Obama and the Elderly: Do As I Say … (Updated)
“I’m a pretty-well-educated layperson when it comes to medical care; I know how to ask good questions of my doctor. But ultimately, he’s the guy with the medical degree. So, if he tells me, ‘You know what, you’ve got such-and-such and you need to take such-and-such,’ I don’t go around arguing with him.” — President Barack Obama, May 3, 2009.
Obama goes on to speak, with genuine feeling, about his grandmother’s decision to have hip replacement surgery after she was diagnosed with aggressive terminal cancer: she died two weeks after the surgery. Although he would have been “pretty upset” if someone told him she could not have the surgery, he questions whether an operation that will not prolong life is a “sustainable model” for medical care. The president proposes to seek guidance from a national “conversation that is guided by doctors, scientists, ethicists” but is “not determinative.”
He’s right: we need to talk about end of life decisions. They are difficult, costly, and potentially destructive for surviving family members. Obama realizes that the bevy of experts he cites might have counseled against the operation. Should he have listened had doctors told him not to treat his grandmother or that a swift passing was best for her?
Surprisingly, this is the advice that many doctors currently give — or suggest — to families of patients suffering from so-called end-stage dementia, and they are backed by hospital “palliative care” units and “ethicists.” These latter say they want to help families make their own decisions, but health care practitioners have an agenda that they pursue aggressively: the speedy demise of the severely demented.
Hospitals deny that they are practicing or urging euthanasia. I think they are.
The most well-known cause of dementia, Alzheimer’s disease, has been diagnosed in some 4.5 million Americans, and perhaps as many more suffer from other causes of dementia. Exact numbers are hard to come by because death certificates often list only resulting complications. Dementia is a progressive deterioration of mental functioning. In its advanced stages, the centers of the brain that control appetite cease to function; patients lose their desire to eat and, eventually, their capacity to swallow. Untreated, they starve to death. A decade ago, physicians commonly installed feeding tubes in these patients, and a large study showed that patients could survive from one to three years with this procedure.
End-of-life health care is costly, and several recent small studies have seemed to show, against common sense, that patients with feeding tubes do not survive longer than those who do not receive them. When pressed, physicians acknowledge that these small studies are inconclusive, but they nevertheless embrace them. It is hard to imagine another case where inconclusive results in a handful of small studies challenging long-standing practice in a life and death situation would trump practice. When it comes to the elderly, though, the medical profession seems to have a different set of rules. So it is that physicians now counsel families not to treat the severely demented.
Death by starvation appears to be as gruesome for the patients to endure as for their families to witness. However, medical professionals insist, without evidence, that the demented cannot feel pain. It is a cruel irony that these same patients, supposed so demented as not to suffer pain, are credited with choosing not to eat. Medical professionals give patients a swallow test: they put some ice in the back of the patient’s throat. Patients who swallow the ice are declared to be capable of swallowing: they are, therefore, choosing not to eat. It is as if doctors would test the muscles in a stroke victim’s arm, find them intact, and declare that he had chosen not to use the arm. The argument is used to mollify families. Doctors recognize the desire not to eat as a symptom of dementia.
Obama…end of life…palliative care?? Is this anything like Obama’s beginning of life palliative care?? What’s his pay grade again? Where do I throw up?
This man might possibly be well-intentioned, but he is just plain wrong. The end-of-life care decisions he is misrepresenting are not euthanasia. They are part of the liberty to decide individually which part of the healthcare system we want to die in: acute care or hospice care. He is advocating only acute care. The amount of suffering and premature deaths that will result from taking his advice cannot be measured.
Here’s the thing: acute care is excellent when it can save your life but there is such a thing as a point of no return where acute care methods are torture and can even hasten your death. Acute care doctors do not know how to manage the loss of appetite and the levels of pain experienced by the dying. Hospice care is great at managing the symptoms of “failure to thrive,” which includes the loss of appetite experienced by the dying. And the great thing about hospice care is they kick you out if you start to thrive again.
The loss of appetite in the dying — not just the elderly — is part of the process of the body shutting down. By all means, if you are caring for someone in this situation, systematically rule out other causes for the loss of appetite. But be aware, once you have ruled out other causes than the simple one of being at the end of life, loss of appetite is a gentle way to go. It is just not right to call it “starving to death” because that expression is used for people who are otherwise healthy and do have appetites and a desire for food. For them, food was denied and THEN their bodies shut down and they died. However, for the dying, FIRST their bodies shut down and reject food, as indicated by their loss of appetite, THEN they die but without the suffering of longing for food (see above, “loss of appetite”).
