Taking care of the Old Old

momj47August 7, 2005

Here's a link to a very interesting article in today's Washington Post about caring for the really old

Here is a link that might be useful: What are we going to do with Dad

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Excellent article. Great article. I've sent it to everyone I know.

Thank you.


    Bookmark   August 7, 2005 at 10:35AM
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Thanks so much for sharing the link to that article...I have now sent it on to my sisters and other family members.
I don't know if it will have the same effect on others who are not caring for their eldery parents, but it certainly hit a nerve with me.
Since I've been caring for mom who has Alzheimer's I've been watching her decline, as I am sure many others have done. I won't go into some of my own thoughts, but I will say that I can SO relate to the author's dream. I hope I don't offend anyone here; there are many on this site that are very religious people. I have certainly changed my way of thinking since mom moved in with me and I see the daily, and sometimes hourly struggles...

    Bookmark   August 7, 2005 at 11:55AM
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One thing that sticks out in that article is that the writer's father was taken into the hospital for congestive heart failure. They waged a battle for days to "save" his life. And now, the Old Old is having to live with the results of that battle. Congestive heart failure, pneumonia, kidney failure may be a merciful God's way of making the end easier for His child. I don't know, but I wonder.

    Bookmark   August 7, 2005 at 12:34PM
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I think this is where the issues of DNR come in to play...I hear what you are saying...how much is modern medicine really helping the old old?
My FIL became ill in January of this year, the flu (he was 89) and felt so lousy he stopped taking all his meds. He didn't tell anyone but his wife knew, she's 88 and was afraid to force him into doing anything and didn't tell us. One of the meds he was on was insulin...stopped that too. By day 5, he collapsed and that is when we found out he was sick. We rushed him to the ER and he spent 7 1/2 weeks in ICU and then a LTC facility, where he died after 3 days. During that time, he refused to eat, then he couldn't eat (lost the ability to swallow) and dementia set in. Before all this, he was relatively healthy and completely clear of mind. It was heartbreaking to watch him...all he wanted to do was die, but his wife fought to keep him alive. She finally agreed to sign a DNR after 7 weeks...just so very, very sad...

    Bookmark   August 7, 2005 at 2:29PM
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Yes, thank you very much for posting this. This is my Mother (rather than my Dad) except she is bedridden and (still at home). Personal care attendent 24/5 and 6 hours each Sat & Sun. She is 88, Dad is 92. They have just about exhausted a $1 mil inheritance taking care of her.

Has anyone read 'Final Exit'? Carolyn

    Bookmark   August 7, 2005 at 3:17PM
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We must remember that hospitals are in the business of healing and saving lives. They have an obligation to do as much as possible. Waaayyyy back when the DNR & Living Wills option first became popular, there was a move to have both declared illegal. The thought was that anyone that didn't want to live as long as possible, was insane and therefore could not sign such a request.

    Bookmark   August 7, 2005 at 6:08PM
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Oops!! I did it again. Logfrog is really Peabee in disguise. I had to put up my membership fee to get on some of the Forums so I just started up a new name while I was at it. I forgot to change it back to post here. I guess I could joke about how the mind is the first to go, but it's not as funny now as it was many, many, many years ago.

    Bookmark   August 7, 2005 at 6:14PM
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I just did some reading on the Final Exit website...quite interesting...thanks for the information...I will be purchasing the book...thanks again, Mimi

    Bookmark   August 8, 2005 at 10:04AM
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My late aunt (died in 12/04) was HORRIFIED by the prospect of nonstop medical "care". Shortly after her cancer diagnosis she spoke with me to ask me to be her medical POA. I agreed immediately. She then spoke to me at length about what she wanted... NO intervention. She was 84, had enjoyed a vigorous life and had decided to let the cancer run its course rather than, as she said, "try to milk out another year/two of pathetic exisitence". She died in Hospice, one week after entering it, 7 mos. after her diagnosis.

