What to do with older people unable to care for themselves.

[Alisoncc]

Just been reading about eight residents of retirement facility in Florida who died after Irma power cut. Apparently there were well over a hundred people in the place.

Having no wish to end up as a dribbling bib-wearing vegetable in such a place I have made arrangements for my own demise. This to be undertaken at a time of my own choosing. I believe the common phrase used is "Death with Dignity".

I am well aware that the medical professions are rewarded financially for keeping people alive for as long as possible, irrespective of the patients condition. Surely there must come a time when society needs to place some limits on this, purely on the basis the expense. How many tens of millions of people in a vegetative state can we afford to support, and of equal importance what good can it do - for what purpose. So why do we do it, and how can we change things.

I am equally aware that religious institutions work hand in glove with the medical professions to perpetuate this stupidity, along with selfish relatives with more money than sense. Just because we have the medical technology to keep people who should be dead "alive", does that mean we should? And for how long?

Once a person lacks the capacity to keep track of the medical costs being incurred to keep them alive, then perhaps a limit should be set on how much can be spent on their life support in the future. It shouldn't be up to a third person or a medical professional. Perhaps a government instigated assessment panel could travel from facility to facility and assess each resident for continuance of their life maintenance or not? It must come to this at some point in time.

Alison

[John Hill]

. Perhaps a government instigated assessment panel could travel from facility to facility and assess each resident for continuance of their life maintenance or not? It must come to this at some point in time.

Something like a "Death Panel"?

[Alisoncc]

Had every expectation that someone here would use emotive words, although I didn't expect it to be you John. Well you know what, someone has to bite the bullet. Given the medical professions sole criteria for success is keeping people alive, when will we reach the stage to say enough is enough. When all the nursing home, retirement places, hospitals wards, etc etc are full of people just being kept alive what then? When your children or grandchildren can't get a hospital bed because they are all taken up with the just-alive elderly.


Alison

[John Hill]

Alison, that has always been a difficult question for every society. If the old duffers are not inclined to leave the igloo and sit on the ice, or eat the poison fruit or just simply sigh deeply, say 'bugger it all' and take their last breath then who is to make the difficult decision?

If you have money your children may see it in their interest to leave you 'sitting in a draught' which I believe was/is one of the methods that have been used. What government would not like to see you clear a bed for a more deserving case?

As I said. It is a difficult question and one no civilized society has, to my knowledge, yet found the answer.

[Pontius Navigator]

The Liverpool pathway was a medical way to limit treatment to reduce pain but not prolong life.
The average time in UK in a care home is 2 years. Basically the person shuts down themselves. People help them stand, wash, toilet, make their bed, cook their food etc.
OTOH my mother in law is 92, drives to the shops, cuts her lawn, and it is not large. cleans, dusts , laundry including ironing for her son who is 55 and his 57 year old wife. She decorates and she also maintains her home. Over the last 4 years she has replaced all her windows, relaid a block drive (not herself of course) and has further concrete paths being laid. You might say she remains active. That is the clue.
Look at Ex-Ascot, busy always.

It is when you stop you die.

[unifoxos]

Very difficult situation. Happened to see a few minutes of a programme about the WM ambulance service. One of their cases was an old boy who had driven his electric disability scooter into a lake to try and drown himself. He had no relatives and nobody to care for him. The ambulance rescued him and got him to hospital, stabilised and on the road to recovery, but he later died apparently for no medical reason but because he wanted to. I guess he just gave up.

If left to rellies it would be all too easy for them to say "Well it was what he would have wanted" when it was what what they really wanted (or to be more accurate it was his money they wanted, or the freedom from having to bother with or care for him. And the idea of a panel who know nothing about me having the power to decide is appalling.

I want to decide what happens to me and I have been thinking about some sort of "living will", I think they call it, where one specifies what one wants to happen when one becomes incapable. Problem is, how can I imagine what sort of situation I am going to be in, in 1, 5, 10 years time? I could have a stroke tomorrow and become a physical veggie, but in full posession of my mental capacities, or I could develop Alzheimers next year and be a total mental veggie but able to manage my physical needs in terms of toilet, feeding, dressing etc. Or I could live to a ripe old age with gradual deterioration until I become totally incapable.

