatic prostate cancer for 5 years. In those 5 years, he had minimal pain and no episodes of infection or hospitalizations. He did extremely well for 4 years and 6 months, even working. The last 6 months were marked by progressive weight loss and weakness, requiring him to slow down. But up until the day before he died, he was ambulatory, showered and dressed himself, argued with my mother, and was pain free. On a Tuesday morning, for the first time in his long illness, he did not get out of bed. He was drowsy and not completely responsive. My mother called to tell me of the change. I left morning rounds at the hospital, collected a few essential medications, and went straight to their home (the home I grew up in). I spent the next and last 24 hours of his life sitting in a chair at the side of his bed, feeding him drops of liquid morphine and haloperidol to keep him comfortable, free of pain, free of confusion and agitation. My mother slept beside him that entire night. When the hospice nursing aide arrived on Wednesday morning it was clear that my father was very near death. We both bathed my father, and I insisted on shaving him. He had about 4 days worth of beard growth, and I knew he would want to die clean shaven. After shaving the left side of his face, he stopped breathing. I kissed him, thanked him for giving me life, and then I completed shaving the right side of his face.