AN update on this client:
As he was setting a third proposed date for his EOL, he developed an intractable bowel complication that was unrelieved by his prescribed pain meds. After an excruciating week, he was put on a PCA pump with hydromorph. At that time, he set his final day. He spent several days receiving visitors, saying goodbye to friends and family. Had this painful complication not ocurred, I believe he would have continued to be very conflicted about ending his life- he still had projects to finish. On his last day he was attended by his palliative physican and a colleague, an RN, and myself (another RN), close friends and family. It was a very large room, full of love and grief.
In the end, the cost of his care did not cause him to choose his final day. However, it caused him much grief and stress during his last few months, worrying about having to die because he was running out of money. I want to continue my education so that I can investigate how situations like his develop and what we can do to change that.