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The Fatherless
LarryD
Posted: Saturday, March 30, 2013 9:42 AM
Joined: 12/1/2011
Posts: 1321


I’m not sure where to post this; perhaps on the main forum where more might read it.



I am reading a book titled, “The Fatherless” which was written by Dr. James Dobson and Kurt Bruner. It has just been published and appeared on my library’s new release’s table just when I happened to be browsing.



I am about two thirds through but could not wait to write this as I see it for what I think is a watchword for things to come, both in this country and around the world.



All nations are suffering these days with dwindling resources and increasing needs. The aging population is growing and the increase of Alzheimer’s disease and other dementia's is magnifying the problem of how do we cope with the combined effect of increasing numbers and increasing costs of care.



Combine that with the costs of caring for other disabling diseases and accident and war victims and the problem appears to be approaching unsolvable dimensions.



Stepping back a little, remember the flack that arose when Dr. Kevorkian made the news a while back for offering assisted euthanasia kits for suffering patients who chose to end their life on their own terms and timing. Generally speaking, the idea of assisted suicide goes against the grain and morals of most but as costs go up, there will be increased pressure to relax some of our scruples and allow alternate solutions.



Perhaps just a little at first, but it’s not a large step to get from pro choice to the financial choice to control one’s own body and therefore when it gets too painful, or expensive, opt for a peaceful, easy end to a life where there seems to be no other solution. We have heard of and probably some of you have already experienced a limiting of services due to the advanced age of the sufferer.



Again, it’s just a small step from denying an organ transplant to an older person in need or pain, to “why not just end the fight” and save the limited resources for more productive individuals. And when this decision is given to the individual, will it be long before the decision will be made by others; for the common good.



I write this to invite you to watch with me as morals crumble and become revised to allow solutions that would have been unthinkable a few years ago or even now.



It is happening already...... 


dutiful deb
Posted: Saturday, March 30, 2013 11:07 AM
Joined: 1/1/2012
Posts: 1884


Well said, Larry!  I will be looking for this book.
Marjorie McCarthy
Posted: Saturday, March 30, 2013 3:27 PM
Joined: 12/20/2011
Posts: 556


Oh my, looks too heavy for me, I'm such a baby about death. Keep us posted though.
dfh
Posted: Saturday, March 30, 2013 3:47 PM
Joined: 8/14/2012
Posts: 427


A friend (age 76) related this to me last week: her DH (77) in a NH, in a wheelchair unable to care for himself & she no longer able to care for him at home. He had suffered terribly the past 10 years with complications from a brain shunt, colon cancer, among many other problems. About a month ago in the NH he got that GI Flu so many have been getting in this area. They told her not to visit him & then called to say they were taking him to the local hospital because he had become so dehydrated. So she met him there in the ER & spoke to his physician who said that he would need dialysis because altho' his kidneys were working, he was nevertheless going into kidney failure. So the dr. said we'll have to do dialysis. Her DH spoke up & said he wouldn't agree to that. (He was mostly lucid as he was when I had seen him a few months ago)The dr. took her into the hallway & asked her to talk him into the dialysis, but she refused saying that he had made the decision & she would go with that. She also has seen this man suffer terribly & she had become burdened by the caregiving. So he was admitted to hospice (which she had only good things to say about), slipped into a coma & died within about 5 days. She told me that as long as the suffering was minimal, she felt she had done the right thing. As a former RN, I'm telling you that had she gone ahead with the dialysis & continued to do all that could be done, the cost in suffering would have been phenomenal to say nothing of the medical costs. And believe me when I tell you that this goes on daily all across the country. We just cannot deal with death in this country. I pray that I can be as brave as my DF. dfh
Johanna C.
Posted: Sunday, March 31, 2013 1:50 PM
Joined: 12/9/2011
Posts: 11212


I read the first chapter online - it reminded me a bit of that film, "Soylent Green." 

 

I am more of an "escape" reader of fiction novels, so I probably won't buy or borrow this book; but as an RN with many years experience both hands-on and administrative; ethical decisions have always been part and parcel of the human experience/condition since forever and things are getting more murky.

 

Medicine has changed and continues to change at warp speed bringing us  to places and decisions we never could have dreamed of several decades ago.  It has not been that long that antibiotics have been available.  Imagine.

 

We now have routine transplants, amazing new medications and procedures; so much change and so much more to come.   Not that long ago, dialysis was restricted to only a few as there was not the capability to provide it for many people.  Ethics Committees made the decision as to which candidate was going to get dialysis and live and who was not and was going to die.  Condition, age and productivity entered into that horrible decision making process.  Now, dialysis is available for all. 

