Text ◆Liang Wanfu “Ming Pao”
“Doctor, I will never go to the hospital again under any circumstances! I want to stay at home.”
Grandma Zheng told me this. In view of my mother-in-law’s strong wishes, I had to make it clear to her and her family that if I no longer went to the hospital, I would be prepared to “die at home.”
There are not many legal barriers to “death at home”; but staying with your loved one at home until the last moment is not an easy task.
(Hong Kong News) Grandma Zheng is 90 years old. She was admitted to the emergency room last year due to acute intestinal inflammation. She was hospitalized for more than three weeks, which was a “brand” for her. Because under the new crown epidemic prevention policy at that time, public hospitals prohibited all visits, and no family members were allowed to visit. My mother-in-law described herself as “a life worse than death” during that period. “As soon as I entered the hospital, I couldn’t see any of my relatives. I was sleeping alone on the bed, not knowing what was going on. I was really scared! I kept thinking all day long: Will I die like this without even being able to see each other… It’s so miserable to see him…”
If you refuse to be hospitalized, you will die at home.
My mother-in-law was later discharged from the hospital, but X-rays and computer scans showed lung fibrosis and required follow-up. When my family saw that my mother-in-law was so resistant to public hospitals, they brought her to my clinic. I examined her and referred her to a pulmonologist, but the condition was irreversible and I could only have her take anti-fibrotic drugs to slow down the deterioration. However, while taking the medicine, Granny Zheng’s condition continued to fluctuate; she once had to be hospitalized for treatment due to sudden shortness of breath, and two weeks after she was discharged, she had difficulty breathing and the oxygen concentrator at home failed to increase blood oxygen levels, so she had to be hospitalized again.
However, when we entered the hospital, my mother-in-law’s daughter whispered to me: “This time I sent my mother to the hospital, more or less, to ‘lie’ her. If she knew she had to stay in the hospital, she said she would rather die than not.”
Sure enough, when Granny Zheng’s breathing stopped for a moment, she lost her temper and wanted to be discharged from the hospital immediately. “Doctor, I really can’t stay in the hospital! I want to go home! Even if I die, I will die at home. My husband is waiting for me at home, and I want to take care of him!” she pleaded.
Oh, it turns out that Granny Zheng has a husband, I didn’t expect it. Although Hong Kong has been the world’s longest-living place for seven consecutive years, the average life expectancy of men is 84.65 years, which is shorter than that of women, which is 89.6 years.
Moreover, in Chinese society, husbands are usually several years older than their wives; therefore, if a mother-in-law is 90 years old, their husband is often no longer alive.
But Grandma Zheng’s husband, Mr. Huang, is 91 years old this year. Due to the COVID-19 epidemic, he is advised to stay at home and rarely go out. I have never had the opportunity to meet him.
In view of my mother-in-law’s strong wishes, I had to make it clear to her and her family that if I no longer went to the hospital, I would be prepared to “die at home.” “Being at home is definitely the wish of my parents and our whole family, but what conditions must be met? Do we need to sign documents in advance? If my mother leaves at home, do we need to call the police immediately?”
asked the eldest daughter of the Huang family.
“No need.” I said.
No alarm pre-signing documents required
The relevant legislation on “death at home” only stipulates that the patient has received medical treatment within 14 days before death. Patients and their family members do not need to sign any documents in advance, and there is no need to call the police to dispose of the body after death.
Within 24 hours of the patient’s death, family members only need to bring the cause of death certificate signed by the doctor to the death registration office. After the death certificate is issued, they can notify the funeral company to handle transportation matters.
The body only needs to be stored in a legal morgue within 48 hours of death to comply with the regulations. Therefore, there are really few legal barriers to “death at home”.
However, apart from the law, the most important factor in “death at home” is the consensus, support and cooperation of the family. Staying with your loved ones at home until the last moment is not an easy task. It requires a lot of sacrifice and pain. Therefore, even though more than 60% of Hong Kong people expressed their wish to die at home in the survey, only a very small number actually achieve their wishes.
