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I go every day to the nursing home to look after my husband. I have seen many residents. As much as we don't want to suffer ill health in our lives, are we over doing it when it comes to medication and things that keep us living longer? I have seen and met up with many brilliant people that now are so demented that they don't know their own name. Would they want that? Would you? Would I? We can hope to have longevity and keep our minds but the truth is...most of us don't. The brain is an organ and it doesn't last anymore than our other organs do.


I'd like your thoughts on this.

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I rue the day my then 95 year old mother pressed her life alert button and was taken to the hospital with a slow heart rate and kept alive with a pacemaker ( it seemed like a good idea at the time... little did I know)... Only to survive now to 98, incontinent, nearly blind, no longer able to enjoy the paper or TV, hating the beautiful AL facility I had to move her to because nothing can replace a beloved home and independence... Paying 1000s (our choice) of our own money because I've seen the Medicaid alternatives and can't bear it... Her wondering what she did "wrong" after we had to move her to hospice level, edema from CKD and CHF swelling her legs to the size of elephant legs, treated with diuretics that make her diapers constantly soaked, creating painful sores... on her legs, open wounds silver dollar size, spontaneous tears in fragile skin that lead to cellulitis and hospital visit and IV antibiotics to keep her alive just to go back for more misery. Just before hospice, she was taken to the ER as unresponsive, had a UTI, treated again with antibiotics.... terrified the whole time because she was alone, I couldn't get there on time...a brain scan given at the same time, who knows how much that cost...a BRAIN SCAN on a 98 yo... For what? Because they HAVE TO.
We keep people alive too long when they're suffering is prolonged, and at great cost emotionally and financially to themselves and society... People on the b outside who aren't caregivers think their parent's decline and death will be gentle and sweet, Gramma at home surrounded by grandkids (never mind who is going to change her 15x a day, wipe her explosive diarrhea, lift her, dress her, wake at 3an when she's scared when the wound on her legs spontaneously opens, feed her, take her to doctor when she can't move...).
In the meantime as a caregiver, my business has suffered and may be destroyed because of the time required to manage the recent 2 rehab visits ( 6 weeks in 3 months) before her worst decline this past month. She's a vibrant funny, smart woman who has been reduced to a fearful, sad shell, kept alive only to be tortured by her incapacity and live in grief. I try hard to help her mental state. But how can I expect her to be content... Blind, almost deaf, incontinent, unable to walk to the fridge for a snack, constantly afraid... Away from the home she loved because modern medicine kept her alive with a pacemaker at 95 and antibiotics for every infection that could have (mercifully) killed her.
I definitely am planning a different exit based on this experience.
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Oh my goodness! You have said almost verbatim what I have been thinking the past few years (even before the pandemic)! I wholeheartedly agree with this post. We all must die eventually, but the question is when to call it quits and call it a life. I do not see the logic in living a long life if I'm mentally or physically incapacitated. If my quality of life is going down the tubes, why be around to suffer through that? Life is hard enough as it is without adding the "grand finale" of suffering at the end. Caregiving has made me pro-euthanasia. If we as people have the right to wear/not wear a mask, get a vaccine, etc., why then can't we choose to end our lives peacefully the way we want?
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I agree that our bodies live too long beyond our brains. The problem is that we don't know when to stop treating the numerous ailments that afflict the bodies. So, we keep on treating until the brains deteriorate and then we become the living dead.
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My mother is 92 and in the second SN facility as the first created alot of problems and she is now bedridden. While I am much happier with this facility it is truly agonizing to witness the residents. There is no quality of life and obvious mental suffering as well as physical.

NO I absolutely do not want this for myself. I do live a much healthier life than my mother did for a long time. My husband and I are astounded as to how more compromised she can be and continue on. We have been told twice the end is near yet she rebounds but even more compromised. I see suffering and I just question why and for how long. It is very emotionally depleting. I also worry about money running out. She already was in a facility that was negligent. I don't want to move her elsewhere similar as she has a litany of health issues that need care.
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Someone referenced a book in this forum months ago. I read it and gained new perspective on this subject:

Being Mortal: Medicine and What Matters in the End
Book by Atul Gawande
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Fil had a kidney removed, was on blood thinners and had both knees done before his stroke in 2020. He had three heart operations plus three head operations. During this time, part of his bowel was removed. He was scheduled for a second knee replacement when he had another stroke, theorized to have been related to these heart ops.