There is a considerable amount of violation and force that attend getting medications, food and fluids into someone who does not want them because their body is shutting down. Forcing fluids and food into someone whose body can no longer handle them makes them vomit. Fluid overload when your kidneys are failing is deadly and much more uncomfortable than being allowed to reject the fluids you don’t want anyway.
Demented persons are frightened by a feeding tube coming out of their abdomen. I think most people with dementia who have feeding tubes have to be restrained during the feeding, which is done by pump — not a person — and can take a long time.
Regarding Obama’s grandmother, it seems unlikely that the option of hospice care was offered to her and fully explained. It also should be asked if her choice of the surgery was a form of suicide.
Cynthia
But ultimately, he’s the guy with the medical degree. So, if he tells me, ‘You know what, you’ve got such-and-such and you need to take such-and-such,’ I don’t go around arguing with him.”
Well, good for him, but the mismanaged care I received nearly cost me my Life so I DO question my medical contacts every single dadgum step of the way now.
And don’t even get me started on his program of Eugenics that has been mentioned a number of times under the guise of “healthcare rationing”.. Pah. The target will be senior citizens and persons with disabilities..
Healthcare rationing = Eugenics = Euthanasia = Murder.
And they know it.
Warmest from Talking Rock..
“I’m a pretty-well-educated layperson when it comes to medical care”
always modest and humble your narcissist in chief. I have serious doubts about his affirmative action degree, not to mention the other abilities he brags about.
Oh and nobody believes your grandmother died the day before the election, she died a lot earlier but you kept it hidden til election’s eve for the Ophra factor.
Great comment, Cynthia (#2). Thank you.
I’m all for an individal CALLING THE SHOTS when it comes to their own health, even when it looks bleak. The Elderly have ‘paid their dues’ and deserve the right have care, or refusal of dragging out the inevitable. No one should be told they cannot have access to health care, simply because of their age or illeness. I know tons of ‘Elderly’ that have a lotta spark in them. They are a wealth of knowledge to all of us.
Someone has to pass the flame….and our Elderly are the ones.
I’m all for an individal CALLING THE SHOTS when it comes to their own health, even when it looks bleak. The Elderly have ‘paid their dues’ and deserve the right to have care, or refusal of dragging out the inevitable. No one should be told they cannot have access to health care, simply because of their age or illness. I know tons of ‘Elderly’ that have a lotta spark in them. They are a wealth of knowledge to all of us.
Someone has to pass the flame….and our Elderly are the ones.
“Obama did all he could for his dying grandmother.”
Oh, you must mean the “typical white person” whose funeral Obama didn’t attend.
Personal liberty, property rights, contract law…as long as we are willing to be deceived about these in the long run, in the short run it won’t matter much whether he’s talking about medical care, the size and color of your car, whether or not he chooses to shut your bank down…
He’s the answer to the old question: “Where does a 500 pound canary sit?” Answer: “Wherever he wants to.”
Can we stop wringing our hands over whoever the target is THIS WEEK and concentrate on GETTING THE GUN OUT OF HIS HANDS??????????????????????
In order to succeed, those who intend to deceive are always dependent on finding those willing to be deceived.
Living “aborted” babies left to die, living elderly left to die. Our country has lost its soul.
Lets see if I have this right – Obama’s grandmother has aggressive terminal cancer and opts for a hip replacement which medicare (our tax dollars) paid for, then two weeks later dies. I am surprised that Medicare did not take a look at the whole patient, and not just the hip replacement problem. I really hope that under Obamacare, we continue to have the option to spend from that great unlimited reservoir of money also know as the American Taxpayer.
OBAMA – a monument to incompetency.
North Korea sets off nuke – Obama plays golf.
US facing economic crises – Obama in Las Vegas.
Memorial Service for our honored military men and women – Obama missing.
BeBe defies Obama (good move) – No response from Obama.
Iram working on nuke – Obama sends it to the UN.
We have an absentee President – still out there campaigning, yet lacks the courage for the tough fights and necessary decisions to keep us safe.
This man’s pernicious policies and behavior, coupled with his miscreant minions is sell America down the river.
Wake up people….we are in huge trouble.
