Waves on the GalapagosFriday I was on vacation, on a boat, in the Galapagos. It is truly a beautiful place.  We were headed out to go hike a remote island, and go snorkeling.  On the way there, the fateful text came.  The question was – my dad was dying.  He had an infection that was not responding to antibiotics.  He was in serious pain from the infection.  Chances of treatment and survival were non-existent, but did I want to have him moved to the hospital for more aggressive treatment, with IV antibiotics.

In that moment, I had to weigh his chances of survival, his quality of life, and all other factors, and come up with a really tough decision.  He was already in hospice, and had already had a large number of infections this year.  He was already under the care of hospice.

He had lost over 25% of his body weight, and was having trouble feeding himself, couldn’t stand, and couldn’t transfer from a wheelchair to chair reliably anymore, without 3 people needing to help him.  Most importantly, many days, he didn’t know who anyone was.  There were a fair number of days he had no idea who I was, who his grandchildren were, or who his caregivers who had been with him daily for years were.

Given all of the pieces of information, I made what was one of the two most difficult decisions in my life.  I decided to not transport him to the hospital for more aggressive treatment.  We kept him at home, with pain management, and called the priest to say last rites.  I made the decision knowing full well that he would die from the infection.  He passed away almost 24 hours later.  Hospice came in and worked to make him as comfortable as possible, and manage his pain as tolerably as they could, with minimal movement of his already frail body.  He was in tremendous pain each time he was turned, so care was taken to minimize the number of times he was subjected to that pain.

You may notice above where I say that I made the decision.  That’s because I was responsible for making those decisions.  No matter where I was, or how painful they might be, I took that responsibility seriously.  The responsibility to care for my dad as well as possible, and to carry out his wishes as closely as possible.  I knew that he would not want his life prolonged under these circumstances, nor would he have wanted to be in excruciating pain.

Sometimes being an adult really sucks, and is hard.  Sometimes it is hard, very hard to be responsible, and do what we know needs to be done, but we do it anyway because it is the right thing to do.