My grandmother’s stroke left my family facing the bewildering prospect of long term hospitalisation. Navigating the hospital procedures as well as healthcare and financial considerations was incredibly taxing to say the least, and emotionally stressful.
My grandmother’s stroke was severe enough to compromise her quality of life, but yet not fatal enough to grant her the blessed relief of a quick death. This might sound callous and cold-hearted but my family was able to say with certainty that my grandmother was ready to die. We were guided by the conversations we have had with her after my grandfather’s sudden death from a heart attack two years ago. She had clearly and repeatedly expressed her readiness to die as well as her wish to die at home so we opted for early discharge prior to the completion of her course of intravenous antibiotics and signed an AOR (At Own Risk) form to indemnify the hospital. We decided that she would have a better shot at quality of life at home after reviewing her medical condition and discussing Advance Care Planning (ACP ) with her doctor and ACP counsellors. Given my grandmother’s age as well as underlying health issues in addition to her stroke, we also made other tough decisions such as not attempting resuscitation in the event of another stroke/heart attack and limiting medical interventions to comfort measures such as painkillers and oxygen.
At the time of writing, my grandmother is in a stable condition. There is still anxiety when she has a health “episode” such as fever or breathlessness. We manage her fevers by sponge-ing her and giving her paracetomol. We have an oxygen tank on standby should her oxygen levels drop as well as the contact of a network of house call physicians for more serious health issues. These are not “pretty” situations but the precious opportunities we had to discuss her wishes (dying at home) and fears (being hooked up to machines) were important. These conversations have relieved my family of having to second-guess my grandmother’s dying wishes (pun intended) and hopefully ultimately serve to ensure that she will have as good a death as she can when my grandmother returns to God whom she now calls her Lord.
Resources and references
Agency for Integrated Care (www.aic.sg)
Living Matters (www.livingmatters.sg)