“Man-made disaster” manifested as drought in San Joaquin Valley…….Medicare system “broken”???
OH Yeah! Sign me up for the SOYLENT SILVER Plan!!
Obama’s a “Wizard of Id” protege.
Cynthia (No.2) sound like someone who has been around dying people. A relative of mind has dementia and can no longer eat. She is a very religious Catholic and has thought long and hard about life and death issues. She chose not to have feeding tubes or any extraordinary measures to preserve her life. For several years, she has been in a care facility and is visited daily by her husband. He now must feed her with a syringe. I have enormous respect for both of them, and I wouldn’t presume to judge their decisions. Quite the contrary, they are an inspiration to me, living examples of the serenity prayer.
What was it his doc said about cigarettes?
thot so.
How patients, their loved ones and their physicians address complex and sensitive issues at the end of life should remain between them. The government has NO PLACE creating some decision tree about who gets to live for how long and when they should die when confronted with difficult medical decisions.
Without a doubt, we need to have a more open and thoughtful national dialogue about end of life issues. Palliative care also needs to be addressed in medical schools so doctors are prepared to have these discussions with paients and families. Right now, the medical profession isn’t doing such a great job in that realm.
However, no matter what the shortcomings are of where we stand today on the matter, no way should the U.S. government be having a say so about how any patient may or may not proceed with treatment. It’s one of many reasons why a single-payer, nationalized health care system could prove extraordinarily dangerous.
Is our health care system broken? Yes. In far too many ways.
Should Uncle Sam be in charge of it? No way!
Doctors want their patients to die ? What are you smoking, Halper?
End of life issues are very complicated and VERY individualized. The biggest problem I see as a doctor is the guilt ridden family insisting that we “do everything for Grandma” despite the fact that Grandma is 102 years old, contracted, hasn’t spoken a word since Kennedy was president and HAS A LIVING WILL STATING “NO FUTILE MEASURES”!!! Not to mention that none of them have visited her in the nursing home for years.
Can I make it any clearer? I watched both of my parents die from long, drawn out cancer battles and thank God they were lucid enough to refuse obviously futile care for certain problems. All too often, extensive care simply prolongs the agony and does absolutely no good in the long run. I’ve seen many families telling us to “Do everything- unless it costs us something”. When I’ve had to explain that what they are demanding is not covered by Medicare and that they would have to pay for it, 100% say ” Oh- never mind”. I’ve had perfectly lucid patients telling me they did not want further surgery or chemo, only to have the family in the room say ” don’t listen to him Doc, he doesn’t know what he saying! Do it anyway!”. So much for individual decisions.
We in the medical field call it “The $100,000 Funeral”. We will recommend what we think will help the patient and will be honest about what will not. But, like Obama and the government, YOU apparently believe that the government should decide what is best for the patient, not the patient and doctor. Call Obama- you have a position waiting for you in his cabinet.
Cynthia Yokey and VB are right. Feeding tubes and IV fluids are meant to be interventions, not a way of life. If Obama lets the doctors make decisions for him, then he’s a fool. A socialist fool. But when the brain is no longer working and the body is shutting down it is not a kindness to shove tubes and needles into a patient. It hurts, and it’s unkind, unloving.
I’m not talking about denying medical care to a patient who wants it and will benefit from it. I’m talking about the right to die peacefully and as comfortably as possible at the natural end of life. Read Cynthia’s post (#2) again. She knows what she’s talking about.
@6 Vindi
I know tons of ‘Elderly’ that have a lotta spark in them. They are a wealth of knowledge to all of us.
~~~~
Yeah, they have a lot of knowledge of Freedom in the face of oppression. They have knowledge of economics in the face of depression and high (to hyper) inflation. They have alot of knowledge of hard work to get ahead. That is a wealth of knoweldge his high mightiness doesn’t want shared.
There’s a cliche that states, “You can’t put a value on a human life.” Unlike most cliches, this one is patently false. We do it all of the time. Take any given terminally ill person. Would you spend a million dollars to save that person’s life? Maybe. Would you spend the entire US federal budget to save that person’s life? Absolutely not, right? Congratuations, you just defined the boundaries for putting a value on a human life. There are always limits to what we can afford to pay.
Government controlled health care is a disaster. Ultimately, we as a country have to decide how much we’re willing to pay for the last months of a terminally ill patient’s life. It’s going to be a tough decision. It can’t be left to the doctors nor to the bureaucrats.
