When Appetite Declines

Barbara Bush died three years ago.

Dr. Marc Siegel, calling Barbara Bush a pioneer, observed that she led the way in choosing well for end-of-life considerations.

“When do you conclude you’ve come to the end of your life? There are questions and more questions.
How is your breathing? How many infections have you had in the past year? How many emergency trips to the hospital have you had to make? How uncomfortable are you on a daily or hourly basis? How would you rate the quality of your life?
We are all mortal, destined to exit this world at some point. How hard do you want to fight, how much pain and discomfort do you want to endure, simply to go on for a few more days, weeks or months?”

A friend’s father in his late 80’s faced serious surgery. The surgeon did not hesitate to go forward, which was a bit of a surprise to some. He said he considers these questions, in addition to considering the individuals surgical risk factors:

Does the individual enjoy close, supportive relationships?
Does he have the financial resources to provide for his care?
Does he have continued interest and ability to participate in daily activities?
Does he have an appetite for life’s pleasures, like pleasure in eating, visiting with others, etc?

Quality of life, not simply heartbeat and breath, is a deciding factor for many.

As I remember these insights I am reminded of how some aspects of Bill’s quality of life had declined from the fall of 2019 and through the COVID trial of 2020. I had been concerned that if he faced a serious health threat he might not have the stamina and determination to fight to survive. Just a week before he got sick with COVID he voiced an acceptance of life with little to look forward to but sitting home in his recliner and watching the hours of the day pass. The toll of the lockdown and anxiety of the pandemic and attendant negativity of it all robbed some of the things that made life interesting and worth holding on to firmly.