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Old 06-13-2012, 11:49 PM
 
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My senior dogs have occasionally had dementia, mostly by getting lost in the yard and staring, and getting "stuck" behind things and barking at the corner of the room, seemingly unable to figure out how to back up. It is sad to see them losing ground, but not as sad as with people- maybe because I've seen end-stage with people at my job.
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Old 06-14-2012, 12:41 PM
 
Location: California
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My 80 year old cousin has Parkinson's so when he fell, he was taken to the hospital. The doctors decided he needed some powerful mind meds but he isn't used to taking strongs drugs which led a very violent reaction - grabbed a nurse and tossed her across the table. Off he went to yet another hospital where they gave more wrong meds which caused more bad reactions. Since he had a DNR, they wanted to just let him die but when it reached the ethics committee, after his son's protests, they decided to talk to my cousin. He was having a better day when they came to ask him about a feeding tube and said he wanted to live. Again, more issues with improper meds but when he was taken off them, he slowly began to recover from the medical communities death sentence. Today, he bounces around in his wheel chair and goes on day trips to his home and museums. He is lucky that his son loves him and stood up to the medical opinions as they were all for just getting him out of the way. I wish I had son so strong as we all need an advocate when we can't speak for ourselves.
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Old 06-14-2012, 02:05 PM
Status: "notary sojac" (set 13 days ago)
 
Location: then: U.S.A., now: Europe
6,302 posts, read 5,587,615 times
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Quote:
Originally Posted by cokatie View Post
....I'm attaching the article here for the rest of you caregivers to have a look at. If it's any comfort at all to you in your situation, you are FAR from alone. Peace out to all of us on this long road we're walking with the shells of our Mommies and Daddies.
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I thank you for that intelligent and compassionate look at ageing and dying. Though, I am too old and handicapped at age seventy-four to be able to be someone's caregiver, and there is no one left who needs that help in any case, I did actually "enjoy" the article.

Last week I spent four days in a lovely city far from my home, consulting with a ("my") surgeon about a serious medical condition. A little over a year ago I had a long, serious and expensive operation - it was a success and I did extremely well; however, two weeks later a totally unforseen surgery-related accident occured and I now cannot walk without Canadian canes (with quite some limitations) and never will again, and that impacts other medical problems.

So, last week was to consult on even further negative developments.

There is no alternative to doing nothing other than to undo what was done last year, and then undergo a ten-hour operation of a more complicated nature. The surgeon said essentially, I do not want to do this but I will at least consider it, if you feel that it is what you might want to do.

My response was that I have four stents in my heart, several other less serious medical problems and then the wear and tear of my present level of existence for the past year. Therefore, I cannot see it being worth the risks involved with the surgery, and furthermore is seems like a stupid way to spend my time and money at this point. Even if there were improvement - for how long given my condition and age?

We parted equally pleased.

I was travelling when my mother had a second heart attack, and was put on life support. She insisted she did not want these efforts, but the doctors demurred saying she could not live without them and they would discuss the question the next day...and then the next.... My step-sister, who had the medical power of attorney, asked if my mother would ever live without this support. The answer was - no. But again the doctor protested about removing these supports, and though it was not a Catholic hospital he even brought in a priest to support his position.

My step-sister, not ever a very aggressive person in my experience, replied, I was told, to the effect that she was going to my mother's lawyer and he would get a court order, and the doctor could then explain to the court why he was torturing her step-mother to death, when she had clearly expressed her wish not to have this support and when the doctor had told my step-sister, in the presence of others, that she could not live without it.

At this point, the support was removed in a matter of less than half an hour; my mother slipped away within a few minutes.

I believe it is in the Daodejing where one of its brief chapters has the summary line: "Knowing when enough is enough, is enough." Too bad this is not part of the Hippocratic oath. It should be.
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Old 06-14-2012, 02:08 PM
 
Location: The Great State of Arkansas
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Kevxu, I cannot rep you - out of points - but that is an EXCELLENT post. Thank you.
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Old 06-14-2012, 06:16 PM
 
Location: Los Angeles area
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Kevxu, good for your step-sister. She did exactly the right thing, in my opinion.
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Old 06-14-2012, 10:17 PM
 
Location: Not where you ever lived
10,852 posts, read 15,182,199 times
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Quote:
Originally Posted by imcurious View Post
The "exit strategy" is something to seriously think about.

If doctors weren't so chicken **** these days, and if the government were not so meddling, you could indicate in an advance directive that you wished for NO medication which would prolong life, but I believe as it stands at the moment, you can ONLY limit "extraordinary measures," and most of the time, as I understand it, advance directives are not even looked at and DNR orders are not considered (if someone calls an ambulance, THEY WILL REVIVE you, no matter what your wishes - unless you have the DNR on the refrigerator and even then, they would probably not even see it).
Maybe it depends upon your state and the circumstances. The DNR is a legal and binding document that will hold water in all states. My spouse had a DNR. The doctor had a copy, the hospital had a copy, My spouse did not want to live hooked to a Ventilator. I did not want my darling spouse to die, so I accepted the essence of the DNR and let my spouse die peacefully at home when I could have made a difference for 30 minutes or one day. It was not the purpose of the DNR.

