MY COUSIN’S HUSBAND IS DYING IN INTENSIVE CARE AND SHE CAN’T LET GO! HOW CAN I HELP HER?

Published: Mon, 04/27/15

Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we INSTANTLY improve the lives of Families of critically ill Patients in Intensive Care, so that you can have PEACE OF MIND, real power, real control and so that you can influence decision making FAST, even if you’re not a doctor or a nurse in Intensive Care!

This is another episode of "YOUR QUESTIONS ANSWERED“ and in last week’s episode I answered another question from our readers and the question last week was PART 2 of

"MY PARTNER IS IN INTENSIVE CARE ON A VENTILATOR! THE INTENSIVE CARE TEAM WANTS TO DO A TRACHEOSTOMY AND I WANT TO HAVE HIM EXTUBATED! WHAT DO I DO? (PART2)"

You can check out the answer to last week’s question by clicking on the link here.

In this week’s episode of "YOUR QUESTIONS ANSWERED“ I want to answer another question from one of our readers and the question this week is

MY COUSIN’S HUSBAND IS DYING IN INTENSIVE CARE AND SHE CAN’T LET GO. HOW CAN I HELP HER?

Hi Patrik,

How can I tell my cousin that she needs to let her husband in Intensive Care go?

He has end stage COPD and is not weanable on a ventilator and he has had a tracheostomy for 2 months now!

My cousin really needs to ask her husband what he wants now, to possibly be removed from the ventilator and whether he wants to die peacefully as it has been such a struggle for years and especially for the last two months in Intensive Care?

My cousin’s husband can’t be weaned off the ventilator, he’s 78 years of age, he’s having endstage COPD and he had a R MAC stroke and heart failure since last November .

I am a LPN AND An OT.

My cousin and her husband have been in denial about his situation for a long time and they now can’t face it.

His been in a poor condition for many years and he’s been very non compliant, without much help from their Doctor either.

He has been having pneumonia in October, which got him hospitalized, he also has a peg tube(feeding tube) ,he has no gag reflex, basically the typical signs of a stroke.

What do you think I can do in order to help them accepting this terrible situation?

Hi Judy,

thank you for taking the time to clarify.

It sounds like your family, your cousin and her husband in particular are in a difficult and challenging situation.

Given that you are a health professional yourself, you probably know how difficult it can be at the end of people’s life to let go.

And I take the age of your cousin’s husband out of the equation, because I have seen people been successfully being weaned off the ventilator at the age of 78 and beyond.

However, from what you are describing, your cousin’s husband obviously had a severe stroke, ended up on a ventilator in Intensive Care, he now has a tracheostomy and a PEG/ feeding tube in order to keep him alive.

Even worse, he has no gag reflex and therefore will be unable to be weaned off the tracheostomy and the ventilator.

The combination of ventilator, tracheostomy and the PEG/ feeding is a combination that can keep people alive for long periods of time.

And I am very glad that you bring up the question and the issue for your cousin, who is obviously in a situation where she can’t or doesn’t want to make a decision of what to do next.

It sounds to me like no “worst case scenario” discussions have occurred before your cousin’s husband was still able to communicate.

That is a big issue and it could often prevent those difficult and challenging situations happening in the first place.

Nevertheless, your first step is to sit down with your cousin and explain the situation from your perspective as a health professional.

Share your views compassionately and also explain to your cousin in detail that the current situation means suffering for all parties involved.

Next, think about how you, your cousin, another family member or the Intensive Care team can bring meaning to the situation.

What I mean by that is, even though the situation is difficult, challenging and probably heartbreaking for your cousin and maybe for other immediate family, is there any meaning your cousin can make out of the situation?

Is it a meaningful death? Is there anything your cousin/ family can learn from the situation?

Are there any religious, cultural or spiritual needs that haven’t been met as yet that would make a transition towards the end of life easier or more bearable?

Also, and this is a big one from my perspective, is there any way that your cousin or your family can end the situation on their terms and not on the Intensive Care team’s terms?

You haven’t mentioned the Intensive Care team and depending on how they have handled the situation, there could have been animosities about how the Intensive Care team has handled this difficult situation and that could have furthered the denial of your cousin.

And I don’t want to speculate here of what or what hasn’t been done by the Intensive Care team.

The fact of the matter is that your cousin or some other key family member needs to feel to be in control of the situation in order to make the right decisions and make meaning out of the situation.

