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We live in CA where there is no Physician-assisted suicide (as in Oregon & Vermont). Dad has a DNR. He told the Facility [where he lives] that he does not want CPR or to go to the ER ever again. The Home claims that the Paramedics (NOT Dad!) decide if he must go to the ER. Is this true?
Dad is taking 15 powerful drugs whose side effects include headaches, dry mouth, heartburn, nausea, blurred vision. Dad has all of these side effects & he is miserable. They give him Tylenol for the headaches & Prilosec for the GERD, neither of which would be necessary if he wasn't taking these 15 drugs! He said that he has lived a good life and now wishes to die. He is incontinent, cannot walk and cannot feed himself. I feel helpless watching my poor Dad SLOWLY fading away painfully with no quality of life. Meanwhile, his meager savings are being drained by his pharmacies, drug companies, medical supply companies (aka, the Medical Industry). This is not right...or humane.
I was shocked to hear that none of Dad's medications have been tested on older people! In my opinion, the drug companies are using fragile seniors as their alpha testers. In other words, Dad has become a little white lab mouse for the drug companies. Is this why the Medical Industry wants to keep seniors alive beyond their natural years?
Dad is on Kaiser, which is a great Plan for young people because it focuses on preventive care. But Kaiser admits that gerentology is not one of their strengths. Doctors are trained to CURE people; my Dad cannot be cured. So Kaiser put him in HOSPICE. When he did not die in 6 mns, he was removed from the program. I am ashamed of my country's unwillingness to deal honestly with the issue of dignity and a Good Death for a generation of people who built our powerful middleclass with their strong work ethic. These people fought in two wars for their country and only ask for decent care and attention to their end-of-life wishes. Can we talk about these issues?
I am Dad's trustee, Power-of-Attorney, his trusted advisor, and his loving daughter. But I am 73 years old with medical issues of my own. This is a case of the Old-Caring-for-the-Old, which seems to be the standard side effect of the current research to keep humans alive indefinitely. Seems that no one wants to ask the hard questions: "What is the purpose of keeping people alive beyond their natural life?" "What will happen when 120 year old seniors run out of money?" "Is this tinkering with the natural cycle of Life & Death even ethical?"

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Dear DeeCent,
In answer to your first question, the Paramedics do not decide, if you have all the necessary paperwork in place stating that your Dad has a DNR in place. It should be posted by his bed. Does he have a medical directive in place? Can you get the doctor to sign off on a POLST form, which very specifically states what should be done in case of an emergency? Most doctor's offices have them. I don't understand why he was taken off hospice. It's an evaluation every 6 months, but if his condition has not improved, he can stay on hospice. It sounds like you are getting some wrong information. Is your father's lung cancer still considered terminal or has his condition changed? Do you have Power of Attorney? If so, you can consult with his doctors. Unfortunately the medical system is not always in alignment with the patient's wishes, but it's important to remember that your Dad has free will. I'm not saying he should stop taking his medications, but it sounds like he needs someone to be a strong advocate for him and get some straight answers from his doctors. Best of luck. I'm happy to continue this conversation with you.
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I don't have an answer for you, but I have the same feelings and questions as you do. I'm going through a similar situation with my almost 91 year old mom, and it's a terrible thing to watch your loved one go through. Just know there are many of us out here who feel your pain, and I don't know what the answer is. Good luck to you and your family.
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Deecent, I am caring for my 90 year old father and he is made helpless from a massive stroke. Very hard to deal with. They have him on his bloodpressure meds, aspirin, and something for gerd. They changed the blood thinners for an aspirin. You said he was on hospice once before and outlived it, { we had the same thing happen) after a few months, I asked to see if he re would requalify for hospice again, and he did, you may try that. They are about comfort and not cure. You might want to see about getting him moved if they do not carry out HIS wishes and see about talking to his doctor , and see if he re qualifies.
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I'll tell you what my dad did at 91 when he was diagnosed with lung cancer and given 12 months to live. He stopped all of his medications. He wasn't on 15, but even without those meds, he lived 12 months and 3 days. If I was you, I'd get the 15 meds reviewed by a trained geriatric pharmacist. You might be able to drop half of his meds and at least make him more comfortable. You can find one here: http://www.ccgp.org/locate-a-CGP And they can do a review if you send them a list of your dad's meds, i.e. you don't have to physically be in the same place.