Death by starvation appears to be as gruesome for the patients to endure as for their families to witness. However, medical professionals insist, without evidence, that the demented cannot feel pain.
Are these the same medical professions that claimed – despite all evidence to the contrary – that newborn babies couldn’t feel pain?
The end of life issue isn’t only defined by the elderly, though they surely comprise the largest group. There are newborns who live for months in Neonatal Intensive Care Units with costly medical interventions that may or may not save their life, and that may (and in some cases, likely) result in a life with profound impairments. Should the government get to weigth in on those lives as well?
As a society, I don’t think we’ve caught up ethically with what we can do medically. And so, we blunder ahead, with doctors doing everything to save patients in order to uphold their Hippocratic oath and our new administration heading down a path whereby the government will decide on the most personal, difficult and sensitive of matters: how long do any of us get to live? Neither direction embraces the thoughtfulness required.
An interesting book that just came out that may be of interest to those posting here:
A LIFE WORTH LIVING: A DOCTOR’S REFLECTIONS ON ILLNESS IN A HIGH-TECH ERA
by Robert Martensen
Meanwhile, Larry J: Great post!
“Death is not the worst evil, but rather when we wish to die and cannot.”
– Sophocles
In your pious pontifications about the value of the opportunity to care for a disabled parent, you completely ignore the most important question of all: what does the parent want?
Put yourself in the position of an old person who is so far gone as to have lost even the capacity to feel hunger.
What would you want?
Would you want someone to shove a tube down your throat and force feed you to drag out your misery to the last possible moment?
Or would you prefer the slow torture of starving to death while onlookers congratulate themselves on their farsightedness?
I know what I would want.
I would want someone to shoot me.
But that is an option that doesn’t even occur to you.
In your best holier-than-thow voice, you ask “what sort of society have we become if we cannot spare the little it costs to sustain for a few months those to whom we owe our lives, our upbringing, and our prosperity?
I ask, what sort of cowards have we become that we deny our parents the same mercy we would unhestitatingly grant to the family dog?
CodeSlinger and others
If nothing else, this discussion should serve as an important reminder to:
Have a living will.
Have an Advance Directive.
Don’t wait until you’re old to address these matters.
Make sure you have a doctor who understands your wishes and is willing to honor them, whatever they may be.
Make sure you’ll have an advocate should you become unable to speak for yourself who will speak for you and what you have determined you want at the end of life.
It gets messy at the end. Loved ones panic. Strong emotions come into play. Not all doctors will respect what may even be written in a legal document.
It’s hard, but there are things we can do to maximize our chances of having our final days be in keeping with what we would or would not want.
Of course he wouldn’t allow you to do the same. He hates white people. Oh, wait…
Treatment of an ill person is matter between him/her, family and the medical team. They can take what ever decision they want? But keeping some one alive just for the sake of being alive is stupid specially when some one is old and lived the life for fullest.
Are we expected to live forever? no
Death is part of life, embrace it. make sure you LIVE your life and when the time comes go woth peace and love.
I have been a dying person. My appetite was one of the first things to go. Food seems a million miles away and has no allure at all.
I also have provided care for my late life partner of over 20 years, who was quadriplegic the last 10 years of her life due to multiple sclerosis. I am a strong advocate for the rights and care of the disabled, especially quadriplegics.
I cared for my mother when she was dying. She was on a long decline when she fell and broke her arm. She stopped eating and drinking almost totally after her shoulder replacement surgery. Her doctor wanted to impose his culture on her and did everything he could to make her death either lonely or violent through invasive care. He shamelessly told the most amazing lies about hospice care. However, I was able to get her the appropriate care for her failure to thrive through hospice care in her home, which I oversaw. This prolonged her life and greatly improved its quality, allowed her friends and family to gather around her and say good-bye, and gave her a passing as gentle and filled with love as was possible. You can’t do this in acute care settings.
Currently I am caring for my father, who is 93. I am enormously skillful in getting my loved ones more time at a high quality of life without great expense, even when the situation looks impossible. So far I have gotten my father an extra 11.5 years and he has used this time to write a book which is still in print (“Information Theory, Evolution and the Origin of Life”).
Hospice care and palliative medicine are the specialties that provide the care for the dying that gives them the longest life at the highest quality of life. You would be shocked at how much longer people with some illnesses would live if their pain were managed properly and their list of medications reduced to what their bodies can handle at the end of life. This is not expensive care. And it is NOT euthanasia.
