Recently, a reader of this blog ask me some questions about substitute decision making.  There are some important things to consider with this aspect of medical care.  So I am starting a new thread that  I am calling “Living Wills.”  The topic of substutute or surrogate decision making is related to living wills.  As with most of my blog posts, I will tackle the topic in small chunks.

More than once I have had patients tell me that they never want me to put them in a nursing home.  This sentiment is easy to understand, but how should we repond to this?  Why do you not want to go into a nursing home?  How much control do we have over things like this?  How much control do we have over our future?  How much control should we want to have over our future?

What if, in God’s design, or the Lord’s plan, for your life is to spend some time, even a long time, in a nursing home?  Will you still say, “I never want to end up living in a nursing home?”  Could we be saying, “Lord, I do not want what you want for my life.”  Where do the words of the apostle Paul fit in when he says, “all things work together for good for those who love God and are called according to his purpose?” (Romans 8:28)  Do you believe that time spent living in a nursing home can be part of God’s good plan for those who love Him and are called by Him?  What about contentment.  Consider the words of the apostle Paul in Philippians 4,

I have learned in whatever state I am, to be content: I know how to be abased, and I know how to abound. Everywhere and in all things I have learned both to be full and to be hungry, both to abound and to suffer need. I can do all things through Christ who strengthens me. (Phil 4:11b-13 NKJV)

How do you think Paul would have responded to the possibility of spending time living in a nursing home?  Consider Paul again in Philippians 1 when he says,

For to me, to live is Christ, and to die is gain. But if I live on in the flesh, this will mean fruit from my labor; yet what I shall choose I cannot tell.  For I am hard pressed between the two, having a desire to depart and be with Christ, which is far better.  Nevertheless to remain in the flesh is more needful for you.  And being confident of this, I know that I shall remain and continue with you all for your progress and joy of faith, that your rejoicing for me may be more abundant in Jesus Christ by my coming to you again. (Phil 1:21-26 NKJV)

Some people, as they get older, may wish to die rather than live in a nursing home.  Paul, too, had a desire to depart but was willing to remain.  Paul realizes that God has a use for him wherever he is.  What if God’s plan is for you to live in a nursing home, so that, througth you, He can reach out to another resident in that home?  Would you still say, “I never want to live in a nursing home.”

Let us be careful not to focus only on the elderly person who may be looking at the possibility of living in a nursing home.  What if the Lord’s best plan for you is that you set aside some other activity in your life so that you can be much more available to help your elderly parent continue to live in their own home?

Now, let’s consider other end of life, or later life, issues.  Could it be God’s plan that, at some point in your life, He sustains you with the use of some kind of tube, such as feeding or breathing a tube?  If this is God’s good plan for you, would you be content to live your life that way for a period of time?   To what extent is such a situation really any different than the issue of living in a nursing home?

This posting in not meant to imply that we should attempt or accept all potentially lifesaving or life-prolonging measures no matter what.  But it is meant to encourage, especially Christians, to ask these kind of questions and to look for the Lord’s direction when faced with such questions.