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Was having some morbid thoughts today and got me wondering. Is our current method of caring for the elderly sustainable. People are living longer but unfortunately that does not necessarily mean healthier. Finding care workers willing to do this type of work is difficult at the best of times, and with the salaries they are offer do not do well to help.



People are not saving properly or simply out living their savings. Which means the bill is left to the states, especially in cases where children let their parents become wards of the state.



This probably can go on like this forever, does anyone else feel like it is time we explored death with dignity acts, and expand on allowing families to make the choice to end their parents suffering early?



I was talking to a social worker about this and what they told me is generally what families do is stop treating issues in hopes they die quicker. If this is the mindset people have wouldn't it be easier just to allow families to opt in to ending their lives.



I am in support groups and a common topic that brings up is people wishing / wanting their family member to just die. One of the supports / organizer of the support group liked to say that for one person with dementia to live carefree, it took a village to maintain that.



Are we getting to the point where the village can not really sustain this?

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I think we keep people alive long after their 'expiration' dates. I do not mean that in an unkind way--we simply have the ability nowadays to treat so many things that used to end people's lives 'naturally'. My daddy's last 2 years with Parkinson's was a horrible kind of hell for all of us. He BEGGED me over and over to OD him--

I'm all for meds that keep hearts healthy and bodies functioning. As long as the mind is 'well' and the person is able to make decisions, then they call the shots.

I think when FAMILY steps in and wants to artificially keep someone going, long past the time when they themselves would have wanted to die.

"Sustainable' can mean a LOT of things.

My MIL is being kept at home '100% sustained' by the efforts of her 3 Sr citizen children and by extension, all their spouses and families. She does not realize the toll this is taking on her kids. And she certainly cannot see past her own nose to see that her needs and wants are met within hours of wanting/needing something, and how very lucky she is that her kids are so ridiculously invested in keeping her 'happy.

She's in Hospice care, and the kids are doing such a superb job, she's probably going to live another year.

She goes nowhere. She does nothing. Can't carry on a conversation, can't read a book and make sense of it. Can't watch a movie and follow the plot. Cannot even tell you what day it is, nor read a clock and make sense of what it means. Can't bath or toilet herself without help. Eats about 400 calories a day. Shuffles along with a walker and sleeps 18 hrs a day. Has no short term memory whatsoever. The kids take 24/7 shifts in order to keep her 'home'.

She can only talk about what went on 30+ years ago. She's firmly stuck in the 80's.

THIS kind of care is sustainable as long as all 3 legs of the stool are intact. It's getting wobbly...

It's also coming at a HUGE price to her extended family. What was initially thought to be a month, at the MOST has now extended to 5+ months and will almost undoubtedly go on for many more months.

She's off all her meds, except the tranquilizers, b/c she 'rages' at times and they need to keep her at a level calm.

Yes, her body is shutting down. She wants to die. But it will happen at a snail's pace.

I have my own thoughts about Dr assisted suicide and will keep them to myself. But when I am at a place where all I am doing is making CO2 out of oxygen--gee, I hope I don't linger like this.

It is, in fact taking a small village to keep this one sad, angry woman alive and happy. The rest of us are miserable.

I'm not even going to touch on the costs of medical care for someone like this. She's NOT in a facility, so it's all 'emotional cost'.

I'd prefer FINANCIAL cost over this. We all would. (The family).
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Hothouseflower Jul 2023
Well said. Reflects my sentiments exactly.
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I think physician assisted suicide should be made available for those who desire it. My body my choice.
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NeedHelpWithMom Jul 2023
Yes!
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What I feel is unsustainable is the way we wring profits out of every aspect of healthcare, every step of the way is owned by multinationals whose sole purpose is to maximize the return for shareholders - altruism is dead.

Assisted living was a concept that began as a way for people to pool resources so that they could have a quality life, look at the monster it has become.

Medical devises were one of my pet peeves when I was caregiving - Does a wheelchair really need to cost as much as a car? Why is it I can buy a hydraulic lift for a car at a fraction of the cost to buy a lift capable of raising a wheelchair a few feet? Those $500 hearing aids you can buy are using tech that was state of the art a decade ago but if you want the service of an audiologist you have to to shell out 10X that amount for HA's that they won't even fix if they are over 5 years old.

And we ourselves as consumers have to bear a lot of the blame, we've become much too accustomed to a lifestyle that minimized the need to compromise or do without, too many of us want only the best and we expect it RIGHT NOW, everything from the latest medical procedure to just b****ing about the food or care in facilities (and I'm not talking about bad food or neglectful practices)

Sorry, getting off my soapbox now 😏
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True. We have a good financial advisor, but he's not psychic. No one could have predicted the timing of COVID-19, what happened to supply lines, serious workforce shortages and inflation--at least not to the extent they have occurred. Many older people saved a percentage of what they were earning plus perhaps 2-3% inflation. It wasn't enough, but who knew then? And who anticipated that they would live as long as they have? The premiums for long-term care insurance have skyrocketed, so even elders who wisely bought policies may now be priced out just when they need it. Even professional actuaries underestimated longevity and the cost of care.
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WOW..kinda don't get me started on some of these topics.
People do not save. The mindset now is Social Security will be my retirement income. Social Security was NEVER intended to be the sole source of retirement income.

Now the add onto that is
Some parents EXPECT their children to support them
Some children support their parents to the detriment of their retirement savings.

