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?
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.
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).
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.
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.
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.
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.
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 😏
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.
https://www.npr.org/sections/health-shots/2023/07/18/1188058399/hospital-at-home-caregivers-family-stress
Caregiving for the elderly as we do it now is unsustainable. Most elderly people if they live long enough will end up on Medicaid unless they are wealthy or have very good LTC insurance which can also bankrupt a person.
If the obscene and heinous greed were removed from the healthcare, decent care for all people (not just the elderly) could be realized.
The first huge mistake is healthcare became an industry. It's not supposed to be an industry. It's supposed to be a service. Like the U.S. Mail, police departments, and public schools. A service that answers to the federal government and is regulated by them. Medicare should be telling drug companies how much they can sell their medicines for in the United States. Not drug companies telling Medicare what they're going to be paying.
Hospitals, rehabs, memory care facilities, etc... are not supposed to be run my shareholders and investment groups. Yet they are.
Homecare agencies can afford to pay their employees a decent wage because they bring in enough from that employee's labor to do so.
When it comes to labor I was always a believer in you get what you pay for. Fair pay for fair work. It's simple. I do it every day.
As for the "village" not being able to sustain it. It can't because the shareholders and investment groups that own the care industry usually end up owning the entire village because a poorly insured person got sick or an elder needed to go into managed care.
So what follows is no one inherits from their elderly parents and they get ahead. Then their children do, and generationally lives improve like they did in the past. Each generation is better off than the one before them. That is what's supposed to happen, but it doesn't anymore.
That needs to come back because if it doesn't then there will be only two classes of people. Rich and dirt poor. There will be no middle class in between.
I know not everyone agrees , but Imo retirement savings is for taking care of you when you are old. If there is any left after you die to pass on , that’s a bonus. Why should Medicaid ( taxes we pay ) pay for a rich person’s nursing home bill ? This is part of the problem .
Meanwhile our taxes will keep going up, as we all are the ones funding Medicaid , making it difficult for people who are not rich to save money or get ahead . Those families will get poorer each generation.
Last year , my husband took my FIL to get POA and the lawyer convinced my FIL to have her draw up papers for a trust fund “ so the nursing home doesn’t take your money “ is what she told him. She charged $6000 for that to be drawn up. I thought it was very unethical due to his advanced age . I wonder how many lawyers do this for people who obviously don’t have 5 more years to live .
Putting money in a trust is subject to the 5 year look back. Even if he lives 5 more years , he will be in a nursing home long before the 5 year look back period would end. And he will die before he could apply for Medicaid or run out of money .
It was a waste of $6,000. My DH never went to the bank to finish setting up the trust . There is no point . So FIL still only has a will and no trust set up .
In in our case, the interventions were done largely to prolong mom and dad’s ability to continue to live on their own, vs the not-very-nice AL they could afford for a few years before being sent to the Medicaid facility. In-home care does not always solve the problem of aging in place.
Not sure how we begin to shift resources away from medical to elder care. How neat that would be if all the elders suddenly had the resources for a NICE AL or nursing home, and aides and nursing staff were paid really well and not overworked, and cooks in the facility were paid a true living wage, and on and on. Right now elder care is the latest money funnel scheme for investors.
I suspect, actually, that many of the health problems might go away if you took away the stress of worrying about the future.
I was just being snarky.
Obviously by 86 health issues are a real possibility, regardless of the care anyone took. What you, and many people do not understand, is that it is not just living a long life; it's the QUALITY of that life from the time you are born for the next several decades AND the fact that you may not have lived that long otherwise that is so important.
A significant percentage of those 85+ are likely to face a period of declining health, loss of ability, increasing dependency and financial uncertainty. Our system is not set up to deal with large numbers of people in that situation over the long term. Elder care should not be a "profit center" for hedge fund billionaires but currently--and unfortunately--it often is.