Oh, and one more thing about heroic measures for the dying: if you are frail and/or have osteoporosis, if you request cardiac resuscitation as part of your care instead of a DNR order that would allow you to die when your heart stops, the nurse or EMT who administers your CPR will probably break several of your ribs due to the force they must apply to your chest.
The moral is that you cannot anticipate your end-of-life care decisions and you are best off giving someone you trust your durable medical power-of-attorney rather than making a living will or advance directive. Some states, like New York, do not allow your healthcare agent or spouse to make a decision against having a feeding tube, so it is wise to describe in your durable medical power-of-attorney whether you want a feeding tube if it will not allow you to recuperate to the point where you can make your own health care decisions again.
Cynthia
Edward, Great article and you touched on some issues which, perhaps in the future, you can expand on and discuss.
The medical establishment has already produced a generation of physicians who have been taught to value, at least implicitly if not overtly,life itself.
For example, assume the case of an 80 year old patient who is in a “non-reponsive” condition (but not comatose) as a result of a medical procedure inartfully performed (drainage for a non sub-dural hemotoma followed by a MRI which was not properly monitored causing cardiac arrest).
Such was the condition of my late father who was a patient in the Neuro-ICU of a leading Ivy affiliated New York area hospital.
For 7 months, I was cajoled,scolded,admonished and lectured by Intensivists, residents and even some nurses at the “waste” of resources in caring for “someone in my father’s condition.”
This unwanted and unwelcome barrage of comments
was not moderated by the medical staff’s admission that they could not be certain whether his condition could not improve, and the level of neurological activity. In fact in an attempt to convince me to sign an Order discontinueing care, I was told by a resident one bright Saturday morning that my father was “brain dead” had no pupil reflex and the brain stem was “dead” or dying. It soon became apparent that this diagnosis was totally incorrect.
Anyone familiar with hospital billing and provider reimbursment details knows that it is often in the hospital’s or physician’s economic interest to have the family terminate treatment.This is sometimes rationalized by reference to concern for the patient’s “quality of life.”
Unless we fight for the sanctity of life, common medical practices based on economics will become
standard practices and codified in the Obama administration’s health policies.
This is a fascinating interview with Dr. Robert Martensen about end of life care. His aged mother was dying as the interview took place and he reflects on that, as well as his father’s death, in very honest and thoughtful ways. He was an emergency room physician for about 30 years and is worth listening to. I’m not sure I would be aligned with him politically, though he doesn’t spell out his views (but I can suspect what they might be). But, the interview is not focused on politics as much as it is on the very sensitive nature of end of life care. It is also quite startling to hear him talk about how, if he were not an MD, measures would have been taken in the case of his mother that she did not want and he did not want. He addresses how powerful and important it is to know where the doctor in charge stands on the matter, a reality check for all of us should we, or a loved one, wind up in the ICU.
http://www.npr.org/templates/story/story.php?storyId=102638208
PS Sorry, also meant to add a brief section of the interview with Dr. Martensen where he discusses the very disturbing rise of intubated patients living in tomb-like ICU’s that are cropping up rapidly – distinct buildings, seperate from the hospital. A frightening sort of futuristic image that has arrived.
So nice to see my former professor here! Even though I was in the graduate program in English at UGA, I’ve always said Professor Halper’s seminar on Plato was the best class I ever had. You could hear a pin drop.
Great insights here.
Is it true that George Soros advocates assisted suicide as a way to “help” those with terminal illnesses? Since Obama follows George’s path, I wait for Obama to suggest it at some time. I enjoyed reading about Soros in the Shadow Party. The section on the McCain Feingold campaign reform was well written. Soros “created” a public hue and cry with his many foundations that he funds directly and then indirectly. Then, Bill Moyers had 3 experts on his show. He neglected to tell the viewers that they were really funded by the same agency – Soros. The experts plus the demonstrators did their act and the McCain Feingold campaign reform act was born. It was a manufactured need. Soros was able to continue his aim to discredit Bush. He brags that he has spent millions to do that. He’s been successful. He said that he dislikes Bush because he is too American – and that we should be going towards a one world government. When I first heard this, I thought I was reading the plot of a science fiction movie for TV. Since, however, I’ve learned how true it is.