For example, my dad AND mom were on Lipitor for cholesterol. I think docs prescribe those like candy. When you hit 60, you get Lipitor. I'm pretty convinced it helped my mom's loss of short-term memory. By the time you reach your 90s, my attitude is screw cholesterol! So I took my mom off of hers years ago and she's heading towards 94 and still in independent living (with a LOT of help from me). And my dad stopped his and his other meds and still lived comfortably for a year with his terminal lung cancer.

And my dad refused to go to the ER one time when he fell, so at least here in Illinois, the patient determines whether to go to the ER or not. If you have POA, I'd get a bit feistier with the facility where your dad lives about honoring his wishes. Is your dad in California? My brother and his wife (in CA) have Kaiser, that's why I ask. I'd be surprised if CA doesn't honor patient wishes.

I agree with what you say about our seniors living too long with poor quality of life. My mom says it all of the time. She's ready to go, but still has a relatively healthy body for her years.
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I think you might find a hospice program that will help your family. If there is a good hospice home available that might be ideal. My Dad was in one and they do adminster whatever meds or treatments make whatever life they have left as pleasant and pain free as possible. Most people wait way too long before making the move.
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Your Dad has the every right to have a DNR and his care facility doesn't have the right to contest it. Absolutely, post it on his bed, first responders are trained to honor people's choices. He also could stop all of his medication, this doesn't guarantee they he will die faster but if he wants to go why take anything. You can talk to his MD about just providing comfort care. He probably was disenrolled from hospice because he didn't fit the Medicare criteria, which can be frustrating. I know this because I worked as a Hospice Social Worker for years and we were often frustrated with the restrictions. Most hospices have a palative care program too, you might want to ask your local hospice if they will enroll him in that program, then as soon as his status changes they will get him back into hospice. I feel so sorry for people like your Dad and possibly us someday that are told they have no rights. You are such a good daughter to try to honor your Dad's self determination. Keep fighting for him!
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I too think it's horrible to sit and watch a parent fail. im in poor health myself .. it really sucks! I'm sorry for u and like kj said I do feel your pain....
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I know what you are going through. My dad's last month was terrible. My mom passed 4 years earlier. She was 74 and he was almost 91. To see what I remember as a strong husky man go down hill like that was unbearable to see. It is hard to get that vision out of your mind.. He didn't deserve to end that way. He should have gone quietly in his sleep. He always said, I fought in 2 wars and I deserve a peaceful death. My heart goes out to those of you going through this.
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At the age of 84,my Dad made it very clear to all of our family that his time had come to die, and he needed to be allowed to die. His mind was clear and he was intelligent but was terminally ill. He also had a medical directive that our family ignored ( with the exception of me). He was in constant pain or discomfort, and his dignity had been taken from him due to his medical needs. When he died, my husband and I were the only people with him because no one wanted to believe he was truly dying. I think people have to let go of those who are elderly, ill, and have the wisdom to realize they are ready to die. Our elders are much wiser than many medical people want to believe. You and you father will be in my prayers. I can tell you that I cried as Dad slipped away but was grateful he was no longer in pain.
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In CA you can get a POLST signed by your physician. http://www.capolst.org/ It helps the patient to make end of life decisions. I have one for my mom in CA. I have not had to use it and she lives with me so we will see what happens when the time comes. This should be able to help your father to have his wishes carried out. I agree with the above statements to review his meds and try to consult with a gerontologist/geriatrician to minimize his meds and make him more comfortable.
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