Next, is there any way that such as having your cousin’s husband die at home would make the situation more bearable?

For example, in countries like Australia or Germany specialised Intensive Home Care nursing services provide Intensive Care Patients and their families with the opportunity to die at home if they wanted to.

That’s a win-win situation as it gives people what they want and it also frees up and expensive, scarce, precious and “in-demand” Intensive Care beds and it saves money as an ICU bed costs around $ 5,000 per bed day and Intensive Home Care is by far more cost effective. For more information check out www.intensivecareathome.com.au

I presume you are in North America and you may have to check out service availability for similar services in your area.

Next, take a look at this article here and make sure that no matter what you or your cousin decide for the next steps, that your cousin’s husband has a dignified death. (click on the link)

A five step BLUEPRINT for DYING WELL and with DIGNITY in Intensive Care!

End of life situations in Intensive Care are a big challenge and I have seen by far too many end of life and death situations in Intensive Care that have been handled poorly.

Also, death and end of life is a process and not an event.

Therefore it sounds like you might need to do some planning in order to make sure that once again, you and your cousin experience a death on your terms and not on anybody else’s terms.

It can make all the difference for having PEACE OF MIND, control, power and influence! And having PEACE OF MIND, control, power and influence in an end of life situation can make all the difference for the future of the family!

Experiencing a bad end of life situation in Intensive Care can leave a very negative feeling for Families and for the Intensive Care team, therefore make sure that all your cousin’s/ family’s needs are met no matter what they are.

99% of families of critically ill Patients in Intensive Care have no PEACE OF MIND, no control, no power and no influence because they are not asking the right questions, they take everything that the Intensive Care team says for “face value” and they are intimidated by the Intensive Care team’s “perceived power” and “perceived authority”.

Experiencing a “bad death” in Intensive Care can leave families bitter and disappointed for the rest of their lives and makes the grief they are going through beyond imaginable.

Recommended resources:

THE 5 THINGS YOU NEED TO KNOW IF THE MEDICAL TEAM IN INTENSIVE CARE WANTS TO “LIMIT TREATMENT”, WANTS TO “WITHDRAW TREATMENT” OR “WITHDRAW LIFE SUPPORT” OR WANTS TO ISSUE A “DNR” (DO NOT RESUSCITATE) OR AN “NFR” (NOT FOR RESUSCITATION) ORDER FOR YOUR CRITICALLY ILL LOVED ONE!

PEACE OF MIND, CONTROL, POWER AND INFLUENCE EVEN IN THE MOST CHALLENGING OF CIRCUMSTANCES THAT YOU, YOUR FAMILY AND YOUR CRITICALLY ILL LOVED ONE COULD POSSIBLY FACE IN INTENSIVE CARE

FOLLOW THIS PROVEN 5 STEP SYSTEM AND YOU CAN LET GO, ELIMINATE& MANAGE YOUR& YOUR FAMILY’S FEARS, FRUSTRATIONS, STRUGGLES AND ANXIETY FAST AND IN THE PROCESS GAIN PEACE OF MIND, CONTROL, POWER AND INFLUENCE FAST WHILST YOUR LOVED ONE IS CRITICALLY ILL IN INTENSIVE CARE!

Therefore make sure that your cousin’s and your family’s values and beliefs are known during this difficult and challenging situation, to make the situation less challenging and more bearable.

Make sure that your cousin knows that irrespective of the challenges that she’s facing that she knows that you support her and gently guide her towards the death of her husband.

End of life and death situations in Intensive Care are challenging and even though you know that your cousin has difficulties of “letting go”, the only way is to probably gently guide her towards “letting go” by making her feel that she is in control.

I hope that helps Judy, please let me know if you have anymore questions.

I can also be available for a FREE 15-20 minute Skype consultation. My Skype ID is patrik.hutzel

Or if you want to be featured on our PODCAST with your story, just email me at support@intensivecarehotline.com

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long-term stays in Intensive Care

end- of- life situations

Family meetings with the Intensive Care team

withdrawal of treatment situations and/or perceived medical futility

what to do if your critically ill loved one is THREATENED with an "NFR" (Not for resuscitation) or "DNR" (Do not resuscitate) order

severe head and brain injuries (including traumatic brain injuries and stroke)

What's happening "BEHIND THE SCENES" in Intensive Care and how it limits your ability to have PEACE OF MIND, control, power and influence

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