 

I was surprised to learn that in Texas, an Ethics Board of medical specialists at a hospital can override a person's own personal decision for their loved one.  Texas is also up front and proactive on carrying out sentences of executions and carrying concealed weapons; each state has it's own laws on these things and have their own cultures and ways of looking at things and often in different ways.  As yet, nothing is standard across the United States.

 

The Texas case I most remember was a young couple who had a child with severe, life compromising conditions. The child was on a ventilator and had been for some time and though the odds for survival were slim to none; the parents felt that somehow a miracle would occur or science would catch up and they wanted to continue on to give their child a chance.

 

The Board met and decided to override the parents decision and against the parent's absolute wishes and despite the parent's pleas to the court, the Board persisted on the decision and the ventilator was discontinued and the child died.

 

Outcome would probably have been the same either way; but this shocked me to the core.  Of course keeping the child alive was extremely costly, but at what point do we override the autonomy of the parent who is the guardian of the child for his/her time on earth?  Slippery, slippery slope.

 

Yes, care is costly and is burdening the already burdened system.  Less and less is costing more and more.  Those making the decisions for us through legislation do NOT have to live with the restrictions the rest of us citizens do.  If they did, things surely would be different, I have no illusions regarding that.

 

I will not get going on the subject of Lobbyists and Insurance Companies and Legislator's pockets; it may well cause my computer to overheat.

 

Somehow, there must be a better balance.  Yadda, yadda, yadda; "The largest part of the healthcare dollar is spent in the last year of life."  No kidding?

 

Well; that is not just for the elderly or those with end-stage cancers/diseases; this is so even if you are a healthy, dynamic young person who gets hit by a bus crossing the street. 

 

Suddenly you are in the ER;  then you are in the OR; you are doing well in ICU and then unexpectedlly throw bloodclots into the lungs; then you are in the mortuary and yes, it did cost more to care for you in the last year of life.  Of course.

 

One could be young and healthy and a sudden overwhelming bacteria strikes or trauma occurs and perhaps you have never, ever been ill and it costs a few thousand dollars in the ER which is not much as you die quickly in the ER - that is STILL the greatest part of your own personal healthcare dollar being spent in your last year of life.   That must not be the overriding factor in making healthcare decisions.

 

If one is comatose and moribund at end-stage cancer or other end-stage disease; it is indeed rare for a family to place that nearly gone person on a ventilator despite the journalistic histrionics some special interest folks espouse.

 

 As patients and families become more and more educated and are provided with direct personal support, factual information, and actual hands-on support such as Hospice and supportive Counseling, more sensible decisions are made.  One cannot just leave an emotionally overwrought family with a diagnosis and then leave them dangling while making demands.  

 

There is a balance in there somewhere and that balance needs to be found and respected. 

 

On the other hand, if one is suffering untold agonies and there will be no surcease, and if a person wants to refuse treatments, refuse tube feedings and even, yes; be helped over the threshold, there is a place for that discussion.  Holland and Oregon are amongst the accepting governments, but not without failsafes.

 

The person in some end-stage cancers whose pain cannot be relieved with any medication; the person with Lou Gerhigs Disease (Amyotrophic Lateral Sclerosis) and is alert, orented, but totally paralyzed including breathing, ability to swallow or even blink and is persistently choking, and wishes to exit the unimaginable suffering; how do we not address the end of life wishes they may make?

 

I am not a fan of those individuals who belong to "societies" that go to people's houses (who have requested the service) and provide them with toxic meds and put plastic bags over their heads and then wait for the person to die - this for me is unconscionable.  I saw a piece on "60 Minutes" regarding such groups and I was appalled by the lack of education, professional backgrounds and lack of safeguards, etc.  Not good.  This is not how Holland or Oregon is managing their end of life assistance choices.

 

No easy answer and it will continue to get more complicated, I just do not want to see this as being an economic only policy with a, get out of the way and die old people sort of dynamic.

 

Sheesh, I cannot even write something that convinces me that there may be light at the end of the tunnel; there is no black and white answer, it is a quandry, always has been a quandry and always will be a quandry.

 

If we were all born with an expiration date on which we just went, "Poof!" and disappeared, it certainly would have been easier.

 

Johanna C.   


