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Thread: End of life and Medicare

  1. #51
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    pinkytoe,

    Thank you for sharing that story. I feel sad about the manner of your mom's death. I would fight against the tendency to regret it.

    Edith Piaf encore regrette rien … originally her lost love, then addiction, then the bearded legionnaires' failed coup d'état in Algeria... now her song is an anthem for the ages.

    http://www.youtube.com/watch?v=fpHAsb2XQOY
    Last edited by dado potato; 5-2-19 at 8:57pm.

  2. #52
    Senior Member catherine's Avatar
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    Great song, dado. Great message. I love Piaf. Thanks for sharing it.
    "Do any human beings ever realize life while they live it--every, every minute?" Emily Webb, Our Town
    www.silententry.wordpress.com

  3. #53
    Senior Member razz's Avatar
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    Quote Originally Posted by catherine View Post
    Great song, dado. Great message. I love Piaf. Thanks for sharing it.
    I finally got a chance to see the English translation and have to say that I feel the same way. Piaf was a remarkable unique singer.
    As Cicero said, “Gratitude is not only the greatest of virtues, but the parent of all the others.”

  4. #54
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    Quote Originally Posted by jp1 View Post

    But eventually we need to decide, as a society, that people who are 90 years old or older, (or whatever we decide is the right age) should not have cancer treatment, not have blah blah blah treatment. It just doesn't make sense. The money spent is a waste. The patient most likely has no hope for any sort of quality of life. I was agonized when a dear friend's grandmother (94 years old) was diagnosed with brain cancer after she had fallen and ended up in the ER. She agreed to surgery and died on the table after several hours. I get it. No one "wants" to die. And no one's loved ones want to say "grandma, you're old, it's time" but at some point it IS time. I can only guess how much that brain surgery cost, but F*** what a waste of money and needless suffering.
    My worst experience was going to the ICU one night to get a 99yo woman for a craniotomy to remove a clot from her brain. She was debilitated and completely dependent for all her needs prior to the fall/injury. The surgeon had strongly recommended NOT going to surgery. Upon my arrival for transport, the family members will still SCREAMING at him to "save her no matter what". It was horrible. She died on our table.

    Having worked trauma shift for nearly 10 years, there are too many to count. I don't believe in heroic measures unless the patient is a minor.

    And more important than anything is: Quality of Life not Quantity of Life. I so admire each of my parents in their choices to LIVE their final months instead of being super sick through treatment just to add months. (neither were curable). They taught me grace to the end of life.

  5. #55
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    FYI: It has been a requirement for many years, that when you admit for services at the hospital, you will be asked if you have a living will. If you say no, you must be offered the form. I've had patients complete them in my lobby prior to entering the preoperative area. I've had patients delay surgery back in the day when 2 witnesses were required and I had to find 2 people who would NOT be providing their care and were willing to sign as a witness.

    Living wills are so very important. And don't forget, initial/date them every year or 2 so that your requests remain current. Better yet, if you travel in your car a lot, keep a copy in your glovebox.

    Mine is in my chart at my current employed facility. Everyone in my family knows this!

  6. #56
    Senior Member SteveinMN's Avatar
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    Quote Originally Posted by pinkytoe View Post
    There was nothing I could do to let her go... until one last pneumonia occurred and all my siblings happened to be in town. We made a plea to the doctor to not administer drugs and for some reason, he finally complied. She passed quickly but to this day, I am so regretful that she had to suffer like that.
    Our handicapped family member was in the ER recently for pneumonia, which, for him, will require months of recuperation. He is already listed as DNR/DNI but we were surprised that the doctors mentioned the option of DNH: "Do Not Hospitalize".

    DNH can run a gamut of choices, from "do not take me to the ER [optional: for <list specific conditions>]" to "take me to ER but no <fill in treatment you don't want (intubation, vasopressor, etc.>)" to "take me to ER but do not admit me to the hospital" and further. Interesting approach to agency in medical care. We haven't yet been able to talk with Family Member to determine where he wants to draw his lines (long story there) but it certainly has engendered discussion among his immediate family on what he might want as indicated in past discussions/his directive.
    Success is to be measured not so much by the position that one has reached in life as by the obstacles which he has overcome. - Booker T. Washington

  7. #57
    Senior Member Teacher Terry's Avatar
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    I asked my DIL how Poland handled this and no different than the states. My dad handled it right and my mom did until her last bout of cancer. I hope I do better.

  8. #58
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    The 5/12/19 edition of the New York Times contained 8 letters to the Editor concerning nurse Theresa Brown's op-ed piece I commented on above.

    David C. Leven pointed out existing guidelines, such as The Hastings Center Guidelines for Decisions on Life-Sustaining Treatment and Care Near the End of Life.

    There is a lot to chew on at the Hastings Center website!

    Advanced directives tend to be either too general to be useful, or too specific to deal with the issue that needs to be decided in a particular case. In some (but not all!) states, a complement document, POLST, has been adopted by the medical profession. A Physician Orders for Life Sustaining Treatment form is completed and carried by the patient, and is more informative than a simple Do Not Resuscitate (DNR) request.

    The website identifies the level of adoption of the POLST paradigm in each state. On a map you can click on your state (or Mom's or Dad's) and see how far along that state has come.

    http://www.thehastingscenter.org/bri...d-of-life-care

  9. #59
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    Thanks dado, I couldn't figure out how to find the map to see how the state of MD rates, but did just have an appointment with the POLST person at my dr. office and we filled most of it out. My husband isn't happy with my decisions - but I've told him it's my choice. I have the big red folder/envelope to stick on the refrigerator, but haven't put it there yet. The questions are more specific.. I went with NO TREATMENT and wonder if that's too much. But we live 30 min. from a hospital...EMTs arrive within 5-10 minutes to the house, maybe faster but I truly just want them to let me die. I am 70, healthy and don't foresee any real issues. But I am still thinking that CPR might be something to have done...or not!

  10. #60
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    Quote Originally Posted by nswef View Post
    I couldn't figure out how to find the map to see how the state of MD rates!
    The state-by-state comparisons are sort of buried.

    I am glad you mentioned it... I should have put a link in my post, like so:
    http://polst.org/programs-in-your state/

    I see MD is "non-conforming", because I gather that completion of a POLST form is not "always voluntary". The website was not specific about Which medical conditions would make it mandatory to complete a POLST form. <Inquiring minds want to know!>

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