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Old 03-11-2015, 06:27 AM
 
Location: Near a river
16,042 posts, read 18,969,510 times
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There was an end-of-life issues thread started in 2010 that went for three years. It got to rambling as many threads do. After reading recent articles such as the one in the link, below, I thought I'd start a new discussion focused on actual planning around healthcare directives. The boomers have awareness and choices that our predecessors didn't, so perhaps we can share information that we find that is helpful to our own planning.

This article is about Hospice, and debunks several myths around it that I'm glad to learn about.

Common Myths of Hospice Care Debunked | Next Avenue
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Old 03-11-2015, 08:44 AM
 
Location: State of Being
35,885 posts, read 67,147,825 times
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NEGirl: A timely topic and things do evolve.

I thought I would share what hubby and I have done. We had everything written up and reviewed by our attorney. Then I got this App and we have all the documents "stored" on it. This was very comforting b/f his last big heart surgery.

Prior to that, I felt I had to carry copies of his directives with me in a folder. We have found that even though we would give copies to the hospital personnel, later they would say they needed a new one or to review things and have it all updated again.

So this way, things are in a central location (besides filed with our will with our attorney).

This is not the only App out there, I feel sure, but we liked this one -- it is from the Bar Association.

My Health Care Wishes App
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Old 03-11-2015, 12:17 PM
 
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There is a retired attorney in Boston who is quite the firebrand on this issue. He runs a blog, and has all sorts of activities going. I will see if I can dredge up links later (unless someone beats me to the punch).
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Old 03-11-2015, 01:46 PM
 
Location: Oxygen Ln. AZ
9,321 posts, read 16,575,490 times
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My mom had hospice care in our home up until she passed. I would opt for hospice over a nursing home or hospital.
The staff were all wonderful, caring and supportive people. I could not have done this without them and am grateful they finally wore me down to give her a bath 3X a week and do her hair. I did not realize how tired I was and at first was offended by any offer of help. So glad we went with them.
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Old 03-11-2015, 02:03 PM
 
Location: Near a river
16,042 posts, read 18,969,510 times
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Quote:
Originally Posted by brokensky View Post
NEGirl: A timely topic and things do evolve.

I thought I would share what hubby and I have done. We had everything written up and reviewed by our attorney. Then I got this App and we have all the documents "stored" on it. This was very comforting b/f his last big heart surgery.

Prior to that, I felt I had to carry copies of his directives with me in a folder. We have found that even though we would give copies to the hospital personnel, later they would say they needed a new one or to review things and have it all updated again.

So this way, things are in a central location (besides filed with our will with our attorney).

This is not the only App out there, I feel sure, but we liked this one -- it is from the Bar Association.

My Health Care Wishes App
Excellent!
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Old 03-11-2015, 02:09 PM
 
Location: Near a river
16,042 posts, read 18,969,510 times
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This is a really interesting podcast on what doctors prefer for themselves vs. what most people think they want, regarding resuscitation:

Reckoning With End of Life Care - Radiolab


For those who have a DNR, where are you keeping it so that ambulance/emergency personnel can immediately find it before they start in on resuscitation? Some elderly do a tattoo on their chest or wear a necklace/bracelet.
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Old 03-11-2015, 10:04 PM
 
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The article on hospice-care, linked in the original posting of this thread, is itself riddled with misconceptions.

First of all, the terms of hospice care - duration, costs and so forth - varies from state to state. Check the laws specific to your state.

Second, hospice emphasizes caring for the patient at home. Who does the caring? Not the hospice staff! Hospice staff visits every other day, or perhaps daily. Instead, the caring is done by the patients' relatives, or by paid home health aides. Round-the-clock care is required for bedridden patients, and that care costs around $400/day. This is rarely covered by insurance, and is NOT covered by Medicare.

Hospice has inpatient facilities too, but see above: eligibility varies from state to state. In Virginia, where my mother passed away under hospice care, patients are taken in by the inpatient hospice facility for a maximum of 5 days. If you're not dead in 5 days, you're expelled (for lack of a better term). Patients are not deemed to be eligible for inpatient hospice care unless a doctor certifies that their symptoms can not be managed at home.

Home hospice care takes a heavy toll on the patients' relatives. I'm an only-child. My dad passed decades ago. When my mom became bedridden, my life revolved around sitting at her bedside. Hospice nurses arrived every other day, to check mom's vital signs and to deliver prescriptions.

Hospice care is certainly superior to no care at all, but it's no panacea. Medicare does pay for drugs prescribed by hospice.