Sea Field
Posted: Sunday, March 31, 2013 7:13 PM
Joined: 8/5/2012
Posts: 1870


Thank you Johanna for a thoughtful reply to a complicated and difficult circumstance.
Jim Broede
Posted: Monday, April 1, 2013 3:44 AM
Joined: 12/22/2011
Posts: 5462


Maybe there are good suicides. And bad suicides. Don’t really know. Good lives and bad lives, too. Ending a bad life/unhappy life could be a good suicide. Depends. On one’s perspective. It’s a judgmental call. About right and wrong. One person’s wrong choice can be someone's right choice. Wise and moral. I learned to accept my father’s suicide. Not initially. But soon thereafter.  After the grieving process. I learned to give willful death a positive twist. An act that may have been good. For dad. And for some of his loved ones. The survivors who used the tragedy as a springboard to a happy and fulfilling and meaningful life. Savoring the blessings. Despite the occasional sadness.  Unfortunately, my brother and sister grieved for a long, long time. Lamenting continuously. At family reunions. Even decades later. Mother and I got over it quickly. She went on to another marriage. The 34 happiest years of her life. Meanwhile, I’ve had two true loves. Including a 38-year blissfully happy marriage. Despite my dear Jeanne's 13-year siege with Alzheimer’s. She died 7 years ago. Now I’m living with my second true love. A charming and delightful Italian. Living life maybe the way my father’s suicide taught me. To stop grieving. To get on with life. As for suicides, there may be all kinds. My brother.  He fell. Fractured his skull. An accident? Maybe. I suspect many suicides are willful accidents. My mother died at 88. She lost her zest for life. Maybe wanted to die. So she willed it. Another form of suicide? I don’t hold suicide against anyone.  People make legitimate choices. About life. About death. No reason for survivors to grieve for the rest of their lives. Better to consider possibility of living forever. Already, I've more than doubled my father’s life span. I'm telling dad I still want to live. As a thriving spirit. As a romantic idealist, a lover, a dreamer. –Jim
dfh
Posted: Wednesday, April 3, 2013 5:19 PM
Joined: 8/14/2012
Posts: 427


Joanna: no there is no easy answer when one deals with the human condition. So we do the best we can & try to stay informed. My own DM (97) is in a NH mostly lucid & is comfortable & always pleasant. Many years ago she made the decision to remove life support from her DH, my father age 66. He had suffered terribly & was septic & there was no chance of recovery. She was certain she had made the right decision based on conversations they had had when he became ill.

 

She also gave my DS & me explicit instructions about her own death & when she went to the ER 3 years ago because of an MI (heart attack) she told the dr. that he must let "her go" if she coded. He agreed (she has/had a DNR) & they only kept her for 3 days in the CCU & we took her home to her apt. She did very well after. We have all the necessary paper work on hand & she reminds us occasionally of her wishes. Oh that all of us could do this. dfh

 

 


George K
Posted: Friday, April 5, 2013 4:47 AM
Joined: 12/16/2011
Posts: 2815


This is an e-mail I received, I have no idea of its truth, but it was on the internet, so it must be true:

.

