Getting health care healthy

Next year we'll spend $17 billion in Medicare money on an oxymoron: preventing inevitable death. Full Story
Been There

United States

#22 Aug 5, 2009
Albigensian wrote:
There's often a lot to be said for hospice care as one approaches end of life. It's also inexusable to deny a dying person adequate pain medication on the grounds that narcotics, by depressing respiration and other vital functions, may hasten death.
But having said that, do we want to slide down the whole slippery slope to "voluntary" euthanasia-- without recognizing that the pressures on the old and sick to just go gently (and quickly) into that good night may become irresistable?
In short, I do not think it irresponsible to fear handing government bureaucrats the authority to deny (or simply not pay for) life-extending treatment for those who might benefit from it.
Perhaps there won't be a "cash for corpses" program tomorrow (such as $45,000. incentives for physician-assisted suicide of those older than 65 and with a poor prognosis), but, it's far from unreasonable to avoid paths that may lead there.
My grandmother has advanced Alzheimer's. She has been bedridden for years. She must be force fed, have her diapers changed, and put back to bed. Her situation is everyone's worst end-of-life nightmare.

If you think she wouldn't have chosen "voluntary" euthanasia so she could control her final days, you are wrong.

We spend way too much time trying to keep people with no quality of life alive. What is the point of her life now? She just lies in bed waiting to die.

We need to move the conversation from "live as long as possible" to "live with as much quality of life for as long as possible." Only you can deicde when your quality of life is gone, but you should have more say in it.
Magnes Welsh

Chicago, IL

#23 Aug 5, 2009
The Chrysalis Room is an important step forward for the dying and their families in this time of multi-person accommodations in nursing homes and hospitals. The privacy and thoughtful accommodations so honor this sacred time of transitioning from this life. Having been in a Chrysalis Room the night before Loretta's mother died, I worked to create a similar environment, without the benefit of a Chrysalis Room, for my father when he was dying in a private room of a hospital in Tennessee a year later. He had lived his last few months in a excellent assisted living home, but they aren't set up for the end of a person's life.
Jack Stephens

Worcester, MA

#24 Aug 5, 2009
A death and dying course should be mandatory for all college students. Make it a part of health care reform. Lets start the conversation about end of life care, now!
**********
Lincoln Park ER Doc wrote:
Finally, some one actually wrote an article in plain English about wasted health care dollars and how to fix the problem and placed the blame right where it belongs: the american public.
Many people want things that they cannot afford that would actually improve their lives and we have no trouble denying them; why do we insist that is is their right to have a wasteful and expensive death that they cannot and have no intension of paying for?
And this does not imply not caringe for the terminally ill; you simply do things that make sense for their comfort and do not pretend that they are not going to die. Doctors should not be engaged in encouraging death, but comforting the patient and family as nature takes it course.
Do not resuscitate does not mean Do not treat.
If we could change this culture, curb the malpractice crisis ( which wildly inflates costs of care), curb insurance abuse ( such as denying patients with pre-exiting conditions and allowing the insurance compaines to cherry pick healthy inexpensive patients), and place some limits on irresponsible behavior by the public, we could go along way toward solving the crisis without spending more money.
Mich

Chicago, IL

#25 Aug 5, 2009
Wayne_IL wrote:
If your grandfather was beyond the ability to make medical decisions, and his wife had medical power of attorney, she would have the legal ability to rescind his DNR. If that was not the case, then the medical facility seems to have acted if not illegally, but at the very least un-ethically, but every situation is clearly unique.
<quoted text>
My grandfather had all his mental faculties to the very last day. My grandfather was a highly-regarded man in his region and I think his doctors really thought their duty was to do everything for this "great man"; even though he didn't want it.
But unfortunately the situation isn't unique from what I've been reading on the boards.
Also, the concept of being no longer medically able to make decisions, that is the supposed to be the whole point of an early DNR; while one has their faculties one makes decisions about the end of life. If the minute you slip into a coma you get declared "unable to make decisions" and they can swoop in and keep you alive on the natural plea from a loved one to keep you alive; that defeats the whole purpose of planning.
Mark in Chicago

United States

#26 Aug 5, 2009
George From Outerspace wrote:
Is this the preparation for RATIONING??. Start with the old and infirm first.
But of course make all the money available for the illegal and welfare crowd FIRST.
This is the kind of post Obama wants to know about.
The Right wing hate must end.

