06 A Good Life to the End - Bishop Allwyn D'Silva

posted Feb 6, 2019, 7:21 AM by Neil D'Souza   [ updated Feb 7, 2019, 5:49 PM ]
The elderly would welcome being able to spend the last days of their earthly life surrounded by loved ones.

A few years ago, my brother-in-law was in the ICU, and it was painfully evident that he was on his death bed. Among those who visited him in the hospital was my relative, Sr Angela of the Daughters of the Cross, a doctor. Amidst the faint buzz of machines and the frenetic pacing of medical personnel, Sr Angela gently, but with a firm conviction, advised my sister to move her husband to the ward. During his last days, it would be better for him to enjoy the company of his whole family, rather than remain in the ICU, where only one person is allowed at a time. I also remember two of my priest friends who were dying of cancer. Since they were in the last stage, they did not want to prolong their agony and take chemotherapy, opting instead for palliative care.

These incidents forced me to read the book, A Good Life to the End by Ken Hillman, an intensive care specialist and Professor of Intensive Care at the University of South Wales. Dr Hillman recounts the peaceful passing away of his grandfather at home, in contrast to his mother's death in the ICU – with the last six months of her life spent in and out of hospitals. He points out how the norm has transitioned from being born in the intimate setting of a home to birth in chaotic delivery wards. As he succinctly observes, our passage from the cradle to the grave has become increasingly medicalised.

A consequence of this is that many of us will spend our last days in an ICU, hooked up to machines, and with foreign material in our bodies, in an attempt to prolong life. However, Dr Hillman asks, will the machines that save the lives of young people with otherwise fatal diseases, be as effective for old patients? While it may be okay to introduce foreign material in the body for young people, the immune system of the aged is not strong, and aggressive treatments often do not have the desired outcome.

Conditions which bring the elderly into hospital are simply markers of someone who is nearing the end of life, requiring a different approach from the radical measures taken in ICUs. As we grow older, we get frailer. Bones become brittle, and our organs just don't function optimally. Ageing is inevitable.