> Before we 'kick the bucket', maybe we should read this…
> > How Doctors Die...
> >
> >
> > Many doctors make dying very costly, e.g. more than $100,000,
> > $500,000, a few million of dollars, (or if the family is unlucky)
> > $24,000,000. After spending most or all of the family money the
> > patient dies like all poor people without doctors and hospital.
> > Staying at home in the last days may be more meaningful and caring.
> >
> > An expensive doctor may ensure that huge sums of money is spent and
> > the patient NEVER COMES HOME ALIVE.
> >
> > How Doctors Die It’s Not Like the Rest of Us, But It Should Be by Dr
> > Ken Murray.
> >
> > Years ago, Charlie, a highly respected orthopaedist and a mentor of
> > mine, found a lump in his stomach. He had a surgeon explore the area,
> > and the diagnosis was pancreatic cancer. This surgeon was one of the
> > best in the country. He had even invented a new procedure for this
> > exact cancer that could triple a patient’s five-year-survival
> > odds—from 5% to 15%—albeit with a poor quality of life. Charlie was
> > uninterested.
> >
> > He went home the next day, closed his practice, and never set foot in
> > a hospital again. He focused on spending time with family and feeling
> > as good as possible. Several months later, he died at home. He got
> > no chemotherapy, radiation, or surgical treatment. Medicare didn’t
> > spend much on him. It’s not a frequent topic of discussion, but
> > doctors die, too. And they don’t die like the rest of us.
> >
> > What’s unusual about them is not how much treatment they get compared
> > to most Americans, but how little. For all the time they spend
> > fending off the deaths of others, they tend to be fairly serene when
> > faced with death themselves. They know exactly what is going to
> > happen, they know the choices, and they generally have access to any
> > sort of medical care they could want. But they go gently.
> >
> > Of course, doctors don’t want to die; they want to live. But they
> > know enough about modern medicine to know its limits. And they know
> > enough about death to know what all people fear most: dying in pain,
> > and dying alone.
> >
> > They’ve talked about this with their families. They want to be sure,
> > when the time comes, that no heroic measures will happen—that they
> > will never experience, during their last moments on earth, someone
> > breaking their ribs in an attempt to resuscitate them with CPR (that’s
> > what happens if CPR is not done right).
> >
> > Almost all medical professionals have seen what we call “futile care”
> > being performed on people. That’s when doctors bring the cutting edge
> > of technology to bear on a grievously ill person near the end of life.
> > The patient will get cut open, perforated with tubes, hooked up to
> > machines, and assaulted with drugs. All of this occurs in the
> > Intensive Care Unit at a cost of tens of thousands of dollars a day.
> >
> > What it buys is misery we would not inflict on a terrorist. I cannot
> > count the number of times fellow physicians have told me, in words
> > that vary only slightly, “Promise me if you find me like this that
> > you’ll kill me.” They mean it. Some medical personnel wear
> > medallions stamped “NO CODE” to tell physicians not to perform CPR on
> > them. I have even seen it as a tattoo.
> >
> > To administer medical care that makes people suffer is anguishing.
> > Physicians are trained to gather information without revealing any of
> > their own feelings, but in private, among fellow doctors, they’ll
> > vent. “How can anyone do that to their family members?” they’ll ask.
> >
> > I suspect it’s one reason physicians have higher rates of alcohol
> > abuse and depression than professionals in most other fields. I know
> > it’s one reason I stopped participating in hospital care for the last
> > 10 years of my practice. How has it come to this—that doctors
> > administer so much care that they wouldn’t want for themselves?
> >
> > The simple, or not-so-simple, answer is this: patients, doctors, and
> > the system. To see how patients play a role, imagine a scenario in
> > which someone has lost consciousness and been admitted to an emergency
> > room. As is so often the case, no one has made a plan for this
> > situation, and shocked and scared family members find themselves
> > caught up in a maze of choices. They’re overwhelmed.
> >
> > When doctors ask if they want “everything” done, they answer yes. Then
> > the nightmare begins. Sometimes, a family really means “do
> > everything,” but often they just mean “do everything that’s
> > reasonable”.
> >
> > The problem is that they may not know what’s reasonable, nor, in their
> > confusion and sorrow, will they ask about it or hear what a physician
> > may be telling them.
> >
> > For their part, doctors told to do “everything” will do it, whether it
> > is reasonable or not. The above scenario is a common one. Feeding
> > into the problem are unrealistic expectations of what doctors can
> > accomplish. Many people think of CPR as a reliable lifesaver when, in
> > fact, the results are usually poor. I’ve had hundreds of people
> > brought to me in the emergency room after getting CPR.
> >
> > Exactly one, a healthy man who’d had no heart troubles (for those who
> > want specifics, he had a “tension pneumothorax”), walked out of the
> > hospital. If a patient suffers from severe illness, old age, or a
> > terminal disease, the odds of a good outcome from CPR are
> > infinitesimal, while the odds of suffering are overwhelming.
> >
> > Poor knowledge and misguided expectations lead to a lot of bad
> > decisions. But of course it’s not just patients making these things
> > happen. Doctors play an enabling role, too.
> >
> > The trouble is that even doctors who hate to administer futile care
> > must find a way to address the wishes of patients and families.
> > Imagine, once again, the emergency room with those grieving, possibly
> > hysterical, family members. They do not know the doctor.
> >
> > Establishing trust and confidence under such circumstances is a very
> > delicate thing. People are prepared to think the doctor is acting out
> > of base motives, trying to save time, or money, or effort, especially