George advocates assisted Suicide. He has his groups ready to demonstrate. They will hit the streets the end of May to the beginning of June. Bill Moyers had his info mercial on the single payer health plan with his 3 experts. I wonder who pays them. The program will loaded with blatant lies and bias of facts. It was well rehearsed – to the point that the members almost sounded giddy. Obama has his web site for those who have health care issues to respond. I am willing to bet that the next word out of Obama’s mouth will be “single payer.” Well, that was a Biden example of one word. I suggest everyone read the Shadow Party by Horowitz in order to know the plan of where our government is going. It scares me tremendously.
7. Vindi:
Good comments. When we have lost respect for our elderly we have lost it all. Some of those who are sick and dying are WWII veterans without whose sacrifice we would not have a free country today. They should not be the target of euthanasia. The baby boomers that advocate euthanasia better watch out. They are not far from being elderly themselves.
Your Prof. Halper should stick to Plato. His pontificating on how feeding tubes placed in people with dementia lasting only a few months is downright asinine. Some elderly live for over a decade lying in bed, unable to move, with no idea where they are or what is going on. It is the living forcing a dying person to linger on that is unnatural and twisted.
Obamacare may indeed end up killing old people due to rationing, but trying to equate that with unnaturally prolonging suffering is a fallacious argument to begin with.
I’m all for people making their own decisions on medical care but a hip replacement for an elderly woman with terminal cancer sounds more like torture to me than waterboarding or sitting in a room with a bug. Hip replacements are extremely painful and require weeks of rehab. If you have advanced terminal cancer you can’t exactly walk around after surgery with a foot-long wound that’s stuck together with staples and see any point in doing it. Why would you want to?
Amen to Cynthia’s comments above. I’ve heard nothing but wonderful things about hospice and palliative care.
When his grandmother was dying in Hawaii, and Obama went to Hawaii with his wife and daughters, Michelle and the girls went SHOPPPING, rather than to to see the great-grandmother they would never see again.
Why? To spare them something? I doubt it. I would love to have an answer to this question which NO ONE asked in any media or on talk radio or anywhere else.
If this is such a loving grandson, why weren’t his girls taken to the bedside of their dying great-grandmother? Don’t tell me it’s because of their age. They’re both old enough to understand death, they’re not infants or toddlers.
So, why?
Thank you Cynthia! As a former hospice nurse, a director of nursing in a long term care setting AND the principal caregiver to both parents, and my husband, I wholeheartedly agree with her. Giving a dying body food/fluids is a tortorous, cruel thing to do. All we have to do is observe our pets as they draw closer to death–do they not stop eating and drinking? It is the natural way of the body to shut down. I am a baby boomer; I do NOT support euthanasia….but I DO support the calm, dignified and respected approach to death.
However, the real issue at stake here, is indeed shedding realistic light on “Obamacare”. If I understand it–and I certainly have been researching it–it is hugely frightening. Educate yourselves!
Oregon and Washington have the right idea for Death With Dignity. I may never choose to use it but I like the idea that it is there. Should I be in severe disabling pain–or the treatments too expensive for my family, I will certainly use it. However I don’t want to be told when someone else thinks I should die. That will be murder. The Obama health plan will decide who is disposable–the disabled, the elderly and the mentally deficient. Just as surely as they approve the murder of babies
both in and out of the womb–they will take the path of clearing out the dead wood. Fascism–for sure.
2, 27. Cynthia Yockey, A Conservative Lesbian:
Thank you for telling your perspectives.
* * *
Government should stay out of medical decision-making.
From a country that has long laboured under socialism and it’s version of “health care” (ye Gods) I offer this glimpse into your future should you let O’Bama massa inflict it on you
http://www.smh.com.au/national/debts-ravage-hospital-service-20090527-bnp5.html
Good luck.
How disingenuous it is to equate the acceptance that life ends, and that a few months of torture is not better than a few days of peace with “euthanasia” (notice I used SCARE QUOTES like out author)
Cynthia and others have it right, people get old, their bodies fail, and they die. The heroic measures one might take to save a person with functioning mind and a long potential life ahead of them are pointless on someone whose body has decided it is time to quit.
Oh, and osteoporosis notwithstanding, correctly performed CPR ALWAYS breaks ribs, but the osteoporotic might have all of them broken.
I am going to gather my replies at my own blog, A Conservative Lesbian, sometime in the next few days, and add more material, or ask Pajamas Media to publish my article on this topic.
