McKnight’s Articles

And he did it ‘his way’ – will you and yours?

Packing for New Jersey to help Bernie (my father-in-law, whom I was honored to call “Dad”) navigate his transition from hospitalization to SNF, something told me to pack a suit.

I did consider the possibility that Dad wouldn’t make it. He was 91 after all, with end stage renal and heart disease. And yet, just a week prior, he was living independently and doing well — sort of.

When we spoke, he told me that he was ready to die, and that he looked forward to being reunited with his beloved Elaine, his wife of 67 years. His plan was to sunset his dialysis and go home or to a SNF, most likely on hospice.

A few hours after this heartfelt conversation, a young internist from the cardiology team bounded into his room and wondered aloud why he never had a transcatheter aortic valve replacement (TAVR).

“It would add quality to your life!” she exclaimed and proceeded to describe how this “noninvasive” procedure was an absolute miracle since it had been perfected in recent years. “Dialysis would become effective again and your quality of life would improve,” she said again without pause.

Short of any prior history or conversation, this well-intended physician was challenging and changing the course of my dad’s care plan and expressed wishes.


Continue reading Steven Littlehale’s guest column on