He rescinded his dnr, not that it was needed this time. This time he still got to go home but now he falls asleep immediately. He asked what we were watching, Monday Night Football, which he’s watched since it became a thing 40 years ago.
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As I read these posts, my humble thoughts about end of my own life is to do at least what I can now. Meaning that while I am able, I choose to put my wishes into writing in the form of an advanced health care directive and POLST. I realize this doesn't cure any ill, but it does give me peace of mind that I have done what I can.
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My answer seems to have disappeared. I recommended that everyone take a look at The Five Wishes and the documents under the course for EPEC project (End of Life Nys Palliative Care course) They are very detailed and people can make their detailed wishes known BEFORE they are unable to do so. You can download advance care planning module for a fee:
EPEC Distance Learning Modules (CME/CE Available)

Online self-paced modules below consisting of text, main points and video cases. The target audience for the EPEC distance learning programs is for engaged in palliative care education and clinical practice but in caring for my parents it was enormously helpful.Once a module has been purchased, you will have unlimited online access to the content of that module. 1.0 AMA PRA Category Credit(s)™ is available per module.
$30 each

Gaps and Elements of Care
This module provides background for the EPEC curriculum by presenting a profile of how people currently die in the United States and contrasts this with data about the way they would like to die.
Advance Care Planning
This module explains planning future medical care in case of the patient being unable to make decisions.
www.bioethics.northwestern.edu
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I know when the choice to die would have been made by my parents. Dad was 92 and dying of cancer. Surgery had left him with delirium, which went away, and worsening but not incapacitating dementia. He knew he was dying and begged the hospice doctor to "give me a shot so we can get this over with." Of course, the doctor would not do it and told dad that he never had done it in all his years as a hospice doctor. Dad lived a few more months, catheterized, in pain, and unable to eat normally. He knew what was happening to him despite dementia. He called out frequently, "Come get me, Mom," and it was so pitiful. My mother had mild dementia and some mobility problems when she started manifesting worse cognitive symptoms. She began to fall frequently, we couldn't keep her in bed and so it kept on and on; her body hurt all over, though often she couldn't say exactly where, and she thought she was going to marry Elvis and other crazy things. Her teeth turned brown. She begged not to have "more needles," meaning shots. Before she was completely bedridden, she cried and cried that she wanted to die, exhausting herself with her pleading. Soon this active vibrant woman could no longer get out of bed and wasted away to little more than a skeleton over the next four years, afraid of her own toothbrush and the shadows she saw in the house. She died at 95. Dad should have had the option to quit this life when he asked to do so. Mom would have chosen to quit while she still could talk, right about the time that she could no longer sit up in her special wheelchair or stand up. Instead there was more suffering than I've described here, more than I ever could have imagined - nor could anyone imagine it if they hadn't seen it. It was brutal, inhumane, and traumatizing for all. We are kinder to our pets than we are to our dying elders. And that's the truth.
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The very old tend to accumulate chronic diseases and their symptoms gradually over years, there is often no one moment where a choice needs to be made to proceed or not. When there are decisions to be made its often such a hard call because nobody has a crystal ball to predict the outcome.

I worried when my mom's heart/stroke medications were reduced that she would have a stroke that would leave her alive and in worse shape than she was in already, the last thing I wanted for her was even more suffering and indignity. Turns out I didn't need to worry about that, but who knew?

I also am left with lingering questions about whether not treating her much more aggressively when she was in her 70s and 80s led to her multi infarct vascular dementia (my diagnosis based on piecemeal information). So in her case might more actually have been better?
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I think people misinterpret the question. If taking the meds give you a good quality of life well into your 90s...then by all means do it. I think the grey area is those who take meds to keep living but really don't have a life. Is it worth keeping someone alive if they are bedridden and their mind is gone? Or they continue to live but everyday is pure suffering? That is the real question.
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I live in a retirement community and know many people in their 80s and 90s who live active and fulfilling lives. I don’t believe we should hold everyone to the same expiration date. But - when it’s clear that health is going into a downward spiral and there’s no hope of avoiding dementia or another fatal or debilitating illness, I’m in favor of a legal and readily available way to end our own lives. However, “my body, my choice” does not seem to extend universally to the hopelessly ill and elderly. It’s shameful.
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There's a way to make money, a pill will be around.
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I absolutely agree we do too much.

As recently as the 1940s it was normal for a person to go along in their life, take a steep decline for one reason or another, and die in a relatively short time. For some, that happened when they were in the 60s like my great-grandfather, but for others like my great-grandmother, it happened in their 90s. Either way, there weren't years upon years of declining health and mobility, and few people ended up in diapers for years on end.

I saw the real beginning of the decline when my folks were in their early 80s. My dad was the lucky(ish) one to have no serious ailments before dying just a few weeks after a cancer diagnosis, but my mother began to lose her vision to macular degeneration in her mid-70s, then she had a major health crisis at 85. She hung on until last year, dying at 92 after seven years of dementia, CHF, incontinence, and the loss of her vision and hearing. She was a dynamic, intelligent woman with a killer sense of humor, and to see her reduced to a lump sitting in a wheelchair staring out the window at nothing was heartbreaking. I'm only glad that in the final years her dementia made her think she was 16 years old again, in love with her first boyfriend, and perfectly healthy. She truly didn't know anything was wrong with her, but that didn't remove the lack of dignity that marked those last years. She'd have been horrified had she known what was ahead of her.