The magic pill that helped your father may not be indicated for everyone. As #18, the Well-Educated Cad, who is a physician, pointed out, medical treatment is highly individualized.
Hospice care is about quality of life, which very frequently results in longer life, too. Palliative care doctors and hospice nurses are THE experts in appetite stimulation because enjoyment of food is comfort care and “failure to thrive” is one of the conditions that hospice care is THE BEST at treating and reversing to the point where the patient is discharged from hospice care. Art Buchwald’s last book was about how well he thrived in hospice care.
If your father had gone into hospice care, I feel certain he would have gotten the care he needed for appetite stimulation immediately — including the magic pill — and would have been discharged as soon as he improved. If you fought hospice care for him, you delayed him in getting appropriate care since acute care doctors don’t really understand “failure to thrive” and appetite issues as well as palliative care doctors and nurses do. (BTW, I am not using scare quotes, I’m using the quotes to ensure that people grasp “failure to thrive” as the name of the condition instead of using their intuitive understanding of the words failure to thrive.) It’s a pity that your the consequence of your article may be spreading the kind of ignorance that leads to this result.
I do not support euthanasia or the assisted suicide programs in Washington and Oregon. They are not mercy. Modest and comparatively inexpensive changes in end-of-life care are what are needed, not euthanasia and not assisted suicide.
I am working on a book on how to navigate the health care system and the changes I think need to be made to end-of-life care that will improve the quality and length of life while saving on overall costs.
Cynthia
Not one mention of our eternal souls . I am stunned . The most important possession is completely ignored and everyone apparently assumes it just doesn’t exist.
Yes ,death is an unwelcome thing but the part of us unseen and unknown to many people is about to make its most significant journey. I am not commenting here to belittle rather to encourage people in these circumstances to open their minds in respect to that amazing force inside of each of us which is about to make an incredible mysterious passage.
Don’t diminish the act of dying to a petty squabble about health care costs and rights. The politicians who use sinister calculations regarding others peoples lives will face a terrible judgment when their time comes.
OBAMA TRIES TO STAMPEDE THE HERD
The “now or never” health care claim is phony and without merit.
http://greensrealworld.blogspot.com/2009/05/health-care-nightmare.html
Obama can pay for anything he wants. Just tax the evil rich. They didn’t work for their money anyway. They just got all the breaks.
Wake up America.
Edward,
It would be helpful to know why your father was hospitalized and I would appreciate your sharing that information.
Cynthia
Cynthia:
You write, “I do not support euthanasia or the assisted suicide programs in Washington and Oregon. They are not mercy. Modest and comparatively inexpensive changes in end-of-life care are what are needed, not euthanasia and not assisted suicide.”
The government has no right to interfere in such matters, or to force a person to wait until the options are so limited. In a free country, a man’s life is his own, and that includes deciding when it should end.
But America is no longer a free country. America has fallen victim to the vilest form of cradle-to-grave totalitarianism. Nothing could demonstrate this more clearly than the State claiming jusridiction over the time and circumstances of death of its citizens — and to give this claim the chillingly Orwellian name of “health care.”
A response to Cynthia (#45):
My father was hospitalized initially for “failure to thrive.” (As you suggest, this designation means that someone is not doing well, but they don’t know why.) The doctors performed a number of tests, discovered that he had an infection, and treated it. They concluded that the root cause of the my father’s problems was dementia, and they recommended against further treatment. They did suggest hospice care, and we met with the hospice people. These latter made it clear that they would not provide treatment of any sort, certainly not an appetite stimulant. The hospital’s palliative care division was devoted to convincing us not to seek treatment and to let go. However, eventually, after my father had been in the hospital 5 days, the doctors reluctantly started him on the appetite stimulant. This was a major teaching hospital, and the doctors provided me with medical literature that supported their decisions. It was clear that they were following the standard procedure for treating the demented.
The care that you have given to your father and your partner is extremely admirable. However, neither suffered from dementia. So we are really talking about different issues.
I have never heard of anyone’s being discharged from a hospice. Your suggestion that hospices are places to go for treatment is certainly not consistent with their intended purpose. I do not think that you are really talking about hospice care, but about nursing care. Your antipathy toward physicians is misplaced. From the medical literature I have read, they prefer nursing care to treatment by feeding tubes, at least for dementia patients, on the grounds that it works as well. In my view, all sustaining treatments should be considered along with nursing care. Since you evidently think the old and feeble ought to be sustained, you are on my side. Your book will be valuable if it persuades people who are capable of providing care for their loved ones to do so. This is best for the patient, but also, as I say at the end of my article, those who can care for parent may themselves get as much or more from it.
