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mahatmakanejeeves

(57,459 posts)
Tue Dec 16, 2014, 05:13 PM Dec 2014

‘Warehouses for the dying’: Are we prolonging life or prolonging death?

This is the sixth installment in the "Business of Dying" series.

‘Warehouses for the dying’: Are we prolonging life or prolonging death?

Aging in America
By Peter Whoriskey December 12 @PeterWhoriskey

....
Unlike TV dramas, where the victims of car crashes and gun shots populate the ICU, this one at Sentara Norfolk General, as in others in the United States, is more often filled with the wreckage of chronic disease and old age.

Of 10 patients Paul Marik saw that morning, five had end-stage kidney disease, three had chronic respiratory ailments, some had advanced dementia. Some were breathing by virtue of machines; others had feeding tubes; a couple were in wrist restraints to prevent them from pulling off the equipment.

For a man at a highly rated hospital surrounded by the technology of medical miracles, Marik sounded a note of striking skepticism: Patients too often suffer in vain attempts to prolong life, he said, because of the mandate to “do everything.” The urge to deploy every last aggressive medical technique, in other words, was hurting people.
....

End-of-life planning key

One key way to avoid unwanted treatment, according to experts, is to solicit a person’s preferences for end-of-life care before a crisis arrives. ... Toward that end, Sentara, which was ranked this year atop the “Best Hospitals in Virginia” by U.S. News & World Report, joined a coalition of hospitals and agencies on aging that in November launched a program to promote end-of-life planning in the Norfolk and Virginia Beach area. It has set up a Web site, asyouwishvirginia.org.
....

Peter Whoriskey is a staff writer for The Washington Post handling investigations of financial and economic topics. You can email him at peter.whoriskey@washpost.com.

As You Wish
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‘Warehouses for the dying’: Are we prolonging life or prolonging death? (Original Post) mahatmakanejeeves Dec 2014 OP
We're prolonging revenue. nt bemildred Dec 2014 #1
+ 1,000,000 nichomachus Dec 2014 #2
Yup. truebluegreen Dec 2014 #10
"I do not wish to become a Vegetable HockeyMom Dec 2014 #3
Don't most people say they don't want to end up on machines? KinMd Dec 2014 #4
That's why it's important to make a living will while you're still lucid and functioning. NYC_SKP Dec 2014 #6
Indeed. hifiguy Dec 2014 #8
My brother died from a motor cycle accident. The hospital was wonderful. They did what they could jwirr Dec 2014 #14
Sorry for your loss, but thank you for sharing your story. NYC_SKP Dec 2014 #15
Sorry to hear about your parents. It is hard to watch them suffer and hard to lose them. jwirr Dec 2014 #16
True, but there are also patients that change their mind. Laffy Kat Dec 2014 #13
I've heard stories of families going to court to get living wills and DNR orders overturned... Odin2005 Dec 2014 #20
Thank you for this post and series. We all face this dilemma in one way or another. NYC_SKP Dec 2014 #5
I went through this with my Dad. janlyn Dec 2014 #7
Dementia, feeding tube, wrist restraints because of the feeding tube and catheter: I opted to place WinkyDink Dec 2014 #9
So sorry for the pain, on all sides. truebluegreen Dec 2014 #11
Thank you so much, truebluegreen. I'm a PITA here often, too snarky for my own good, but DU is WinkyDink Dec 2014 #17
Make your choices ahead of time and tell your doctors csziggy Dec 2014 #12
I have a dear friend who beats herself up everyday... malokvale77 Dec 2014 #18
This is why I got a living will despite only being 28. Odin2005 Dec 2014 #19
 

truebluegreen

(9,033 posts)
10. Yup.
Tue Dec 16, 2014, 07:37 PM
Dec 2014

Amazing how quickly and painlessly the end can come when the coverage runs out....oh, wait: no more lifetime caps!
.
.
.
.
.
.
We really need to take the profit motive out of health care.

 

HockeyMom

(14,337 posts)
3. "I do not wish to become a Vegetable
Tue Dec 16, 2014, 05:25 PM
Dec 2014

in your Science Experiment to see how long you can keep me alive." My Mom said that 25 years ago before she saw an attorney, made out her Living Will, etc., and went into a hospital to die. She was 75 and had cancer.

Obamacare and Death Panels? If you have lived that long, you know your own mind. Leave it up to the INDIVIDUAL to determine how much end of life care THEY want. I am 66 now and feel the same way as my Mom did. Her death was how SHE wanted.

 

NYC_SKP

(68,644 posts)
6. That's why it's important to make a living will while you're still lucid and functioning.
Tue Dec 16, 2014, 05:49 PM
Dec 2014

It overrides family wishes.

It's a favor to them, really.

Nobody wants to risk a lifetime of wondering if it was the right thing to do.

I was asked and allowed my stepfather to live longer than he probably should have, but I didn't want years of wonder if it was the right thing to do or not had I let them let him go.

Odd feeling, for hospital staff to ask you, under their breath, if I want to let him go...

 

hifiguy

(33,688 posts)
8. Indeed.
Tue Dec 16, 2014, 07:23 PM
Dec 2014

That is what my mother did when she was in her 80s. No artificial life support, no machines, no nothing except for pain management and palliative care. I agreed completely with her wishes and was given power of attorney to enforce them. At 86 she was diagnosed with a large, slow-growing colon tumor and she absolutely refused surgery. A few months later she slept peacefully away.

