Often, doctors and staff choose to inform the caregiver of the present status and proposed measures, instead of the patient. You may be required to convey this information to your patient. In such situations, sometimes the caregiver is tempted to withhold disturbing information. Instead, they try and cover up, saying all is well. However, I would suggest that the patient is always as well informed as possible.
You can be gentle and supportive. But withholding the truth has little benefit. Keep in mind, that even sedated or unconscious patients have been known to absorb conversation around them. The chances of the patient hearing part or mistaken information, from one of the many people surrounding him, are quite high.
Besides, you would be depriving the patient of preparing himself mentally, as also of informed decision making. He will be the one bearing all the consequences. Would it not be more fair to ensure that you, the caregiver, maintain an honest and trusted role in his life?
Clarify the Patient’s Choice
Be sensible and honest with each other.
Discuss honestly, the possible course the disease may take. Understand your patient’s views clearly. Encourage him to make an oral or written “living will”. This way, you will have a clear understanding of which treatment and extent of medical support the patient desires. Convey this information to the primary physician too. Doing all this when the patient is in relatively stable or good health, is always better.
Ultimately, the patient is the one who endures all the physical trauma. Your emotions may cloud your judgement, if you are called upon to make these choices. If your patient is not in a position to convey his own options, your choices will be hard and difficult. It is far better to be armed with clear knowledge of the patient’s will and intent, to execute such decisions.
Prepare yourself mentally to the possibility of having to actually execute such wishes. Insisting upon “Do Not Revive” may be the hardest thing you ever have to do. But if your patient has insisted upon this, like any other “will”, his wishes should be honored. As also, any eye or organ donations that he may have willed
You can be gentle and supportive. But withholding the truth has little benefit. Keep in mind, that even sedated or unconscious patients have been known to absorb conversation around them. The chances of the patient hearing part or mistaken information, from one of the many people surrounding him, are quite high.
Besides, you would be depriving the patient of preparing himself mentally, as also of informed decision making. He will be the one bearing all the consequences. Would it not be more fair to ensure that you, the caregiver, maintain an honest and trusted role in his life?