> > if the doctor is advising against further treatment.
> >
> > Some doctors are stronger communicators than others, and some doctors
> > are more adamant, but the pressures they all face are similar. When I
> > faced circumstances involving end-of-life choices, I adopted the
> > approach of laying out only the options that I thought were reasonable
> > (as I would in any situation) as early in the process as possible.
> >
> > When patients or families brought up unreasonable choices, I would
> > discuss the issue in layman’s terms that portrayed the downsides
> > clearly. If patients or families still insisted on treatments I
> > considered pointless or harmful, I would offer to transfer their care
> > to another doctor or hospital. Should I have been more forceful at
> > times? I know that some of those transfers still haunt me.
> >
> > One of the patients of whom I was most fond was an attorney from a
> > famous political family. She had severe diabetes and terrible
> > circulation, and, at one point, she developed a painful sore on her
> > foot. Knowing the hazards of hospitals, I did everything I could to
> > keep her from resorting to surgery.
> >
> > Still, she sought out outside experts with whom I had no relationship.
> > Not knowing as much about her as I did, they decided to perform bypass
> > surgery on her chronically clogged blood vessels in both legs. This
> > didn’t restore her circulation, and the surgical wounds wouldn’t heal.
> > Her feet became gangrenous, and she endured bilateral leg
> > amputations. Two weeks later, in the famous medical center in which
> > all this had occurred, she died.
> >
> > It’s easy to find fault with both doctors and patients in such
> > stories, but in many ways all the parties are simply victims of a
> > larger system that encourages excessive treatment. In some
> > unfortunate cases, doctors use the fee-for-service model to do
> > everything they can, no matter how pointless, to make money.
> >
> > More commonly, though, doctors are fearful of litigation and do
> > whatever they’re asked, with little feedback, to avoid getting in
> > trouble. Even when the right preparations have been made, the system
> > can still swallow people up.
> >
> > One of my patients was a man named Jack, a 78-year-old who had been
> > ill for years and undergone about 15 major surgical procedures. He
> > explained to me that he never, under any circumstances, wanted to be
> > placed on life support machines again.
> >
> > One Saturday, however, Jack suffered a massive stroke and got admitted
> > to the emergency room unconscious, without his wife. Doctors did
> > everything possible to resuscitate him and put him on life support in
> > the ICU. This was Jack’s worst nightmare. When I arrived at the
> > hospital and took over Jack’s care, I spoke to his wife and to
> > hospital staff, bringing in my office notes with his care preferences.
> > Then I turned off the life support machines and sat with him. He
> > died two hours later.
> >
> > Even with all his wishes documented, Jack hadn’t died as he’d hoped.
> > The system had intervened. One of the nurses, I later found out, even
> > reported my unplugging of Jack to the authorities as a possible
> > homicide. Nothing came of it, of course; Jack’s wishes had been
> > spelled out explicitly, and he’d left the paperwork to prove it. But
> > the prospect of a police investigation is terrifying for any
> > physician. I could far more easily have left Jack on life support
> > against his stated wishes, prolonging his life, and his suffering, a
> > few more weeks. I would even have made a little more money, and
> > Medicare would have ended up with an additional $500,000 bill.
> >
> > It’s no wonder many doctors err on the side of overtreatment. But
> > doctors still don’t over-treat themselves. They see the consequences
> > of this constantly. Almost anyone can find a way to die in peace at
> > home, and pain can be managed better than ever.
> >
> > Hospice care, which focuses on providing terminally ill patients with
> > comfort and dignity rather than on futile cures, provides most people
> > with much better final days. Amazingly, studies have found that
> > people placed in hospice care often live longer than people with the
> > same disease who are seeking active cures.
> >
> > I was struck to hear on the radio recently that the famous reporter
> > Tom Wicker had “died peacefully at home, surrounded by his family”.
> > Such stories are, thankfully, increasingly common.
> >
> > Several years ago, my older cousin Torch (born at home by the light of
> > a flashlight—or torch) had a seizure that turned out to be the result
> > of lung cancer that had gone to his brain. I arranged for him to see
> > various specialists, and we learned that with aggressive treatment of
> > his condition, including three to five hospital visits a week for
> > chemotherapy, he would live perhaps four months.
> >
> > Ultimately, Torch decided against any treatment and simply took pills
> > for brain swelling. He moved in with me. We spent the next eight
> > months doing a bunch of things that he enjoyed, having fun together
> > like we hadn't had in decades.
> >
> > We went to Disneyland, his first time. We’d hang out at home. Torch
> > was a sports nut, and he was very happy to watch sports and eat my
> > cooking. He even gained a bit of weight, eating his favorite foods
> > rather than hospital foods. He had no serious pain, and he remained
> > high-spirited. One day, he didn’t wake up. He spent the next three
> > days in a coma-like sleep and then died.
> >
> > The cost of his medical care for those eight months, for the one drug
> > he was taking, was about $20. Torch was no doctor, but he knew he
> > wanted a life of quality, not just quantity. Don’t most of us? If
> > there is a state of the art of end-of-life care, it is this: death
> > with dignity.
> >
> > As for me, my physician has my choices. They were easy to make, as
> > they are for most physicians. There will be no heroics, and I will go
> > gentle into that good night. Like my mentor Charlie. Like my cousin
> > Torch. Like my fellow doctors.
> >
> > Ken Murray, MD, is Clinical Assistant Professor of Family Medicine at USC.
 