Your comments and those of others reminded me that many if not most people have a very different view of the medical profession. The standard picture is that doctors are quick to take extraordinary and painful measures in hopeless cases, measures that prevent patients from having the dignified, peaceful death that they would surely prefer. Not this, but the opposite happens when the patient suffers from dementia. Then, doctors recognize that the underlying cause cannot be treated, they judge the patient’s life not worth living, and, therefore, urge the family to allow the patient to die. Such patients do not typically die of the disease but of treatable symptoms. This is what I regard as “euthanasia.” It happens when the patient is severely demented, but also by a slippery slope when patients are not so severely demented. Again, my point in the article is that doctors do not want to treat the demented because they judge their lives to have no value and their prognosis to be hopeless. That these patients have lives worth living is, I think, a view you share.
I think your article mixes up a few different issues. I don’t know enough about feeding the dememtia patient to comment, but hip replacement surgery is so medically inappropriate for someone with an aggressive terminal cancer. If it was an issue of hip pain, then pain medication would have been better. The fact that Obama would have been “pretty upset” had they decided she couldn’t have the surgery means that he’s just like all the rest of us– you want to do “everything” for your loved one– even though that is irrational, it isn’t in their best interest and, yes, it is not sustainable. I thought Obama was expressing that he too is irrational and we all have a lot to learn. Since the hip replacement was not only expensive but medically inappropriate, it certainly is proper to come to the realization that a huge number of pregnant women could have been given prenatal care they were otherwise not receiving (by which I mean folic acid, screening for protein and sugar in the urine, bp monitoring, breastfeeding education–it’s a learned art and its teachers don’t charge much) with that same money. And one elderly cancer patient would not have been any worse off. (probably better off, in the sense that her last weeks would not have included the torture of futile major surgery).
wHEN GOVERNMENT CAN DECIDE WHO IS TO LIVE AND WHO IS TO DIE THAT IS WHEN YOU KNOW DEMOCRACY IS DEAD AND THOSE WHO HAVE THIS POWER ARE WORSE THAN HITLER. tHIS POOR COUNTRY HAS VOTED ITSELF INTO THE WORSE KIND OF DICTATORSHIP. hELP THEM LORD FOR THEY KNOW NOT WHAT THEY HAVE DONE.
My father finally succombed to the lack of food and water and died yesterday morning after a long fight with the frualdulently appointed “Fiduciary” Karen Deville 602-506-5842. She issued the death warrant on my otherwise dimentia and healthy 77 year old father Lee Mealer. He begged for food and water for the past month, but she forced the nurses and dotors to NOT feed him. KAREN DEVILLE FORCED THE DOCTORS TO NOT FEED OR GIVE WATER TO MY FATHER. She refused to allow us to feed my father until finally due to outside pressure they allowed what the doctor called pleasure foods since my father was already a week beyond saving.
6’3″ 190 lb Lee Mealer was down to 135 lbs and begging for food! By the time the family found out and believe me, we were totally shut out of this due to Karen Deville and her legal guardianship as fiduciary.. By the time we fouind out and rushed to Mesa Christian Care Center 255 W Brown Rd, Mesa, Az 480-833-3988, it was too late.
I watched my dad beg for food. I also watched him eat after the ultimatum was given and we were about to “kidnap” him to safety against the wishes of Ms Deville. The doctors wanted to feed my dad, but Deville said NO. She’s not a doctor! She has no medical background! This murderer needs to be living penniless and homeless under a bridge in refrigerator box and she will be when I get through with this entire murder plan she instituted on my dad. She is demanding he be buried or cremated asap to hide the evidence, but we are so far, successful in fighting it for an autopsy and veteran’s funeral at a veteran’s cemetary.
So far, Gov Jan Brewer has lent support and has helped with the limited time we have known about this. Call and thank her if you care to…800-253-0883. Kevin McCullough and Stephen Baldwin, KTAR, KFYI and hundreds of others (including militia members out of Idaho) who lended me a hand getting my dad fed a week too late to save him. The phone calls made the difference, but it all came about too late.
Do not allow this happen again!
JL Mealer
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