Facts are simple the United States government is massively in debt, and what programs do you think they will cut when they are crying poor? Entitlements and social services this is just the way things will play out. What we are doing is not sustainable, but no good alterative has ever been presented, and I doubt one ever will. This is a situation that has no good answer, and just like many of us are told regarding caring for our loved ones, sometimes it is not a choice between good or bad, but a choice of the least bad.
Best any of us can do in this moment right now moving forward is make sure you do what you can to not leave your families and loved ones with a burden when you get older.
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.
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,
NO ONE has to have any medical care they don't want! That exists now. They can get an infection, opt-out on antibiotics and call in hospice. THAT EXISTS NOW! We had a relative who did this 15 years ago.
You are proposing something different, no?
I'll be back to see your answer tomorrow.
Why prolong the suffering for years to come. I am not saying it should be an option for people that have a quality of life, more so for people that really have nothing going on?
LIke one resident at my mom's care facility has no family that comes to see them all they do is stare at their wall for the entire day.
Seems cruel does it not? Another person can no longer look at mirrors because their appearance frightens them to the point where they will try to attack the reflection.
What I am saying is why is the slow process okay for people but the quicker one is taboo to talk about?
I also think people should be educated on their right to die and what it entails. It should be a conversation to have like any other when one gets older.
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.
As an example I know what my mother wants, and I cannot give that to her. So does that mean she should spend the next 20 to 30 years in a holding cell as someone put it?
In the future see it as a strong possibility that either families will be forced to provide care for their LO, or real hard talks will have to happen cause no way this cost can be sustained.
There's still predictions (prophecies) yet to come. Everything's lining up in perfect order. I don't think you'll need to worry about death with dignity Abzu. Get a bible. Read the book of Revelation. The same ending is mirrored in the book of Daniel for the Jewish people. Ask God if it's true. Ask God if He's real. He said "Anyone who searches for Me with all of their heart will find Me." I pray for you to search and find because these solutions to snuff out our seniors earlier than God intends are, as another poster wrote, "abhorent!"
I do not think you're a bad person. Just misguided in your present thinking.
I'll pray for your enlightenment. I'm believing that prayer will be answered.
I'll close my soapbox now and bid you all a pleasant day.
"Takes a village" is an African proverb that means the village as community, not just those with professional specialties.
With that being said do you not everyone involved in caring for your LO people? Are they just hired hands nothing more nothing less?
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.
Reality is he was unhappy and it was his time to go. Doctors saving him would have meant more years of suffering. Doctors cannot work magic they are also only human.
Each person born is a child of God and God decides when it's time for each life to end. Period.
If you are going to assert that god decides when it is time for each life to end one has to wonder why some endings are more barbaric than others. For example a child that is beaten to death. A woman raped and murdered. Someone with cancer that causes them excruciating pain for months on end. Starvation. And the list of horrible and terrible ways to exit this life can go on and on.
Faith is just as much a theory as evolution is.
But this isn't the place to spout and argue religious semantics because it has nothing to do with the purpose of this forum and it will be my only comment on this topic.
And that's why everyone should take a stand against abuse in all forms. I will totally agree though that many people do not even know they are being abused! Sometimes by their family and "friends"!
That's not a village at all. Those are service providers with professional specialties. "A village" is where everyone, or nearly everyone, in a village is giving their time and efforts to help someone. A village is not just professionals.
The economy can revolve around health care and I agree it's getting worse really fast. The solution for me is to stay healthy by engaging in healthy practices. Like for example, I walk an hour a day. I do not smoke or drink alcohol. I try to eat healthy. Just those 4 things done or not done, smoking and drinking, account for like 80% or more of the total healthcare costs. It's an individual responsibility. Not one to be be mandated by others who think they know better.
No one is arguing preventive care is important, but let us be fair that can only go so far. My mother was not overweight, never drank nor smoked. Did not have high blood pressure, heart disease, diabetes. She worked out regularly.
For whatever reason she had a stroke, and now she is how she is. You can only do so much to prevent something from happening.
Sadly. the current political climate in the US at least will never allow it . I can’t speak for other countries.
Yes, because such thoughts are abhorrent.