Figures show that more than 90% of Hong Kong people can only lie on cold beds in hospitals at the moment of death. Some people, even their loved ones, are not allowed to see them off and go on the road alone.
In addition to the need to increase home hardware such as medical equipment and nursing equipment when “dying at home”, care and support at home are also the primary consideration. Because when people reach the end of their lives, they are in great need of round-the-clock care and companionship. Ideally, there should be at least three family members taking turns taking care of them. “
When talking about this, Mrs. Huang’s daughter responded affirmatively: “Doctor Liang, don’t worry. In terms of care, I believe we can handle it. My parents also have a foreign helper sister at home, who is very helpful. As for our three siblings , and even each other’s significant other will definitely accompany them. If necessary, we will take turns staying at our parents’ house.”
Old husband and wife need each other
So I visited the Huang family and met Mr. Huang for the first time, which was a bit unexpected.
Because in my impression, the 91-year-old man must be a “care recipient” who is in great need of care.
However, Mr. Huang is an out-and-out “caregiver”.
He took great care of his wife.
My uncle told me that the couple were inseparable and could not be separated.
There is actually no boundary between them as to who takes care of whom.
In short, we all need each other. As long as we don’t see each other for a day, we will be distracted and worried about each other.
Therefore, he said: “When my old wife was admitted to the hospital, one day was really too much!”
The old man even said: “Not everyone will understand that kind of concern. You know, at night, as long as she pats me gently, I will immediately know what she wants. I can help her immediately. I am there for her She sleeps well when I’m around!”
I was convinced of this, so I told my uncle to measure my mother-in-law’s blood oxygen level on time. I also told him that he could adjust the oxygen supply level of the oxygen concentrator for his wife if necessary. The uncle loved his wife so much that he not only went all out, but also measured his wife day and night, frequently replaced the battery of the measuring device, and carefully massaged her hands and feet. He said that after each massage, the blood circulation and oximeter readings will improve.
Wanqing takes care of her and it hurts her heart to say goodbye
However, in Wanqing’s care, “farewell” is often the most important thing. No matter how reluctant you are to leave, those who want to leave will eventually leave. When we arrived at Huang’s house that morning, the old lady’s breathing deteriorated rapidly and her blood oxygen continued to drop sharply. I can only tell the family members that I believe the patient is not far from the final stage. The most important thing is to make her comfortable. If there are still relatives who want to say goodbye to her, please come as soon as possible within a few hours. I will return to the hospital first.
When the old lady stops breathing, please notify me immediately and come back to sign her death certificate.
When I left Huang’s house, I expected to receive a notification at 3 p.m. at the latest. However, after waiting and waiting, an afternoon passed, and by dinner time, I still had not received any news, which was really unsettling. At 9:30, the Huang family called: “Dr. Liang, come and take a look!”
When I rushed to Huang’s house, I saw Mr. Huang half-bent beside his wife’s bed, with his head lowered, pressing his hands on his wife’s chest, pressing it down with concentration. His non-stop movements lasted at least a whole afternoon and evening, if not a whole day. When he saw me, he said with great reluctance: “Doctor, you don’t have to come so soon. She hasn’t left yet! I feel…she hasn’t left yet…she really hasn’t left yet…”
The breathing of Mrs. Huang who was lying down had obviously stopped. She believed that she had been walking for a while. Reluctant to give up and unbearable. I could only say: “Uncle Huang, don’t worry! Mrs. Huang is so peaceful and contented! Her whole family is with her, and she passed away so peacefully. You can let go and leave her to me without worry.”
At this time, Mrs. Huang was really peaceful and content! She closed her eyes, raised the corners of her mouth, and smiled. She is like a sleeping girl, loved by all, and extremely delicate. How happy it is to be able to take the last journey at home with your loved ones! , It turns out that happiness will shine when it hangs on your face. I wish Mrs. Huang a safe journey. Mr. Huang, rest assured!