It is your patriotic duty to forward information about these radicals to the White House.
Don’t hesitate to use this tool, given to us by Obama, against the radical right.
Please include all pertinent information. Who, what, when, web sights, personal/ overheard conversations etc., so that the database of these threats to our National Security can be through and accurate.
CHANGE is here!

“There is a lot of disinformation about health insurance reform out there, spanning from control of personal finances to end of life care. These rumors often travel just below the surface via chain emails or through casual conversation. Since we can’t keep track of all of them here at the White House, we’re asking for your help. If you get an email or see something on the web about health insurance reform that seems fishy, send it to flag@whitehouse.gov.”

http://www.whitehouse.gov/blog/Facts-Are-Stub...
mrbobb

Chicago, IL

#27 Aug 5, 2009
John wrote:
If we are not sure if Obama is legally President, why talk about health care? Republicans are fact based. We just want to see a birth certificate. Otherwise, this talk about health care might as well stop.
Sore loser. We aren't going to let you hijack the discussion. Obama will accomplish more in 8 months than Bush did in 8 years, and he is starting in the hole Bush dug us into.
The article could also have mentioned palliative care, which focusses on quality of life above all. http://www.getpalliativecare.org/
Health care improvement can save money and improve quality at the same time.
Travis

Brooklyn, NY

#28 Aug 5, 2009
You made some great points. Sounds reasonable to the healthy person. But an unacceptable theory when it comes to one/or one's family when that person is sick/near death.
That's just the ways it it. So until such time lets seek to overhaul the system so that we can get as much real health care as possilbe. That's just common sense. Legislation without a public option fails to provide a solution.
whatever

Chicago, IL

#29 Aug 5, 2009
Jack wrote:
I think this shows...let them die. We waste so much money on health care and welfare, why not use that money on the people best able to contribute to society? But elderly and minorities are voting blocks, so we'll continue to bribe them with handouts for their votes.
When talking about welfare get your facts straight it's not minorities that is on welfare! GO D**
whatever

Chicago, IL

#30 Aug 5, 2009
mrbobb wrote:
<quoted text>
Sore loser. We aren't going to let you hijack the discussion. Obama will accomplish more in 8 months than Bush did in 8 years, and he is starting in the hole Bush dug us into.
The article could also have mentioned palliative care, which focusses on quality of life above all. http://www.getpalliativecare.org/
Health care improvement can save money and improve quality at the same time.
Agreed Bush was the worst President ever!
Been There

Concord, CA

#31 Aug 5, 2009
When my mother had her last heart attack my brother wanted the surgeon to re-do her 14 year old bypass. He was looking for quantity not quality, thankfully the heath care POA named me the POA and I listened to her wishes and let her slip away as she wanted. It's hard to let go but it was what she wanted.
Gina L

Chicago, IL

#32 Aug 5, 2009
The POTUS should convene a panel consisting of reps from the AMA (doctors) and insurance companies. A protocol should be developed for patients (whatever their age) who are dying.

Anyone who has health insurance, whether it be through Medicare, their employer or another private or government plan should be required to sign a "living will" document which lists instructions to follow in case of imminent death. People could choose to have no extraordinary life saving measures or all life saving measures.

This would end confusion over what the patient wants. It would end fights between doctors and families. And it might help drive down costs.

Most important, it would ensure the patient's final wishes are carried out.
W-T-F

Highland Park, IL

#33 Aug 5, 2009
Mark in Chicago wrote:
<quoted text>

Add your hateful descent at your own peril.
Gladly,since when you run the Death Squads you will probably get a neighbor with a same sounding name, not me, seeing how proofreading/spelling is not one of your Gestapo strengths.

How's that for dissent !!!
Aaron

Glenview, IL

#34 Aug 5, 2009
This is a good article. If someone is terminally ill why are we prolonging their life in a hospital. That is a waste - and if it were me it would be an unwanted waste.

