ISSUE #11
 
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CMC's Unconventional Suggestion Leads to Amazing Result for Elderly Patient
 
Mrs. "DM" is an elderly senior with a long history of attendance at CMC's Senior Center programs. Although advancing dementia in her later years greatly reduced her participation in significant learning or meaningful conversation, DM always maintained her appreciation of the Center's uplifting social atmosphere and its vibes of positive energy and joy.
 
In recent months however, DM's condition declined dramatically further. She lost interest in eating, turned into a shadow of her former physical presence, and appeared to have become apathetic to life. Concerned, DM's daughter admitted her to the hospital for testing, which showed DM to be suffering from dehydration.
 
Although DM passed the hospital's swallow test, she continued to show no interest in eating, and a very low level of responsiveness in general. Doctors in charge of DM's care stated that since her level of eating was insufficient to keep her alive, family members needed to choose between two approaches: 

1) Committing DM to significant life-sustaining interventions, including an invasive procedure to place a feeding tube and having a full-time caregiver; 

2) Transferring DM to hospice, whereby she would receive "comfort care" only, thus allowing DM to pass away via "nature taking its course." 

The doctor encouraged DM's daughter to carefully consider and undertake consultations before making this important and difficult decision.
 
Thus, DM's daughter explained her conundrum to Rabbi Wolf, emphasizing her deep reluctance and grave misgivings about both of the options that lay before her. On the one hand, was it really worthwhile and proper to keep her mother alive in such a state by performing a feeding tube operation? But on the other hand, could she ever feel comfortable with making a decision to just allow her mother to die?
 
Keeping in mind Judaism's primary focus on the essential value of life - even under difficult circumstances, and even without long-term guarantees - Rabbi Wolf pondered deeply to think of a way to extend DM's life without needing a feeding tube operation. He spoke to the medical team and confirmed that the hospital's tests had failed to discover in DM any underlying organ failure or infection. 

Musing that DM's unresponsiveness was perhaps caused by her lack of nutrition, the Rabbi asked if it would be possible to try inserting an NG tube, which is a non-surgical feeding tube that enters the body through the nostrils. Perhaps a few days of nutrition via this temporary method might cause an improvement in DM's interest in eating and overall responsiveness? Moreover, as Rabbi Wolf encouraged DM's daughter, even if the NG tube ultimately failed to make a difference to DM's long-term condition, at least she would know that she had made an extra effort to find another solution to extend her mother's life.
 
From a medical perspective, the suggestion was somewhat unconventional, as the doctor had never heard of an NG tube being used to temporarily provide nutrition for a patient under similar circumstances. Nevertheless, the medical team was willing to give Rabbi Wolf's suggestion a try, and DM's daughter was agreeable as well.
 
It didn't take long for the amazing result to become apparent: Following just 3-4 days of receiving nutrition through the NG tube, DM's interest in eating returned, and her overall responsiveness was greatly restored - in fact, it was as if she had become a completely different person! Once more, DM's daughter was able to cook for her, relishing the fact that her mother would again enjoy her home-made nourishing meals.
 
Of course, DM's dementia conditions remains, and her future is not guaranteed - after all, no-one's future ever is. But the story serves as a powerful reminder of Judaism's teaching to value life, and to cherish every single day that a person has as a precious and awesome Divine gift that must be protected and treasured to the fullest.


 
For over two decades, CMC has been counseling patients and family members throughout the Chicago area concerning end-of-life issues such as those mentioned above. CMC connects patients and families with local Rabbonim who are expert in the end-of-life field, so that they may be reassured of having authoritative halachic answers that are tailored to their specific individual circumstances.

To request CMC guidance and/or support regarding an end-of-life issue or for any patient and/or family member struggling with illness, please call CMC or click this link to visit CMC's website.
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Rabbi Aron Wolf
Chicago Mitzvah Campaign
2939 W Touhy Ave
Chicago, IL 60645
1-866-MY RABBI (1-866-697-2224)