Iff only there were some sort of IQ test that could be administered by medical tests rather than paper exam. It would mean I could specify that if my IQ dropped to, say, the level of a politician, I would be put down immediately, otherwise I would be allowed to make my own decision, even if, due to some medical problem I was unable to speak or write - say like Stephen Hawking.

[AtomKraft]

There's a lot of things wrong with India, but one thing they've got right is this 'old buggers' issue.
Here, your kids stay in your house after marriage, look after you when you are too old to do it yourself, and when you snuff it, you do so in your own bed surrounded by your family.
In turn, their kids do the same for them.

Maybe there's a better way, but it seems to work ok. Beats ending your days stinking of pish and surrounded by strangers who also smell of pish, in a council run hostel that smells strongly of pish......

[Pontius Navigator]

A neighbour in Scotland was suffering from Alzheimer's. He had periods of lucidity but realised that we would become a burden on his wife. I don't know about relatives.

One day he got in his car to 'pop to the shops'. It was winter time and he drove off into the wilds towards Ullapool. He parked up, switched off and downed a bottle of whisky. It was a very cold night, snow all around. He opened his car door and went to sleep.

While he removed the long term burden from his wife, it was an incredibly selfish way to go. She was distraught when he didn't come home and it was the following day before the police discovered him. The car had to be recovered and of course an inquest.

[Pontius Navigator]

Atomkraft, I stayed with one such family. The parents were a company owner, he made engine gaskets, the old Cork and copper ones. His wife had a masters but didn't work. No 1 son ran a hair business with No 2 sending hair to USA for wigs. His wife was in the US doing a masters. No 2s wife had a degree but worked in a travel agency. No 2 was head of household though both parents were still very active. It was the only home I stayed in with no servants.

[Capetonian]

There is no 'good' resolution to this situation. There never will be.

Even if we could simply 'switch off' when we felt it right to do so, that's fraught with questions and pitfalls too. What I am convinced of is that both my parents, one with Parkinsons and one with Alzheimers and both in what was little more than vegetative state, should have been given their final departure clearance a considerable time earlier than was the case. Nursing homes and drug companies make a huge amount of money from unnecessary and inappropriate prolongation of life.

[Alisoncc]

There was a time when each individual life was considered sacrosanct. A view perpetuated by religion in order to maintain the numbers within the tribe. Also necessary given infant mortality. Now with a population of seven billion, it's a concept that has long passed it's use-by-date. Religious bodies will fight it tooth and nail but a quantum shift in attitude is needed to one whereby an individual should be able to self-medicate as and when they feel it's appropriate. Death with dignity shouldn't be just a catch-phrase. The right to die should be enshrined in the UN basic Human Rights charter.

Anyway that's very much my personal view.

Alison

[John Hill]

The 'right to die' sounds all very noble but by enshrining that right we would be opening the door for people who are at their weakest through age, dementia or illness to be influenced even pressured to do the decent thing and pop off the planet.

It is 12 13 years since I was diagnosed with a terminal condition and the life insurance company said to me "So sorry you are going to die so take your money now and you can stop paying the premiums", should I have declined the medical treatment on offer and 'done the decent thing?'

[rgbrock1]

Just been reading about eight residents of retirement facility in Florida who died after Irma power cut. Apparently there were well over a hundred people in the place.

Having no wish to end up as a dribbling bib-wearing vegetable in such a place I have made arrangements for my own demise. This to be undertaken at a time of my own choosing. I believe the common phrase used is "Death with Dignity".

I am well aware that the medical professions are rewarded financially for keeping people alive for as long as possible, irrespective of the patients condition. Surely there must come a time when society needs to place some limits on this, purely on the basis the expense. How many tens of millions of people in a vegetative state can we afford to support, and of equal importance what good can it do - for what purpose. So why do we do it, and how can we change things.

I am equally aware that religious institutions work hand in glove with the medical professions to perpetuate this stupidity, along with selfish relatives with more money than sense. Just because we have the medical technology to keep people who should be dead "alive", does that mean we should? And for how long?