 


Johanna C.
Posted: Friday, April 5, 2013 8:10 AM
Joined: 12/9/2011
Posts: 11212


Findings in this writing were taken from questionnaires or advance directives filled out by medical students between the years of, 1948 and 1964.

 

I am an RN of many years experience, this article means well and supports the beliefs of the writer; BUT when push comes to shove, this does not always or even often hold up.

 

Over the years I have seen physicians with terminal conditions who go on and on and on looking for their own miracle, just like anyone else and who utilize every way to continue living even at the last of the disease. I have also seen physicians rise to the challenge with grace and courage.

 

I recall one particular physician who would occasionally talk about end stage life with a terminal disease and he would avow, NEVER, ever would he go on looking for treatment; he would simply take all steps to die as soon as possible.

 

Horror of horrors, this healthy, fit man developed an aggressive cancer.  He went miles and miles seeking out all treatments and at the end he was desperate enough to seek out alternative treatments - - - - when actively terminal, he had a feeding tube put in and it became a virtual nightmare as he continued to seek anything and everything to save himself.  He hung on as long as possible, but eventually did die.  This of course is simply one experience.

 

In my experience, the MDs do indeed want to live and many of them do indeed seek out every last possible modality of treatment and will keep pushing, seeking high and low and upon occasion, even in other countries, for treatment.   Some will travel to far flung medical centers to seek out everything they can and most of them will continue to push and push when it is evident all is lost.  Hope is hope no matter what.

 

What one puts on an Advance Directive, or states when healthy and robust and feeling invincible is abstract; but when the dreadful thing happens, perceptions and feelings can indeed change in a split second.  For many, this happens.

 

If one has an abrupt heart attack and is unconscious, Advance Directives easily fall into play.  When there is a different disease such as a cancer, things can take on a different meaning.

 

No, this does not mean that physicians never use common sense or never refuse extraordinary measures; it just means that plans made when one is healthy may change dramatically when one faces one's own mortality.  I've seen it often enough.

 

And by the way - let me add that if a physician is receiving care in their medical center, believe me, he/she is receiving CARE in ways you and I would not.  The perks, the personal one on one care, the private rooms, the "no billing", the easy access to any kind of medication, the longer length of stay with cadillac care, the specialists coming in and sitting at the bedside for long lengths of time (professional courtesy), the not shoving the patient out the door to a NH,  etc., etc.  It is a different set of dynamics

 

So, choice of what one will do when faced with the end of life is a highly individualized dynamic when the rubber hits the road.  The article is interesting, but not accurate data.

 

Once again, it is indeed all about the human condition and one size definitely does not fit all. 

 

Johanna C. 


Jim Broede
Posted: Friday, April 5, 2013 10:21 AM
Joined: 12/22/2011
Posts: 5462


I suspect Ed wanted to die. He was 90. And lived a full life. I didn’t really get to know Ed until three years ago. He lived in my neighborhood. I had seen him many times. On my daily walks. For a long time, I didn’t even know his name. But then I decided to take a keener interest. In my neighbors. Ed was a veteran of World War II. A mechanic. On a plane. That bombed the hell out of Germany. He also had a hobby. A woodcarver. Ed’s wife died many years ago. He lived alone. In a lake shore home. Ed was a jovial fella. Enjoyed life. Took daily jaunts on his motor scooter. Stopped and gabbed with people.  Ed was slowing down. Not necessarily by choice. A caregiver came in daily. To prepare meals. And to assist with household chores. Ed stayed alone every night.  Children and grandchildren encouraged Ed to leave his lake home. And go to the big city, Minneapolis, to live at the Veterans Home. A nursing home, really. In a month, Ed was dead. Natural causes. But I wonder. How many old people will themselves to die? An intentional sort of thing. Fulfillment of a death wish. A form of suicide. My mother did it. At age 88. Ed could have decided he no longer had reason to live.  My father made a similar decision. At 38. Killed himself. Death was ruled an obvious suicide. Only difference, it was by traditional means. As for Ed and my mother – well, they had ‘natural’ deaths. Still, maybe it amounted to a a less obvious kind of suicide.  Tired of living. They willed themselves to die. To stop breathing. To take their own lives. In the most natural way possible.  –Jim
LarryD
Posted: Friday, April 5, 2013 11:38 AM
Joined: 12/1/2011
Posts: 1321


This thread has veered in a direction that is not exactly what I had in mind and I almost deleted it at one point but perhaps there is nothing wrong or earthshaking to let it live a little longer and see where it goes.


