News, Hospitals Giving 'Death Test' to Seniors (55, supplement, 2013)
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Well, as a Mackerel Snapper (Catholic) my church is not in favor of it but I can certainly see where it would appeal to some. Realistically, however, we all already have that choice and the means, while some could be messy, are handily available.
LOL, I have not heard that completely non PC term in quite a while.
Well, as a Mackerel Snapper (Catholic) my church is not in favor of it but I can certainly see where it would appeal to some. Realistically, however, we all already have that choice and the means, while some could be messy, are handily available.
Oregon has had physician assisted suicide available for 17 years now. It is not commonly used. The medical community eased up on their puritan rules about opiates and started easing people's pain while dying. Who cares if somone gets addicted, if they are going to die in a few weeks anyway?
When my mother was getting close to 90 years old, her doctor said to my sister, "Let's try to keep her out of the hospital". That's what was done and I agreed totally with that philosophy. She died at home, with hospice services, a couple of years after the doctor made that statement, one month short of turning 91. It must have been about 12 years ago the doctor said that - he must have been ahead of his time, as the attitude and philosophical stance the comment represents seems to be becoming more accepted (witness this thread).
As a recent widow I feel there is a need for this type of "test" or whatever you wish to call it.
I think my husband's choices would have been different regarding treatment, how he chose to spend the precious time he had left. I feel that he would have chosen less treatment and more fun/family/us time while he could still enjoy it.
I know many doctors feel they have to save a life at all costs- but studies have shown if the roles were reversed, the doctors would forego those very same treatments themselves and just go home and enjoy the rest of their lives..
It's about time that they are able to do the same for their patients! In theory it may sound terrible, but I think it's a valuable tool for patients. Been there, wish they'd done that.
After watching my parents decline and die, I agree with you. My mom had congestive heart failure and she was in and out and in and out and in and out of the hospital for YEARS when she really had no quality of life left. I feel like the doctors just kept propping her up and keeping her alive because that's what they were supposed to do. And we, the family, went along with it because you are supposed to want your loved one to live as long as possible, right?
100 years ago, or even 50 years ago, there wasn't a choice. There weren't interventions that would keep someone alive like that. When someone started to decline, they went pretty quickly. After watching my mom, I am not sure the interventions are such a good thing. Would it be better to die 5 or 10 years sooner and go quickly once you started to decline? Or is it better to stay alive as long as possible even though your body is in a constant state of being unable to maintain homeostasis and you need constant intervention - pharmaceutical, mechanical, etc. to stay alive?
Once she was on hospice, my mom only lived 10 days.
In her 80's my mother also suffered from congestive heart failure and had a calcified aortic valve. The heart surgeon was eager to replace it. I protested because of her age and he said, "I just replaced one in a 92 year old lady this morning." Our family and my mother reluctantly agreed to the surgery, but her results from the procedure can only be described as the prolongation of suffering. I have felt guilty for years that I did not stand up to her doctors--all of whom collected a hefty fee for their efforts. I found out later from a family member that the 92 year old lady never made it out of intensive care.
Honest end of life consultation and care is needed badly in this country.
When my grandmother-in-law was around 95 or 96, she was diagnosed with breast cancer and they were going to give her radiation or chemo, can't remember which. Turns out they found later that the diagnosis was mistaken, so it's a good thing she didn't allow it. That was ridiculous imo.
In her 80's my mother also suffered from congestive heart failure and had a calcified aortic valve. The heart surgeon was eager to replace it. I protested because of her age and he said, "I just replaced one in a 92 year old lady this morning." Our family and my mother reluctantly agreed to the surgery, but her results from the procedure can only be described as the prolongation of suffering. I have felt guilty for years that I did not stand up to her doctors--all of whom collected a hefty fee for their efforts. I found out later from a family member that the 92 year old lady never made it out of intensive care.
Honest end of life consultation and care is needed badly in this country.
This is the problem with our "fee for service" medical system. Between that and wrongful death lawsuits, doctors are ALWAYS going to recommend tests and treatments over common sense advice. Which means that unless we want to get sucked into the medical system vortex, we're left to figure out on our own which treatments to take and which to pass on.
"Dr Cardona-Morrel said the test was designed to help doctors begin a conversation with terminally ill patients, particularly elderly patients, as to whether they would like to continue to receive treatment and where they would prefer to die."
Development of a tool for defining and identifying the dying patient in hospital: Criteria for Screening and Triaging to Appropriate aLternative care (CriSTAL)
Younger folks need to understand that the elderly do not share their fear of dying, that it takes a bit of time to die, and that the LAST thing most older folks want is to have a youngster try and fight them on it.
Absolutely. Although I'd substitute "fear of death" for "fear of dying". It's not the former, it's the latter that can strike fear in our hearts because too often the dying process is unnecessarily prolonged.
On this Retirement forum and also in the Caregiving forum, there's a wealth of experience in dealing with loved ones whose dying was long and drawn out. Many of us have had the experience of watching our loved ones undergo invasive, painful, expensive, and ultimately unhelpful procedures. We've also experienced situations in which our loved ones' wishes to not do so were honored.
Quote:
Originally Posted by PNW-type-gal
Here is the actual criteria they use to develop a score:
It looks to me like they are trying to develop a checklist to be sure they are taking the larger view of overall patient health into consideration rather than just a specialist's view. The list looks like it could also be used by a doctor/hospital to justify not treating a patient aggressively, which I don't think is a bad thing, necessarily.
If you talk to hospice workers, they'll tell you that there is a clear pattern of behaviors/physical symptoms that signal (some) patients are near the end of life and those signs need to be respected, not "treated."
Thank you for the link. I read the criteria carefully, it provides a strong framework for the patient and family to have a frank discussion with medical professionals and caregivers. In fact, I'm tempted to print it out for use in my own family.
I've had a number of family members in hospice and your comment about hospice workers recognizing end-of-life signals is right on.
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