Hospice DNR is different as they anticipate the client to die in 6 mo. or less. They don't treat colds, flu, pneumonia; they do not transport patients to doctors, or hospitals. Our doctor's nurse and I talked about Hospice and palliative care.. My position is and was my spouse would have treatment --- if it would change the situation, or IF sickness was involved. The skin was very fragile. When my spouse got tangled up in the dog collar, muscle was exposed and blood was dripping on the floor. I was not going to let my spouse bleed out when I could dress a wound. We did not do elective surgery. My spouse was as functional and comfortable as possible. When the lungs stopped functioning the DNR kicked in. There was no attempt to resuscitate. There was no autopsy. There was no TV drama.

Last edited by linicx; 06-14-2012 at 10:26 PM..
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Old 09-19-2013, 08:10 PM
 
1,777 posts, read 1,777,793 times
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My apologies, I just realized that the link I had originally posted no longer worked. I still think this is one of the best articles written on an aging, sick parent so I am going to re-post a working link.

Parent Health Care and Modern Medicine’s Obsession With Longevity -- New York Magazine
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Old 09-20-2013, 07:50 AM
 
Location: NJ
7,126 posts, read 13,803,559 times
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Our aging crisis: the need for a dignified death - September 14, 2013 : 6:14pm

When it became necessary for Jeffrey to undergo hernia surgery, his cardiologist suggested that they implant a pacemaker.

The family agreed, unaware of the downsides of what was such an (they would only later find) unnecessary preventative treatment.

Now, Jeffrey’s heart would tick on, long past his time should have been up.

“Not having a pacemaker would not have guaranteed my father a quick or easy death,” she writes. “But having a pacemaker deprived him of his best chance for one.”

Despite the surgery — or perhaps because of it — Jeffrey quickly got worse. Like about one third of those over 80, he suffered from dementia. His eyesight went, then his mobility. He began misspelling words. Then he began to see things that weren’t there. He became bladder and bowel incontinent.
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Old 09-20-2013, 10:56 AM
 
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I remember being 16 working as an aide then and seeing people in such horrible shape (nursing homes). I was a strong kid I guess, but I felt early on it was so inhumane. Fast forward many years, as a nurse I've seen it all. But, to me quality over quantity is the thing--death is better than some fates and my heart goes out to anyone dealing w/ seeing someone they love just in a sad situation, tragic really. The whole topic is at a critical mass I believe. Will be easier to exit out eventually when quality of life is gone. I'm hoping anyway.
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Old 09-20-2013, 12:48 PM
 
Location: Simmering in DFW
6,884 posts, read 10,130,252 times
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Default The Poison Pill

I just read most of the NY time story. Living much of it now. Nodding my head vigorously with almost every passage! Mom has mid-stage dementia with frequent urinary tract infections that cause wild delusions and downright crazy behavior.

Probably the thing that strikes me is that my parents never believed in LTC insurance because they had stashed away in their medicine cabinet, they said, a toxic potion of pills that would surely end their lives when each became aware that the slide into long term care was beginning.

Always, I would hear "That won't be our plight; we will end it waaaay before you guys ever have to deal with that nursing home stuff...." and "Just kill me now rather than ever consider using your inheritance that way, ain't gonna happen."

Dad died in his sleep a few days before turning 80.

But, with her 90th birthday coming, we will be putting Mom into a memory care facility. She hasn't forgotten about her pledge and threatens to kill herself on a daily basis. She gets ahold of a bottle of pills -- maybe even thinking she may do it --- and then promptly throws its contents down the toilet. And of course, without meds she is a red monster. So we need to keep meds locked down to manage her behavior.

This month's 24 hr home care bill is close to $20k a month, and we need to make a change for safety and also to make sure the money lasts for another decade -- she is in perfect physical health. Mom clings to her home and begs to stay there; every 51/50 - involuntary mental eval hospital stay (3 so far because of strangers' police calls) concludes with begging to go home and promises to agree to taking her meds. That promise is broken w/i 10 hours with scream of "they are trying to poison me." I am not blaming the victim -- she is incapable of remembering promises about her behavior. If you told her today she was in the hospital 2 weeks ago, she'd would say you are a liar and she's never been in a hospital in her life. And she would believe it.

And so, the nest egg my parents proudly called "the family trust -- our legacy to our kids and their kids" is swallowed up, and we write the checks to care for our mother the best way we can. Our parents voices, from their vital past days, are screaming in my head that this situation is indeed a bitter pill for all of us.
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