I posted it in Musings because I guess I suspected it might not be everyone's cup of tea on the forums that are dedicated to problems and solutions. What I wanted to address when I started it was the way society as a whole is changing. And with that change; the way human life is viewed and valued.


If it is only valuable to the individual then certainly he or she might have the right to end it. But most won't and cling to life as long as they can. If, as Jim says, it's not wrong for someone to end their miserable existence by their own hand, should others be allowed to help? Should family, or friends, or government, or anyone, be authorized to make that decision for them?


If they are no longer any use to the common good, should it be okay to dispose of them? Should people be like the items in our grocery store that have a "use by date" and when they pass that age, be humanely disposed of?


That's what I am watching and that's what I fear is coming as we see the decay of our morals and substitute "today's standards" based on our enlightened viewpoint. If I can request to be euthanized when I think my life is no longer worth living; is it too much of a stretch to think that society might take that option when I can no longer think for my self or worse yet, when they think it is time?


This whole discussion gets even more hairy when the subject of living wills is introduced. But even I am in favor of taking the extensive abilities of the medical community to keep a person breathing out of their hands when there is no hope of life. 


Perhaps that is the proverbial camel's nose to numb our thinking about this whole issue. Remember today's smutty and "realistic" movie industry began with Clark Gable saying, "I don't give a damn". Once that dam was broken and accepted, here came the waters of profanity and what we now accept as reality. 


 




Be Strong 2
Posted: Friday, April 5, 2013 4:50 PM
Joined: 12/14/2011
Posts: 1751


Larry,


I would ask that you not delete the thread.  While I don't necessarily agree with all posters I do believe that there are many positive things to think about.  If the thread gets too off topic I think you could request that Adm. just close it, without deleting it.


This thread has brought thoughts to mind as I contemplate my wife's current and future care.


My wife is in late stage 6, doesn't communicate sense (to me) but seems to enjoy life.  She smiles and tries to make wise cracks when I visit.  She is and always will be a valuable human being.  Taking care of our elderly and sick is what separates us from the animals.


I've been contemplating end of life decisions.  I hope, and have no reason to think otherwise, that she will have a fairly long life.  She is only 60 years old.  Other than  the Alzheimer's she is in good health, if she quits falling.


I've thought about feeding tubes and respirators and have no trouble saying "no", because that is what she put in her health directive.  When we were in the emergency room in January, however, the ER doc asked if I wanted DW shocked if her heart should stop.  I'm sure my eyes got a little large as I asked, "and why would her heart stop?"  She had taken a fall and had a bloody nose.  The doctor answered, "No reason, but have you thought about it?"  I hadn't but have since.  Would I want to resuscitate her, to break ribs and cause pain, to bring her back to her current, or maybe even a more advanced condition?


It's tough making these kind of decisions.  My answer is "No!"  It still is not a happy answer.  I believe God will take each of us when our time comes but just like the rest of life He sometimes allows us to interfere, for a while, with His will.  I have determined, with trepidation, to not interfere and cause pain.

This summer, when my wife sees her new doctor, I will request that he sign a DNR order and put it in her file.  At the same time I will institute the DNR form with the MCH so the EMT's are instructed in our wishes.


While I am firm in this resolve I just hope that when the end comes that I can still rest assured that I did my best by my wife.  These decisions are hard!



Remember, we're all in the same boat, and the darn thing leaks!


Bob  


Johanna C.
Posted: Saturday, April 6, 2013 1:45 AM
Joined: 12/9/2011
Posts: 11212


 

Yes, Larry; I agree - we live in a world of "slippery slopes" and I do not like the way things are moving with not the "right" to die, but the "obligation" to die.  It is very dangerous on multiple fronts - where would it all stop? 

 

Wonderful response, Bob.  Jeanette is enjoying a wonderful quality of life.  She is content, happy and enjoys all that is around her.  You have seen to it that she has that in her life while she still  can.