Once a person lacks the capacity to keep track of the medical costs being incurred to keep them alive, then perhaps a limit should be set on how much can be spent on their life support in the future. It shouldn't be up to a third person or a medical professional. Perhaps a government instigated assessment panel could travel from facility to facility and assess each resident for continuance of their life maintenance or not? It must come to this at some point in time.

Alison

Alison, I'm sure you'll correct me if I'm wrong but are you saying - in essence - that we should begin deciding who lives, and for how long, and who dies? I hope to God not.

And "government instigated assessment panel"? A death squad? Holy crap.

[rgbrock1]

Had every expectation that someone here would use emotive words, although I didn't expect it to be you John. Well you know what, someone has to bite the bullet. Given the medical professions sole criteria for success is keeping people alive, when will we reach the stage to say enough is enough. When all the nursing home, retirement places, hospitals wards, etc etc are full of people just being kept alive what then? When your children or grandchildren can't get a hospital bed because they are all taken up with the just-alive elderly.


Alison

There is no price on a human life. Period.

[BenThere]

I was my father's executor. He died at 88 years in 2006. He fell and hit his head. At the time he was deep into dementia and a burden to my mother, who still had full faculties, but who bore with a faith and devotion I will always revere. Dad's fall caused a brain injury that ended up with two neurosurgeries and two weeks in intensive care. There was never much hope for any sort of functional recovery. The tab, almost all paid by his insurance and Medicare, came to $140,000, just in those last two weeks. I think that exceeded his entire lifetime contribution to Medicare and all his insurance. And the cost was incurred after he had lived his useful life. Dad was ready to die before he fell.

The moral issues and medical technology to preserve life, especially if cost is not a factor, are challenging. My take is that at some point we have to let go, and make our heirs and carers know they need to let go, too. The last thing I want is to bleed the estate I've worked so hard to build on futile health care. My goal is to leave my wife, who is ten years younger than me, with the means to live out her years without want.

[Alisoncc]

There is no price on a human life. Period.

On all seven billion of them. Get real. Or does your "no price" only apply to WASP's - White Anglo-Saxon Protestants? or whatever it stands for.

Should all individuals in hospitals deemed brain dead be kept alive in perpetuity, because some religious fruitcake cannot accept that they are effectively dead. Does carrying out hip replacement ops on someone who is so infirm as to be unable to walk or carry out simple tasks even with the op make sense?

[probes]

I absolutely support your personal view, Alison.
And I've been thinking about it a lot - as my father is coping more or less with the everyday things (food and hygiene), but you can see he misses his real self - the sociable, outgoing, considerate man full of good humour. It hurts not to remember things. And I feel guilty for thinking I wouldn't want to live that long - as actually it's no real burden or anything for me. Except seeing him fade away. But.

"...are you saying - in essence - that we should begin deciding who lives, and for how long, and who dies? I hope to God not."
but, dear RGB, we are. Deciding who lives. And for how long. What about the premature babies (who often end up having major disabilities) on life supports? And the tubes and stuff imposed on people? Supposedly helping them to 'stay alive'.

P.S John, when you're young(er) and it's a condition, it's different. Even if it's supposed to be terminal.

[Slasher]

The right to die should be enshrined in the UN basic Human Rights charter.

Yep...that'd become yet another reason to detest the UN and the same with its ***** human rights charter too.

I'll be fuct if I'm gonna allow any bloody low-life dogooder put pressure to pull the plug on my life-suppport in old age simply because I'm "too old and in pain and should die with dignity".

Besides, the bastards would probly want to flog me off later as Soylent Green fodder or fertiliser anyway.

[Cacophonix]

Oh ****, just close your eyes and shoot them. Moral abnegation and cowardice is so much easier than love and care...

And in Ben There's case, absolute avarice...!

Caco

[BenThere]

And in Ben There's case, absolute avarice..

NO Caco, there was no avarice in my case. I had nothing to gain. My observation was that the cost of preserving a life that had functionally come to an end was questionable. I loved my father and would have done anything for him. But he came to his end. Collectively our society paid that $140,000 for his last few weeks. My sister and I deferred to our mother to decide on the second surgery. The doctor had told us there was little hope of survival, and less hope of any recovery. She couldn't let him go and we went ahead. He died a few hours after the second surgery.

Your characterization of that as avarice is nasty and cruel.