Since: Apr 09

Chicago

#35 Aug 5, 2009
As a social worker who has worked almost 2 decades in health care, I saw it over and over again that patients and their loved ones felt so unprepared to make these tough decisions about care when a situation was becoming terminal. Out of frustration, I wrote a book about it to guide families to work with their care team so that everyone is on the same page about the goals for treatment.

Other countries don't do what we do and I have to wonder who is being the more compassionate. It's one thing to prolong life; it's quite another to prolong the dying process.
James Cappleman, LCSW
Clark Kent

Skokie, IL

#36 Aug 5, 2009
Gina L wrote:
The POTUS should convene a panel consisting of reps from the AMA (doctors) and insurance companies. A protocol should be developed for patients (whatever their age) who are dying.
Anyone who has health insurance, whether it be through Medicare, their employer or another private or government plan should be required to sign a "living will" document which lists instructions to follow in case of imminent death. People could choose to have no extraordinary life saving measures or all life saving measures.
This would end confusion over what the patient wants. It would end fights between doctors and families. And it might help drive down costs.
Most important, it would ensure the patient's final wishes are carried out.
NOT THE JOB OF THE FED! What a foolish idea!

The people who want government to control their lives are really starting to make me sick! Go to Cuba or China!
Jack Stephens

Worcester, MA

#37 Aug 5, 2009
Hope you were/are against the Federal Marriage Amendment, otherwise you're a hypocrite!
**********
Clark Kent wrote:
<quoted text>
NOT THE JOB OF THE FED! What a foolish idea!
The people who want government to control their lives are really starting to make me sick! Go to Cuba or China!
Kate

Chicago, IL

#38 Aug 5, 2009
Fabulous article.

One can show their greatest respect and love for ill family members by abiding by their wishes.

While still healthy, speak with them in DETAIL to understand their wishes. When terminal illness strikes, respect and abide by those wishes.

Focus on those who are dying, not those who remain. To not follow a terminally ill patient's wishes shows no respect for them or their lives.

Since: Nov 07

Buffalo Grove, IL

#39 Aug 5, 2009
As long as it is the choice of the patient, let them choose how they want to go. My grandfather just wanted to go home. He lasted 16 hours in hospice after six weeks in ICU.

But if you want to go out fighting and put up with all the tubes and needles, that should be the patient's choice as well.

Since: Nov 07

Buffalo Grove, IL

#40 Aug 5, 2009
Mark in Chicago wrote:
<quoted text>
This is the kind of post Obama wants to know about.
The Right wing hate must end.
It is your patriotic duty to forward information about these radicals to the White House.
Don’t hesitate to use this tool, given to us by Obama, against the radical right.
Please include all pertinent information. Who, what, when, web sights, personal/ overheard conversations etc., so that the database of these threats to our National Security can be through and accurate.
CHANGE is here!
“There is a lot of disinformation about health insurance reform out there, spanning from control of personal finances to end of life care. These rumors often travel just below the surface via chain emails or through casual conversation. Since we can’t keep track of all of them here at the White House, we’re asking for your help. If you get an email or see something on the web about health insurance reform that seems fishy, send it to flag@whitehouse.gov.”
http://www.whitehouse.gov/blog/Facts-Are-Stub...
Wow. The new Gestapo is forming after less than 8 months in office. And I thought those right-wingers were just paranoid. I can't wait to see how the Obama administration tries to stifle dissent.
jan

United States

#41 Aug 5, 2009
Good, sensitive article. Twenty years ago my dad died, at home in his own bed, the way he wanted. He wasn't afraid of death or in a state of denial about his mortality. He just didn't want to hooked up to a lot of tubes in a strange hospital bed at the end of a long, healthy life that he had enjoyed.

I took care of him those last years, so that he could end his life the way he wanted. Afterwards, my siblings wondered about my real motivation. Fortunately, dad had made it clear for years that he didn't like doctors and wanted to die at home in his own bed.

Here's my good advice: Think about your death now. Decide where you want to die, at home, hospice or hospital. Put your wishes in a living will, and tell those around you where that document is and what it says. Make a written will/trust so that you don't leave a legal mess after you're gone. And most of all, don't be morbid. Be sensible about your own death. It's not as if you're immortal. And don't worry, you will be loved and remembered fondly.

If you don't plan ahead, you are vulnerable to scams and silly debates about euthanasia. Be smart.

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