 

It was the same with my LO.  She could no longer ambulate, and had many restrictions of body and mind; yet, she could enjoy visitors, family members, food; she could smile and laugh and seemed quite content.

 

I felt she would continue on her medications for blood pressure and any other non-heroic type med she would need. 

 

I did however, decide to sign a DNR order should she suddenly have a terminal event occur.  Why would I want to drag her back in a very assaultive manner and perhap in much worse condition.

 

By the way; one can authorize a "chemical code" only but no other resuscitation such as paddles or ventilator.  In a chemical code, one is authorizing IV drugs to steady an arrythmia or to start the heart, etc.  It stops short of anything electronic and no breathing tubes.  Still; this would not have been the right thing to do for my mother considering her condition.

 

This was not an easy decision and I felt very unnerved when signing the papers.  There was almost a feeling of guilt even though I knew this was the right thing to do and Mom did have Advance Directives.

 

We love our dear ones and they absolutely ARE valuable members of our society; just in a different sort of way.  They deserve our honor and respect and the good Lord willing, when the time comes, a good death.

 

Such difficult decisions to be made, but when you think them out as you have done Mr. Bob, this is honoring the personhood of your dear wife.

 

Johanna C.


Jim Broede
Posted: Saturday, April 6, 2013 7:32 AM
Joined: 12/22/2011
Posts: 5462


You’ve helped stimulate wide ranging thought, Larry. Good thought. Significant thought. And musings is the right place for it. Thing is, in musings, we all seem to be nice to each other. Respectful.  Understanding. Tolerant. --Jim
milmac111
Posted: Sunday, April 7, 2013 11:26 AM
Joined: 10/2/2012
Posts: 1283


Larry ~ Your musings or topics are always thought provoking, and I apologize for veering from the intent of your musing. Some of those responding are in health care, I am not, and so I just needed to let this out after reading the posts....

 

I have already been faced with making this decision for my father who hung onto life by a thread after a horrendous automobile accident.  He went from doing well one day to near death the next. It was the proverbial roller coaster. He and my mother were separated at the time and she wanted nothing to do with any decisions for him. A very compassionate social worker and Dr. at the hospital told me that even the best case scenario was going to be a very poor quality of life for him. I felt the weight of the world on me,  I signed the DNR . Things seemed to improve, he had been weaned off of the ventilator, almost impossible a feat they told me, considering his condition, the length of time he had been on it (over 30 days) and his age (82) . So off to the rehab we went. After one week there, I came in to visit him, only to find he was in respiratory distress, his body was shutting down. They told me to go and say my good byes...........I tried, but soon was begging for them to do anything, to not let him go.  The Dr. took me aside and shook me, and said think carefully about what you're asking. I understood, and went back to him and said my goodbye and told him it was okay to rest.

 

My mother is nearly 88 with many medical problems, and I see her growing weaker all the time.

My husband is mostly in early stage 6 AD. I may likely, be faced with the same choice(s) again. Even though I have made the decision before it will be no easier if I need to do that again. I have health care proxy's for both.

 

I agree that euthanasia ( Larry's topic) is a very slippery slope and needs to be scaled with much careful and compassionate thought, or we one day, may very well be categorized into most worthy or least worthy groupings.

 

Bless you all and stay strong,

Milly


LarryD
Posted: Sunday, April 7, 2013 12:17 PM
Joined: 12/1/2011
Posts: 1321


Dear Milly,


No need to apologize. These threads sometimes take on a life of their own and at least a part of this whole forum experience is putting our feelings and ideas out there where the world can see.


Similar to your experience with your Dad, my Mother went into the hospital, for the umpteenth time at age 88 with severe emphysema and perhaps other ailments caused by her age, years of ill health, and my stepfather's cigar smoking in the house for years. She weighed about 80 pounds when she went in the hospital that last time.


I went to visit her and prayed silently for her and she was in so much distress that I kissed her and told her I loved her and thanked the Lord for her. She began to scream, "Don't let me die" over and over again. Frankly it scared me because it was not what I expected from a woman who had raised me in what I at least thought was a Christian home. 


We consulted with the hospital authorities and a hospice chaplain and my step father and the decision was made to not resuscitate her if she passed, which occurred a short time later. It was not a hard decision because her life was so full of pain; and to return her to that by the aggressive methods that they explained would be needed made it easier.


I have asked the Lord why she was so fearful at the point of death. I have rested in the thought that it was because she was so committed to my step father and did not want to leave him alone. He passed away less than a year later.