GET IT IN WRITING, PEOPLE! Then no one can dispute it.

jwirr

(39,215 posts)
14. My brother died from a motor cycle accident. The hospital was wonderful. They did what they could
Tue Dec 16, 2014, 08:08 PM
Dec 2014

for him. They were testing him to see how he was functioning and when they finally gathered all the information they called all of the family together and told us that he could be kept alive on supports but he would never again function like before. Most of us immediately were ready to let him go because we knew he would not want to live that way. His wife took longer but in the end everyone felt better that he was not going to live in a vegetative state.

He did not have a living will and we were extremely fortunate to have all agreed to the need for taking the supports off. He died that night.

I and my disabled daughter have living wills. The one exception I have made for her is a feeding tube in the stomach. She was born with a digestive problem but it meant that she would slowly starve to death. She was 35 years old and only weighed 50 pounds. The tube has allowed her to gain weight and live until 55. Her doctor says that her vitals are so good he is considering putting a tube in all his patients.

Talk to your elderly members before it is too late and Don't forget yourself - my brother was not expecting to die. Most of us are not. But it happens.

 

NYC_SKP

(68,644 posts)
15. Sorry for your loss, but thank you for sharing your story.
Tue Dec 16, 2014, 08:12 PM
Dec 2014

Mom and dad had living wills, both passed last year.

Dad's was a natural death after serious decline, it was years earlier that I was asked about saving him.

It wasn't so much about life extended life support- he had water on the brain and had suffered a seizure and they seemed to be asking me whether or not to even try to pull him out if he seized again.

Mom went a few months later, by choice, through hospice.

Laffy Kat

(16,381 posts)
13. True, but there are also patients that change their mind.
Tue Dec 16, 2014, 08:07 PM
Dec 2014

I've seen it happen a lot. Time becomes precious even for the suffering. I may not make the same decision myself but I can't help admire some peoples' courage.

Odin2005

(53,521 posts)
20. I've heard stories of families going to court to get living wills and DNR orders overturned...
Tue Dec 16, 2014, 10:43 PM
Dec 2014

...because of the intensity of their denial. the Terri Schiavo case being the most famous, obviously, because the Right saw an opportunity to use Schiavo's relatives' denial to score political points.

 

NYC_SKP

(68,644 posts)
5. Thank you for this post and series. We all face this dilemma in one way or another.
Tue Dec 16, 2014, 05:42 PM
Dec 2014

For our parents, children, ourselves, it's a topic that's difficult to avoid.

We'd all love to pass in our sleep, avoid prolonged stays in long term care facilities in pain and under medications, using up all fund in the estate or becoming a financial burden on others.

The aging of Americans coupled with increasingly sophisticated and costly medical resources, spells fiscal and ethical trouble, there's no way around it.

Take care and thanks again.

janlyn

(735 posts)
7. I went through this with my Dad.
Tue Dec 16, 2014, 07:14 PM
Dec 2014

He had a living will, and yet the doctor asked me if I wanted to override my Dads wishes. Evidently in Arkansas a family member can go against the wishes of the person with a LW. When I told the doctor I would not go against what my father wanted, he gave me a look that clearly stated he thought I was a murderer.
Even if my Dad didn't have a living will, I would not allow doctors to extend his life. I went through that with my Mother. They insisted on treatment ( chemo and radiation ) even though they knew her brain cancer was not survivable. And lied to her and us about her chances of survival.
Its all about the almighty dollar. And we live in a country where we show more compassion for our animals when it comes to end of life!

 

WinkyDink

(51,311 posts)
9. Dementia, feeding tube, wrist restraints because of the feeding tube and catheter: I opted to place
Tue Dec 16, 2014, 07:27 PM
Dec 2014

my husband into Hospice care, AKA, the easing-out.

First Christmas without him.

 

WinkyDink

(51,311 posts)
17. Thank you so much, truebluegreen. I'm a PITA here often, too snarky for my own good, but DU is
Tue Dec 16, 2014, 08:45 PM
Dec 2014

a haven for me.

csziggy

(34,136 posts)
12. Make your choices ahead of time and tell your doctors
Tue Dec 16, 2014, 07:39 PM
Dec 2014

My family has been through end of life decisions three times - for my oldest sister, my brother in law and my father. My sister set the example for all of us. She made her decision to not prolong her life past a certain point and communicated it to her doctors and to the entire family while she was still able.

My brother in law went through treatments but once he realized his quality of life was gone, he stopped all treatment and went into hospice care. My Dad fought to live but once he was not longer aware the family put in into hospice care and let him go. They made it so much easier for the rest of us by making their choices so we didn't have to.

As a result of all these cases, every time I have gone into surgery (9 times since 2001) I have updated my Living Will, let my family know of my choices, and made sure every doctor and facility involved knew my wishes. My Mom at 93 has made her choices and her living will is on the refrigerator, well marked so any of her caretakers can find it and give it to any first responders.

In addition to having a living will (or advanced directive), everyone should designate a health care advocate to enforce their choices and to help monitor their care. It's easy to find the forms for living wills and health care advocates online. AARP has a page about them (http://www.aarp.org/relationships/caregiving-resource-center/info-11-2010/lfm_living_will_and_health_care_power_of_attorney.html) and links to forms for each state: http://www.aarp.org/relationships/caregiving/info-03-2012/free-printable-advance-directives.html

malokvale77

(4,879 posts)
18. I have a dear friend who beats herself up everyday...
Tue Dec 16, 2014, 09:49 PM
Dec 2014

for trying to hang on for so long to her severely brain traumatized son.

She cannot forgive herself for allowing him to suffer for so long.

Odin2005

(53,521 posts)
19. This is why I got a living will despite only being 28.
Tue Dec 16, 2014, 10:37 PM
Dec 2014

One should never trust one's relatives to have the clarity of mind to not go into denial and try to keep a person alive beyond all reason.

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