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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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It has been said many people 70 + with multiple medical conditions could live 20 years longer by taking 20 medications a day.
I believe in not denying medical care, life is in most cases worth living, prolonging suffering is not, hence medical assistance in dying as individual choice, for those who are able to choose without anybody’s influence. Only sick person and 2 independent doctors can decide. That should never change.
No, to answer your question about expanding on allowing families to make the choice to end their parents lives.
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Abzu00 Jul 2023
I would agree, but don't families already do this when they turn down treatment options for their parents? Why draw the line at that point? Not everyone's situation is the same but why allow for a slow and grueling process of letting the body slowly shut off verse hastening the process to end the suffering instead of mitigating the pain with Morphin.

I am not saying it should be done without oversight. Like cases where a family waits to long to put their LO in a facility and their LO is kicking and screaming day in and day out. Only way for them to at peace is drugging them up.

What kind of life is that? What kind of life does the elderly gent have that family no longer sees him and all he does is either stare at a wall or watch TV for 18 hours a day.

These cases are common and we are essentially prolonging their suffering because we have this thing about ending one's suffering. Just seems like a weird double standard to a degree. I cannot tell you how many times I have been told, do what you must they will most likely not remember.

Or you have POA do as you feel is best. Yet if I wanted to end my mother's suffering my only real option is to let it runs its course and watch her suffer.

I do feel with proper oversight it could be established if a person's currently quality of life is considered one that is worth persevering / living especially if we hold it to what people would consider a reasonable standard of living.
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It has baffled me how aspects of healthcare have became a for profit venture.

I have learned a lot from this thread, I did not know that was the intent of AL, wonder when did it shift from that concept. I have also become far less hopeful for the future. Money seems far too deeply rooted in our healthcare system to change anything.

It is also interesting how this mindset trickles down into aspects of the wealth gap. It is interesting to see how Inherentiece was a means to build generational wealth. Though with rising healthcare costs Inherentiece is a concept left only to those who are already wealthy making it harder on poorer families to do better then the previous generation.

Not sure if I agree with the concept of parents should leave something behind for kids, or each generation inherently should be better then the last. Still an interesting concepts and take the situation.

I have no idea how to prevent the ship from taking on water, it seems all the powers at be only care about the short term and once this venture dries up they will move onto the next.

I will make one suggestion, maybe it is time to get rid of insurance. If insurance no longer existed prices would have to fall down to sensible rates cause if no one can afford treatments they can no longer make their profits.

LIke I wish I had the ability to charge 300k for my work because I know insurance will pay for it. I think insurance has added to the inflation to medical treatment. Also think we should not allow credit to used for medical treatment. A payment plan could be established with the care provider but it should be a zero interest payment plan.

We should have sensible pricing for treatment.
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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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Atul Gawande's book Being Mortal

https://www.agingcare.com/products/being-mortal-medicine-and-what-matters-in-the-end-433866.htm

is a decade old now but still very relevant, if you haven't read it your library probably has a copy.
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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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My parents were very diligent about saving for their future. However, due to an accident my mother has needed care, initially from just my father, then with the aid of caregivers and now in a nursing home. My father died, but their savings, well over $1 million has been spent on my mother's care. This doesn't include medical bills as since my father died, she has needed very little medical care as she is bed ridden and has requested no treatment. But she survives with medication and extensive hands-on care. She is almost a husk of a person, unable to do anything on her own, often in paid and alone.

Even with all of that, she will outlive her money and go onto Medicaid. The cost of care is astronomical, but there are no other options. We will not be able to sustain this, but no one wants to make the hard decision to do something different.
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ElizabethAR37 Jul 2023
Perish forbid that I should end up in that situation--bedridden, totally dependent, in pain and alone. Personally, my worst nightmare! It also seems completely counterproductive to see $1 million vaporized on care which appears to be prolonging "existence" rather than life, with Medicaid in the future. I have specific written instructions in my healthcare directive covering what I do NOT want at EOL. I can only hope that they will be followed proactively.
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Besides his 401K at work , my 33 year old son has separately invested in a company that is building assisted living facilities . He’s assuming despite paying into social security, there will be no social security left for him . He says he hopes to get his social security contribution money back this way by investing in the care of baby boomers I find this an interesting take.
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ElizabethAR37 Jul 2023
I agree--interesting take. I don't think S/S will completely disappear, but he's hedging his bets. Older adults/residents-to-be should hope that the company he's investing in plans to operate quality facilities at somewhat affordable prices with a reasonable return on investment. If it's strictly bottom-line oriented, though, that's a HUGE if.
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Thanks for the info--there certainly can be a difference between simply building a senior facility and operating it. My message would apply more to the operator, which may yet to be determined.
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