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The state of Death Care care in America.

2.3K views 39 replies 24 participants last post by  daddyusmaximus  
#1 ·
Recently we had a friend who was deteriorating quickly, he had "great insurance" and "VA benefits" he moved in with us so we could be of more help to him. Getting him some initial rehab wasn't too bad but he needed more at every step of the way there were obstacles he had Medicare and VA, he was in the VA system but he tried not to utilize it till now and unless you know the system it's very hard and slow to navigate.

Our friend was getting worse by the day you could literally see changes from one day to the next, in a matter of a week or two he couldn't walk and had a hard time speaking. While we didn't really believe he was going to pass away soon we did ask for hospice. For those that don't know hospice is there to keep you comfortable but not get you better. That's when we saw the mountains move and we saw people doing something (help him die in comfort) all the resources were made available and all you have to do is ask and in a lot of ways you don't have to ask because they bring you everything.

Does anyone remember the "death panels" discussed a couple elections ago? This is what hospice reminds me of, don't get me wrong hospice is great but what if we allocated more resources to keeping these people alive?
 
#2 ·
#3 ·
As more power is given to ins companies to dictate who, what, when, why, where and how for the covered, expect more problems.

Queen and sis-n-law both work in medical field and have to fight daily for patients. Ins will demand Mrs Flipflop has to change her rx because new one is cheaper. Queen goes to swinging the bat that rx Mrs Flipflop has been on for the past xx years works. Too bad, gotta change or ins will no longer cover it.

Ins is a necessary monster, unfortunately.
 
#4 ·
Does anyone remember the "death panels" discussed a couple elections ago? This is what hospice reminds me of, don't get me wrong hospice is great but what if we allocated more resources to keeping these people alive?
🤬🤬
When I have time I’ll post what I witnessed.
Wasn’t even my relative and took every bit of self-control to not do something I’d get taken down for.
 
#25 ·
I used to say that. It sounds good until you can't breathe or have trouble moving. Then I'll take whatever pharma I can get. Some of us need to stay independent for as long as possible because we don't have anyone to take care of us. I do what I can on my end but there's going to be a time when pharma will help me stay out of the hospitals and nursing homes, and I'll take it.
 
#7 ·
I'm sorry to hear about your friend. Did he have a terminal illness? Was he elderly? No family?

I am kind of torn on the subject. On one hand we have those who need access to healthcare and quality of life treatment while on the other we have an enormous population of aging fatties and lazies who rely on the medical and pharmaceutical industry to perpetually extend their lifestyle.

My Mother's husband uses the VA and likes it but man does he abuse the crap out of it. Probably at the expense of others. He won't do physical therapy, change his diet, or lifestyle but throws a tantrum anytime they change his medication or try to get him to help himself. My Mother is spending her retirement years being his full time care giver and is declining because of it. I wish he would just pass away.
 
#12 ·
No terminal illness, for some reason after getting a certain shot he started going downhill and having multiple strokes the last 2-3 months it's been incredibly sad.

I agree that "the system" is less than perfect and plenty of people abuse it, he was not a big offender. He was a lifelong outdoorsman/hunter but because of what he was exposed to in the military his health wasn't great but after the shot he was not the same.
 
#8 ·
I am on the fence on this. If you are not going to "get better" when the pain is so bad you are so stoned what is really the point. Is that any kind of quality of life. On the other hand I can see you not wanting to let a loved one go, that would be so hard to do.

We are all on a dead end road, it will end. The pot holes along the way make all the difference. If it gets to the point I am in a bed pooping and wetting myself, and that is going to be it till the end. Not able to say a thing, do a thing but soil myself. I would want the option to hit the off switch.
 
#9 ·
I agree. When my mom went I was fortunate to afford the best care. We had to move her to a higher care place. The lady there said, "Why isn't she on hospice." It was night and day.

Me, I'm not interested in dragging things out. When it comes time I have a place picked out on the rim of the Grand Canyon with a nice view where I'll sing my death song. My life, my choice.
 
#26 ·
Wellll........

I have seen this first hand. Depending on what kind of "shape" you are in it might not be your choice. And this goes well past after you have passed. Unless you have everything laid out in a very legal manner that is the only things MIGHT go the way you want it to at the end....and after the end if you catch my drift.
 
#10 ·
This is what hospice reminds me of, don't get me wrong hospice is great but what if we allocated more resources to keeping these people alive?
Sorry if I'm taking it wrong,but this is 2 different things.
Hospice is end stage,enjoy/relax whats left,quality of life,blah,blah,blaf..its a blessing,they are so caring from my personal cantact with my wife and recently my Dad,..keeping them alive(curing/saving) is not what hospice is for.
 
#14 ·
The father of my daughter in law was suffering with Leukemia. Normally - a bone marrow transplant is tried.

In this case - his is 81, normally making him not even eligible. Happily, as former SOF, he stayed/ is in peak condition, running 5 miles a day / running a jump school...and is whipcord lean (yes, still green, still lean, but now bit more mellow).

The good news, his doctor pushed his case - and I'm very happy to say, his treatment was successful.!!