My mom had both Medicare and a health insurance policy retained from back when she was working. Here's perverse irony: the combination of Medicare and health insurance paid 100% for her hospital stays. But it paid 0% for her home health aides.

Bottom line: the best way to die is to die suddenly. A slow, medicated decline is going to be unpleasant and expensive, whether with hospice, or without.
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Old 03-12-2015, 07:10 AM
 
Location: Near a river
16,042 posts, read 18,969,510 times
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Quote:
Originally Posted by ohio_peasant View Post
The article on hospice-care, linked in the original posting of this thread, is itself riddled with misconceptions.

First of all, the terms of hospice care - duration, costs and so forth - varies from state to state. Check the laws specific to your state.

Second, hospice emphasizes caring for the patient at home. Who does the caring? Not the hospice staff! Hospice staff visits every other day, or perhaps daily. Instead, the caring is done by the patients' relatives, or by paid home health aides. Round-the-clock care is required for bedridden patients, and that care costs around $400/day. This is rarely covered by insurance, and is NOT covered by Medicare.

Hospice has inpatient facilities too, but see above: eligibility varies from state to state. In Virginia, where my mother passed away under hospice care, patients are taken in by the inpatient hospice facility for a maximum of 5 days. If you're not dead in 5 days, you're expelled (for lack of a better term). Patients are not deemed to be eligible for inpatient hospice care unless a doctor certifies that their symptoms can not be managed at home.

Home hospice care takes a heavy toll on the patients' relatives. I'm an only-child. My dad passed decades ago. When my mom became bedridden, my life revolved around sitting at her bedside. Hospice nurses arrived every other day, to check mom's vital signs and to deliver prescriptions.

Hospice care is certainly superior to no care at all, but it's no panacea. Medicare does pay for drugs prescribed by hospice.
Thanks for posting this. I was unaware until recently that hospice varies from state to state. A student of mine whose husband passed away in hospice care had a less than satisfactory experience with it. She had thought that the caregivers would be there for significant time periods every single day, and they were not. I don't know whether she expected to pay for the round-the-clock care. But your post adds to the fact that we should not rely on hearsay regarding hospice care, we should find out firsthand how it works in our state.
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Old 03-12-2015, 09:04 AM
Status: "0-0-2 start!" (set 15 days ago)
 
Location: The beautiful Rogue Valley, Oregon
7,289 posts, read 15,342,559 times
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Quote:
Originally Posted by newenglandgirl View Post
For those who have a DNR, where are you keeping it so that ambulance/emergency personnel can immediately find it before they start in on resuscitation? Some elderly do a tattoo on their chest or wear a necklace/bracelet.
Emergency personnel generally do not care if you have a DNR bracelet or an advanced directive that someone is waving in front of them. If they are summoned (by someone calling 911 or any other means) it is their job to get you to the hospital alive, particularly if you are still breathing.

Some states (California is one) allow paramedics to follow a DNR and not attempt resuscitation if the patient is not breathing. But if you are still breathing, still alive, the paramedics will generally ignore a DNR to get you to a hospital.

There is a document called an "Out of Hospital DNR" in some states which is a medical order, signed by a physician, which paramedics MAY honor. It is generally available only to terminally ill patients.

Last edited by PNW-type-gal; 03-12-2015 at 09:14 AM..
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Old 03-12-2015, 11:47 AM
 
685 posts, read 564,330 times
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Quote:
Originally Posted by newenglandgirl View Post
There was an end-of-life issues thread started in 2010 that went for three years. It got to rambling as many threads do. After reading recent articles such as the one in the link, below, I thought I'd start a new discussion focused on actual planning around healthcare directives. The boomers have awareness and choices that our predecessors didn't, so perhaps we can share information that we find that is helpful to our own planning.

This article is about Hospice, and debunks several myths around it that I'm glad to learn about.

Common Myths of Hospice Care Debunked | Next Avenue
Good link, newenglandgirl: I knew it because I've been there and done that. My dad was easy to get him
to use hospice. He was of the mindset that just because he's on it, he doesn't have to die. He didn't for about nine more years and got on it again. My mom believed being on hospice=death and in her case, it was true. But you can't stall death unless you're really lucky.

I think you probably know this but I'll assist posting end-of-life directives and such - I did before to a small degree. As my partner and/or I take classes, I'll post it for you here. I've been trying to let y'all know what I'm learning. The dying process has picked up and for many is now accepted and thankfully not taboo.

Our predecessors (parents and whoever) did have help from doctors with end-of-life keeping out of pain but it just couldn't be obvious.
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