I think medical care is remarkable. But I DO NOT understand why we so routinely call out the cavalry to save someone who really might be better off dead. That's just my opinion. Mum has been quite candid about this. She faced the prospect of death from cancer 2 years ago. In the depths of a terrible depression she adamantly said, "NO BAG! I don't want to pee into a bag!".

Once, however, we got the depression under control and she began eating again, she decided life was sort of nice... she had the surgery and in general she's doing well. The stroke has made more work for me, but there's no guarantee she wouldn't have had one anyway.

Her stated wish is that she not be revived if her heart fails. She is not to kept alive on ventilators, etc.. Pneumonia is not to be treated. I have spoken to her (young and very hip) doctor about this... he is "on the same page"! But these are very tough issue that too many people and families don't ever discuss.

    Bookmark   August 8, 2005 at 12:02PM
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Chelone, I dearly hope that her (young and very hip) doctor is on duty if that time ever comes.

    Bookmark   August 8, 2005 at 12:29PM
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Chelone , I definitely agree with you and your mum .
Even though I am 'only' about 73 , I have a Living Will and hope it will be respected .

    Bookmark   August 8, 2005 at 1:55PM
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It's all about quality of life. I can't understand how anyone would choose to keep someone alive on a ventilator (assuming that person had left no instructions to the contrary), when there is no hope of recovery. Would any of us CHOOSE to be kept alive by artificial means? Surely not.

My mother got pneumonia towards the end, and I elected to treat it with antibiotics only because I wanted her to be comfortable and be able to breathe. It didn't matter anyhow; one day later, she suddenly took a turn for the worst. She remained conscious enough to see me when I got there. Then she slipped into semi-consciousness, could no longer swallow (thus no antibiotics), and she passed three days later.

I can't believe it's been nearly a year. I am taking a trip to Greece next month, the same week that she died. In a way, it's honoring her life because I know she would want me to continue on with mine. And if she were here, she'd say, "GO, DEAR. Have a good time."

I miss her so.

    Bookmark   August 8, 2005 at 8:47PM
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Yes, I truly believe in the 'quality of life' issue. My dear (departed) FIL developed pancreatic cancer just after his 80th b'day. He stated he did not want chemo, radiation, etc....he wanted to be able to enjoy what time he had left....and for one year he was able to do so...the last 4 months were not good and his stupid doctor 'didn't want to give him morphine so he wouldn't become addicted!'...I told my hubby to tell the idiot Dr. it didn't matter if he became addicted or not - the man was dying! Fortunately hubby's stepsister is a nurse and her hubby is also a Dr. Morphine was started in less than a week after she became involved.

We are facing the same "quality of life' issues with Mom...who has very advanced MS, cannot do anything for herself. Feb of 04 she was rushed to the hospital in acute respiratory, kidney and bladder failure. Although she has an advanced medical directive, it is my Dad and my sister who hold making those decisions.

She was put on a ventilator, and neither Dad or my sister would have it removed. Ten days later (and $80K later) she was sent home.

However, during that time we (Dad and all three children and their spouses) met and all agreed we would not do that again. She is now under hospice care, rather than home health care, and everyone (hopefully) is now on the same page.

Hubby and I both have agreed that we will not participate in 'advanced' medical care for ourselves when there is no hope of a quality life. Just because modern medicine can keep us alive doesn't mean we should actually be kept alive. Thus, the purchase of Final Exit.....


    Bookmark   August 8, 2005 at 9:41PM
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From the time I was a little girl, my mother was always very firm with me: "NO MACHINES!" So even if I any doubt in my mind (which I didn't) of what was the "right" thing to do when the time came, I knew what her wishes were. Of course, they had to ask me at the nursing home and the hospice nurse carefully explained that -- in the absence of a DNR -- if Mom went into arrest, they'd have to cut open her chest, jump start her heart, put her on a ventilator, and she would still have brain cancer. The vision was too horrible to contemplate.

    Bookmark   August 9, 2005 at 9:45AM
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I think that's one of the problems that we have with dealing with the situation. Few people are aware of what can AND WILL be done to extend life if the doctors and hospital staff are not instructed. My brother in law was kept alive for over eight weeks. His son kept insisting that the doctors "do something."

