Getting Started

Lets just get rolling right off the bat. Today's subject is the prolonging of death.

I am going to tell you some of the things EVERYONE should know.
If you or your loved one is age 70 or greater, and you arrest(die) in or out of the hospital your(or their)chances of ever leaving the hospital alive are abysmal. I mean the odds stink that you(or they) will ever leave the hallowed institution vertical and ventilating.
Why bring this up? Every day we see the same sad story...poor septuagenarians and octogenarians (our 70 and 80 year olds) are pounded relentlessly with everything "medicine" has to offer, and we know damn well most of them are going to die regardless of what we do. There are plenty of studies to look at but know that rarely do people survive that arrested with any quality of life just to the point of discharge from the hospital, almost none are "alive"(depending on how you define it) at 1 year.
There are several factors at work here but lets just take a gander at a couple of the glaring problems.
The seeming inability of physicians to take the time to sit down and be honest about just how grim the situation is would be laughable if not so damned wrong. I am shocked daily as I watch as plethora of consultants each check their own little system as Grandma slowly circles the drain. I know its wrong, the nurses by god know its wrong, and yet most people let it drag on until we have thoroughly exhausted the patient, the family and the system.
Lets don't forget the families. Many of us have the propensity to be selfish about losing someone we love. I am continually shocked though at those family members that just blindly say "do everything to keep momma alive...EVERYTHING YOU CAN. Ok. Lets stick her 83 year old body with needles every day, lets let her lay there and poop and pee herself, lets plug every orifice with some sort of tube, lets keep her sleep deprived....lets do all of this knowing that at her age momma aint gonna make it out of here, much less have any quality of life for another year or more. Its important that WE feel ok about it...we did EVERYTHING we could to keep the body "alive", the pain and discomfort to momma be damned. Worst of all a lot of you don't even show up to see what your commitment to momma is putting her through.
This isn't hard folks. Ask yourself if momma or daddy could have seen into the future 20 years ago, have known that at this age they would be in this sad/sick shape...before the dementia, the strokes, the depends, the amputations,the heart attack, the diaper rash, the nursing home....if they could have looked ahead and answered the question of whether they would want to "survive" like this what would they have said? I think most of you know.
So why in the hell don't we give them at least that peace, dignity, relief if you will.
DOCTORS need to discuss this early and frequently.
FAMILIES need to discuss this early and if needed frequently. Ask them while they can answer if possible. BE SPECIFIC...do they want to be on a ventilator, do they want artificial feedings if they are unable or unwilling to eat, or unable to even sense their hunger? Do they want I.V. fluids and medicines in the vein if that is the only thing keeping them hanging on?
Damn people, take some responsibility here. Just because we can do all this doesn't always mean we should. While money is not the primary concern here, realize that the more medicare dollars are spent on the final year of life than any other entity. Think about that for a minute.
And by the way, most of the "cookbook" living wills and advanced directives are so general that they are not worth the paper the are written on. Moreover, a large majority of the families can't even define the "life support" that momma did or did not want. BE SPECIFIC...then honor them by honoring their wishes.
The last best thing we can do for our parents, grandparents, friends, is honor their wishes(gotta know what they are first) and provide them with as much peace and dignity as we can as it relates to the concluding days of their lives.