Another "problem" is doctors that want to test, test, treat, treat and fail to accept that there is no cure, there is not going to be a quality of life yet they treat, treat and test some more.
My logic is If there is no point in curing why test or treat? (I am talking someone with Dementia being subjected to a colonoscopy or other testing that may result in a diagnosis that will require either more testing or extreme treatment.

There is nothing wrong with death. We are kinda all going that route. It is another "fact of Life" that no one wants to talk about. (sorta like the sex talk that no one wants to give or get)

I remember sitting next to my Husband the last week of his life and I was holding his hand and talking to him (he was not aware at this point) and I said I was going to miss him and I was crying and it suddenly dawned on me that I was crying what I called "selfish tears". I say selfish because for me to want him to continue to exist the way he was was not fair to him. He would not have wanted to live the last even 2 or 3 years the way he did if he had had anything to say about it.

Abzu00 your thoughts are not morbid. They are valid and insightful
Sounds like you have a good Support Group
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Geaton777 Jul 2023
True, many people don't save at all or enough, but those who did diligently and sacrificially save are reaching retirement now and having their savings outstripped by the rising costs of just about everything. I bet few financial advisors anticipated this rate of increase when doing the planning back then.
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I absolutely believe in death with dignity. So did my parents.

My mother certainly didn’t want to live to be 95 years old with Parkinson’s disease and dementia. I cared for her and it was horrific for me to watch her decline.

My father died when he was 85. He had heart disease and a stroke. I cared for my dad too.

My parents were tired of living after losing their quality of life. I don’t blame them one bit.

I truly hope that I don’t live as long as my mother did if my health starts going downhill.
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Abzu00 Jul 2023
Likewise, I have pediatric MS, and I hope my go long before I become a burden to my family.
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I don’t think Medicare should be paying for pacemakers for 94 year olds as it did in my mother’s case. The hospital
bill was $319,000, my mother owed $200.

My father overrode her DNR last year and insisted she get it. My sisters and I felt she had no quality of life. She had mobility issues, arthritis, was in pain because she could not get decent pain meds for her arthritis. We thought it was her time.

That $319,000 would have been better spent providing her with 24/7 care. Now we are left with a woman who complains every single day that she is still here.

Instead, the cardiologist and hospital made money off of the government. My mothers money is dwindling now and she will probably outlive it.
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Basictakes99 Jul 2023
This is a good point, if the money that insurances paid out for life prolonging treatments just went into paying for homecare for families this may be a different conversation. The fact insurance is willing to pay a facility as much as they do to provide care, but deny families home care coverage because it "costs too much" is beyond me.

Currently got my wife to get get mother on Medicaid and the amount of hoops you have to go through to get home care funded is insane, but if we drop her off the hospital and say we will not take her home, they are willing to fund stays like that.

The system at the core is broken,
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I consider many of the treatments and operations doctors and surgeons do on old people in poor health to be abuse. Prolonging death is not natural. It's called futile care. And I'm against it across the board.

I believe that Italy did the right thing, for example, during COVID when they prioritized younger people over older people to get ventilators. But that wouldn't fly here in the U.S. among the Silent Generation and their Baby Boomer children who would cry "ageism". And the politicians, most of whom are themselves beyond long in the tooth, have no incentive to lead any overhaul.

I believe the entire system - from birth to death - needs an overhaul. But I've seen too much, know too much, am too realistic about how much money drives things in this country to believe that an overhaul will happen. Rather, I think it will just continue to implode.
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Hothouseflower Jul 2023
I think you are right.
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Because of the moral/spiritual component and the vulnerability for having something like this abused... this should be something set up in advance by each person, similar to a Advance Healthcare Directive: ie, others don't get to decide to take this route for someone else, but each person can choose it for themselves in when they are in their right minds and when certain conditions are in play.
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Abzu00 Jul 2023
I agree, hopefully in the future death is not such a scary topic to engage with. Though I do think at a certain point things may get to the point where funds will not be present to allow people to "live" the way they want at the expense of others be it family or tax payers.

I think we are getting close to the point where we may have to put our foot down with care expectations and what is covered going forward. Was looking at what the facility bills, granted they do not get the full amount but it is crazy how much medcaid pays.
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In a word, yes, it may be time. I think many middle-income older adults (I speak primarily for those of "The Silent Generation", of which I am a member) did try to plan and provide for their old age, but at least in some cases their plan has been derailed by unexpected longevity and the cost of long-term care. Neither my husband (93) nor I (86) ever anticipated reaching our respective ages--but here we are. Even when older people have savings, at today's care rates of $10,000+/month (in our area), they are likely to be exhausted within 2-5 years.

I do not believe that the current system is sustainable. There really is no established "village" to support it. Unfortunately, I do not have a comprehensive solution. Personally, I am a strong advocate for mentally competent individuals having agency over their own end-of-life choices. I also think that older people should be able to designate in advance, in writing, what they want done/NOT done if they develop dementia or other life-destroying medical conditions.

Prolonging the existence of very old, very ill, very frail, very dependent people who have NO quality of life and have outlived their resources just seems totally unsustainable and untenable--to me. There is no "cure" for old-old age and a worn-out, failing body. Why continue to test/treat/test some more? My healthcare directive calls for no heroic measures and specifies in detail what I consider these to be. I also have a POLST and a personal letter. I have tried to do what I can NOT to become an ongoing problem to our adult children.

I fully recognize that some will disagree. That's entirely O.K. End-of-life is--and should be--purely an individual decision. In an ideal situation (which is rarely the case in today's world) it would be made in conjunction with a knowledgeable and caring healthcare team, other appropriate professionals, and a fully informed and understanding family.
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