My husband and I both have had some serious talks about our futures. His dad died from a brain bleed because he was on blood thinners he may or may not have needed years after a minor heart issue, and my mother lived at least seven years longer than her body probably wanted to. Neither of us really wants to be taking a fistful of pills every morning, noon, and night either. Right now we're in our very early 60s and have no health issues, but I expect to make it to about 75-80 before things really start going south. I'm sure we'll have grandchildren by then, so we may not be as willing to check out without intervention as we are now, but it'll definitely be in both our minds to keep the doctors largely at bay.
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I agree Freqflyer. There is a woman who was a contemporary of my parents (1920ish) who I often see out walking for exercise - no cane or rollator, and she goes at a speedy pace too. I also know of unlucky people who have ill health and a very poor quality of life who are only in their 50's and 60's... age alone should not be a measure of whether to choose medical intervention.
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FivePeppers, wish there were demographics that showed how many people 80 and up were leading fulfilling lives.

My Uncle recently passed at 95, and he was still gardening and selling produce at his local produce stand up until the week before he passed. On days off he would go fishing. His kids, grandkids, great-grandkids would always be swarming around him. He drove his tractor with a wagon behind it filled with free pumpkins for many years, in the town's Thanksgiving parade. He lived in a Mayberry type community in the mid-west.

My boss died when he was 85 from covid in 2020 [before the vaccine was available], otherwise he would still be coming to work on a daily basis, meeting with clients, having lunch with his buddies, etc. He was playing his weekly round of golf just days before covid hit him. His buddies were around his age, too.

There are a lot of actors who are 85 and over who still keep busy working. And probably a lot of not so famous people who have a fulfilled lives.
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Medicare: Todays news was about Kaiser and United Healthcare defrauding govt for extra or extraneous care.
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I think so as folks 85 , 90 and 100 do not lead fulfilling lives.
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If it wasn't for modern medicine my parents [who were in their 90's] wouldn't have been able to outside raking and bagging leaves. Or Dad tending to his small vegetable garden.

When Dad was in his mid-90's he moved into senior living after my Mom passed. He was happy as a clam where he was living. My Dad's god-children use to call him on a regular basis because he was such a store house of information and he could make them laugh. A former neighbor of Dad use to stop over weekly to chat about history.

Oh, when my parents were in their late 80's, they were still doing volunteer work 3 days a week at a local hospital [information desk]. After their shift, they would go to Roy Roger's for their favorite meal.

Who knows, there may be more older folks out there that are enjoying their older years then we may think. Since we here are only focusing on those that need major caregiving.
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I think it really depends on the quality of life you have. My father went into assisted living at 89. He still had 2 more years where his life was decent enough. The following two years were not. He was confused, could no longer talk on the phone mostly due to his refusal to get hearing aids, he had a permanent catheter, no longer enjoyed watching tv so he just sat and stared, eyesight was failing, couldn't hold a conversation with other residents due to lack of hearing, didn't participate in anything the AL had, and his primary focus in his life was his next bowel movement. It was heartbreaking to see a person who was once larger than life living like this. At least he wasn't bedridden. I know I wouldn't want to live this way, but apparently, he was content to do so. His monthly pharmacy bill was in excess of $200..so many supplements, etc...for what?
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Google " Plan 75 ", movie.

Thought provoking.
Some say the Queen Mother's life was prolonged too long.
Me : I do not agree ; she is the exception.
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The human body really isn't designed to live much more than 80 years.

Compounding the issue is that the nervous system is the least understood part of the human body, while giant steps are made in other areas of healthcare.

We can keep blood pumping, livers working, dialysis for kidneys, etc., but we can't fix the brain yet. The end result is a massive population of dementia/Alz patients living for 10+ years.
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Yes!
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Dementia dx-
i wouldn’t commit suicide but i would stop most or all meds prolonging my life.

living too long-
i saw a woman in my aunt’s mc facility who had to be assisted in chewing her food, i.e. the aid held her bottom jaw and moved it up and down for her. Otherwise the woman would pocket the food in her jaw or blow it out of her mouth.

i sure as heck don’t want to live like that!
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Good question. I know people who say, "If I get dementia, shoot me."...or they plan to kill themselves beforehand, if they realize they're starting to have symptoms.

I also know elderly people who have a little, not much, dementia, and who are sincerely very happy with life. Appreciating every day! My guess is that your question is such a personal one; everyone must decide for themself, what they would want (if they can plan suicide...). Personally, just for me, I wouldn't commit suicide. I would live till the end, whatever it is. In addition, I realize that our survival instinct is very strong; our bodies/our whole soul, tries to live, even under harsh circumstances.
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Yes. Yes. Yes. It also amazes me how some seniors can survive numerous cancers, stents, and other things while other seniors succumb to a small illness.
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Medicare enables people to the tune of billions to get the latest surgery or procedure for free until they get to the point of needing diapers and 247. Then the elder and fam are shocked they have to pay for it.

Most caregivers here are booomers or gen x. We will have it far worse and probably be about as bad as these senior brats and or dementia sufferers are. I expect right to die will become more of an acceptable option.
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temper13, that's an excellent question.

When I think about it, the meds I am taking today at mid 70's are meds that my late parents were taking when they passed in their mid-to-late 90's. Imagine if a doctor said that if you are past the age of 65, you can no longer take that medicine? What would be the cut off age? Don't let Congress get wind of this, someone would try to pass a Bill to cut cost to Medicare :P
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