    Bookmark   August 9, 2005 at 10:04AM
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My parents made it very plain that they wanted no machines or medical intervention to extend their lives. I have no regrets that I honored their wishes. (A home care supervisor came to our home and tried to force me to go against Dad's request that no feeding tubes be inserted. I had several extremely rough days over that, but I'm grateful I respected Dad's wishes.)

    Bookmark   August 9, 2005 at 10:57AM
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I also am so glad that we honored Mom's wishes....now that we look back we know Mom knew something was going on with her....a year before the doctors said she had alz. Mom went to a nephew that is a lawyer and had her living will done....my Mom did this for us...she always said please don't do anything to keep me alive. I remember the look in my Mom's eyes trying to feed her and she would cough...the last time we tried I saw the pain...when the hospice nurse told us it was time to stop I remember the feeling of...how can I ever eat knowing that she can't...you do go on and you pray,cry and watch this person you love so much leave you....hospice told us that after a few days Mom would no longer be hungry..the natural things happen in the body....I wounld hold on to that....it took 14 days to see my sweet Mom leave her earthly body....so painful for all her loved ones to watch....but Mom was ready to go home and rest with her Lord....I would whisper to her how much I loved her and that we would all be o.k. and I would take care of Daddy....and for her to go and be with Jesus. I miss my Mom so very much but and have looked back over and over again and the one thing I know is that....we loved her...gave her all the care we could and we honored her wishes to go Home!!!! It is so painful to go thur but I realized it was not about "Me"....it was all about "Mom" and her journey Home....God is faithful!!! Nora

    Bookmark   August 10, 2005 at 8:29AM
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my father was only 78, but we joked that he had 300,000 miles on his chassis.

chronic obstructive pulmonary disease
a weak spot on his aorta that could blow any day
a leak in one of the valves they replaced 10 years ago
diabetic, taboot.

the 'crisis' was a gall bladder dead and swollen to the size of a beer can.

that was the end of april.

ICU. PCU. Ventilator-capable rehab faciltity.

13 doctors. 3 social workers. 27 fruit baskets. 7 separate forms that my mother had to fill out to authorize the staff to provide me with information. Two shouting matches with nurses who couldn't find one of those seven separate forms.

sepsis. oedema. dialysis.

finally, one angel with red hair got through to my mother what I'd been saying for six weeks- that the doctors would pull dad back from the brink of death until the money ran out or she made them stop...but leaving dad in a bed too weak to work the remote control while his skin degraded before our eyes was no kindess.

and never in my life have I been more proud of, or close to my parents than when I stood by while my mother asked 'can you forgive me for letting you go?' and my father mouthed back 'can you forgive me for going?'

dad's last request was 'don't let mom watch'

but my husband, an old friend, and I took mom home, grabbed the tallis that dad have been Bar Mitzvah'd in, came back, and sat with him through one last sunset. then the two of them gathered me up, and took me to where friends were waiting to catch me when I fell.

one of them asked me how I felt.

the only word I could think of was Exalted. I had lived up to my parent's greatest need.

I'm taking this week and next off...and then I'm going back, to thank the angels and the people who really worked hard to try and help us all...

and if god is merciful, he'll hide the callous, and the stupid, and the obtuse from me. but if he's just- I'll find them, and I don't think they're going to like it much.

    Bookmark   August 12, 2005 at 1:48PM
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You realize you're a "grown up" when you've watched a parent die. You "get" then"news", but when you watch the life drain out of a parent you have a visceral understanding of the continuity of life. Perhaps it's because I've never borne life, that the ending of one has been such a seminal point in my own existence... but seeing a life end is no less or more important than giving life to the next generation.

I saw my father die. It was horrible and frightening. But it was also a great relief. He NEEDED to be dead. I was dumbstruck, RELIEVED, and left wondering what to do next. !

But most of all, I was RELIEVED!

    Bookmark   August 12, 2005 at 9:53PM
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