How the patient feels after taking hospice medications, from the hospice nurse

After years of living independently and discreetly, Jane knew what to expect after receiving her terminal diagnosis.

She didn’t want to be bedridden or cared for by someone else in such a deeply personal way. Because of this, she wanted to control her death and chose to end her life by dying in California under dignity laws.

Hospice nurse Julie McFadden, 40, was there as Jane took her last breath. She recalls that before she took the medicine, Jane’s family and friends came together because they knew she was ready.

“They all said their goodbyes and it wasn’t sweet. She only allowed a few close friends and family in the room. Then she had drinks,” McFadden said. News week.

“Before she fell asleep, she lay down, and her family surrounded her and said ‘I love you,’ and they said the same thing back. Just thinking of the beauty and love that I had witnessing then and there, I cried. then she lost consciousness, her heart stopped and she passed away peacefully.”

Each patient’s situation is unique, but in the state of California, where McFadden works, terminally ill adults with less than six months to live can qualify to die with dignity. “It’s a personal choice, but I think it has a lot to do with their management and their specific disease because there are some diseases that are more difficult to kill,” McFadden said.

EQUAL News week previously reported, euthanasia is the life-ending drug for terminally ill patients. They must have the physical ability to take medication independently and be fully aware of their decision.

Julie McFadden, 40 years old, from California. McFadden worked for many years as a hospice nurse in California, which passed a bill legalizing death with dignity in 2015.

Currently, death with dignity (which may also be called medical aid in dying or physician-assisted death) is allowed in only 10 states as well as the District of Columbia. These states include Colorado, California, Washington, Hawaii, Montana and Oregon, and there are growing calls for it to be allowed in other states. Legislation is currently being considered in Massachusetts, New York and Pennsylvania that could potentially allow patients the ability to choose when they die.

In California, the End of Life Options Act (EOLOA) was passed in 2015 and took effect in June 2016. Data from the California Department of Public Health shows that 5,168 prescriptions were written in the period from June 9, 2016 to December 31, 2022. Of those prescriptions, it is believed that 3,349 people died from taking the drugs.

Of those EOLOA expected to die in 2022, 66% were cancer patients and 11% had cardiovascular disease. Other underlying diseases that account for fewer deaths include neurological diseases, respiratory diseases and kidney diseases.

What effects does the medicine have?

There’s no doubt this is a divisive issue in the US, with a 2018 Gallup poll finding that 65% of respondents said physician-assisted death should be allowed and the law The law is different in each state. Although it is often talked about in obvious terms, there are many complex things that happen before and after a person takes a drug.

As someone who has facilitated patients who choose to follow this path, McFadden discussed the effects of drugs on the body and how it ends a person’s life.

“There are two main things we want to happen when you take the mixture,” she says. The first thing is sedatives, so there will be heavy drugs to sedate the patient and that’s why they fall asleep first.” Weekly.

“Then the second drug will cause them to die. The patient will take these high doses of cardiovascular drugs that cause their heart to stop. It’s pretty simple because it makes you sleepy and stops your heart.”

After taking the drug, she said, people will have “very normal” signs that occur during natural death as they enter the active dying phase. These can include temperature fluctuations, changes in skin color, and muscle relaxation.

“So what happens is, you take the drug and the drug makes you sleepy, then your breathing slows down to the point where your body starts to shut down. When the body starts to shut down, it switches into what we call active death.” , which is the final stage of life. That happens whether you take that drug or you die regularly,” McFadden said.

“Body temperature may fluctuate as the person loses the ability to control their body temperature, their breathing will change as they are experiencing metabolic and physiological changes. The person will also begin to breathing differently, their muscles will relax, meaning their mouth or eyes can open because the muscles are very relaxed.”

Julie McFadden from California
Julie McFadden is wearing medical scrubs. McFadden is aiming to remove the taboo of talking about death by sharing why people can choose to die on their own terms.

How long does this process take?

For those who feel this is the best option for them, getting approval from two independent doctors can take months, especially since they are under no obligation to agree to the request.

Outstanding research in 2019 Yale Journal of Biology and Medicine involved sending a survey to 1,000 doctors across the United States to gauge views on death legitimately. The results indicated that 60% of doctors thought the procedure should be legal, but 13% said they would practice the practice if it were legalized.

Once the patient is approved by two doctors and receives the medication, he or she can choose when to take the medication. According to the Death With Dignity website, most eligible people choose to take it at home, and whether they want to be with family or have a medical professional present is an individual decision. The California Department of Public Health said that a health care professional was present in 47% of EOLOA deaths in 2022.

McFadden explains that the death process after taking the drug can take different lengths for each individual.

“It usually takes about 45 minutes to an hour,” she said. Each person is different, sometimes it lasts for hours, but I have not seen that happen.” “But I’ve talked to other people who say that sometimes people will continue to be in the dying stages when they’re unconscious. Sometimes it can be larger people, people who are taller or larger. larger, and therefore their bodies will handle it longer.”

Are there any possible complications?

Taking end-of-life medications is not without complications, as McFadden says some people may vomit during the process.

She told News week: “It’s never happened to me, but one possible complication is vomiting. We usually give anti-nausea medications (two different types) an hour in advance. I usually say that because it varies between states, but this is my experience.

“Generally, about an hour before that you’ll give two different anti-nausea medications, so the person doesn’t vomit because you don’t want them to vomit that medication. But I’ve heard that when people vomit, it still works.” move.”

Having never seen a patient vomit, McFadden notes that it only happens in “few and far between” cases.

Any other complications they may experience, such as pain, may be a result of the disease or condition for which they are dying. For this reason, McFadden says a medical professional may be on hand to help manage ongoing symptoms.

There are so many complications to the process that McFadden regularly shares videos answering people’s questions on his TikTok account (@hospicenursejulie). The videos regularly generate thousands, even millions, of views at a time, as many social media users praise McFadden’s insights.

It gives people a sense of control

The limited time left is a daunting prospect, so choosing to end one’s life early is not an easy decision for a person.

While each individual may have his or her own specific reasons for taking that step, McFadden believes that much of the reason comes down to wanting to control the inevitable.

“It’s scary knowing you’re going to die from this incurable disease but not knowing when it will happen. A person can have a lot of symptoms that make them quite uncomfortable, so this gives them a sense of Take control back,” she said.

“From what I see, a lot of people seem calm. They’ve decided to take back control and this is what they want. I think it’s a certain personality type that wants to do that.”

In states that allow death with dignity, individuals must be over 18 years of age to be eligible to receive the drug. But McFadden suggests that it’s “less about age and more about personality” that makes a person inclined to go through the process.

“I’ve seen people of all ages do this, and I think when someone is younger and they’re dying of a disease, it’s usually not a good disease,” she said. “A lot of times, people get that diagnosis and they think they don’t want to do this or they start to see what their life is going to be like.

“I can only say from what I’ve heard, but it seems like someone has reached a point where they’re almost over it. They don’t want to live like this and they’d rather choose This is better.” . They are still alive but they are in a lot of pain and they just want it done.”

Details of Jane’s case have been changed to ensure confidentiality.

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