So, a disease isn't always fatal, with someone on your side.
 
#27 ·
The father of my daughter in law was suffering with Leukemia. Normally - a bone marrow transplant is tried.

In this case - his is 81, normally making him not even eligible. Happily, as former SOF, he stayed/ is in peak condition, running 5 miles a day / running a jump school...and is whipcord lean (yes, still green, still lean, but now bit more mellow).

The good news, his doctor pushed his case - and I'm very happy to say, his treatment was successful.!!

So, a disease isn't always fatal, with someone on your side.
This is a bit different, and really falls into each person is a different case. And really why the .gov needs to keep its nose out of it.

Your example there is treatment that is known to work most of the time. If he was 41 it would have been no question. The only reason it came up is he is 81. A very fit 81. And your local Dr could go to bat for him. He is in fantastic health he could have a good 20 years left in him. This is far from the norm, and when the .gov starts to stick their nose in there is very little room for working outside the box. This is what it is on paper, no exceptions are made.....well not for "normal" people.

IF he did not have someone to go to bat for him it would have been a very different story. I am happy it worked out for you all. Hopefully he is passing on what he has learned in his years for the next gen....or two.
 
#15 ·
It's hard because every case is somewhat unique.

Even with the very best of care, would that have given him more years of quality living? As mentioned, it's a dead end road for this ol' meat suit. We can do what we can and are willing to do. Otherwise, there is a point beyond which it just ain't goin' on no more.

Sometimes it's not the person dying that's wanting all of the best of high-tech to keep 'em going, it's the family that won't let them go.

One thing about hospice, if you get on it and you don't die, you get booted off of it. That has happened a few times.

FWIW, I'm not one that goes to the doctor. And pushin' 60, I know there may come a time in the not so distant future when somethin' could go wrong. I try to look after myself, eat right, get exercise, stuff like that. Even check the BP every so often which is normal. But when my time comes, I don't wanna drag it out. I'm of a mindset that there is another life ahead, one that's better than this one. But that's not quite where this thread was goin'...
 
#24 ·
.

One thing about hospice, if you get on it and you don't die, you get booted off of it. That has happened a few times.
We had a lady I know that went on hospice, and came off it on this side of the grave. She took care of herself, stayed busy, and doesn't spend her time looking for things to complain about. I drove her to the doctor one time, and told her she was an inspiration. She told me she had an evil cat that she loved and knew no one would take care of him after she died so she decided she couldn't die until the cat did. I told her I had an evil cat too. She gave me a hug and said that then I was going to live forever. That damn cat may have earned his keep. LOL
 
#16 ·
My FIL was a diabetic due to poor lifestyle and ended up on dialysis. He always had an excuse to lay in bed all day and watch TV. This went on for decades. In his 60's he finally got a kidney transplant and swore it was second chance at life. He went directly back to watching tv in bed all day. He lasted a couple more years doing this. He broke my wife's heart.

He had all the healthcare and opportunities one could possibly have but always had an excuse.
 
#17 ·
Funny, I was thinking something like this earlier today. Friends and I were discussing how complicated the health care system is today and I remember thinking how uncomplicated it got for my mom when she entered hospice in early summer of '22. Every drug and supply needed to help her die was suddenly easy to get.

But, I think it's definitely much harder to keep people alive than to let them die, under any circumstance, so there is that.
 
#18 · (Edited)
Hard to think about it let alone write it out again.
Here’s my take: (shortened version).
Death panels are real, and headed by hospital appointed “patient advocates.”

An in-law of mine had a stroke.
Little rehab and was good to go.
5-6 years later she had another stroke.
We took off to go to the hospital to visit cause we heard it was “bad.”
At hospital the next day doctor comes in and tells family that brain scans look good, but affected speech centers, and movements of left arm. Recovery would be long but prognosis was fairly good.

Miss **** could still eat if fed. Wasn’t on ventilator, could follow instructions etc.

Nurse came in after doctor left to administer medication. In-law at first refused, then nurse said “now miss ** you need to take your medication, and miss ** did.

10 minutes later the most silver tongued manipulative, inhumane, ignominious devil I mean “patient advocate” entered the room.

She asked who was responsible for end of life decisions then starts talking.
We are still in the same room with miss **** (I was their as emotional support for wife).

Patient advocate says she is appointed by hospital to look after what’s best for the patient.
She says, “now I’ve talked to the doctor, and we are at the point of looking at quality rather than quantity.”
Miss **** is no longer aware of what’s going on around her.
Miss **** has has a quality life and if it was my mother I would make it easy on her by moving her to a back room sedating her until her she passes away peacefully.

At this point miss **** starts using her good arm to gesture, point, and try to pull herself up. Started trying to twist and turn in the bed….making noises etc.

(by this point I was becoming enraged at the “advocate” stripping miss **** of her human dignity talking about ending her life while in the same room and talking about her like she was a piece of old furniture).

The “advocate” used miss **** attempts to get up, “see how bad shape she is in? She doesn’t even know what she is doing. She’s no longer all there.”

One responsible for decision still wasn’t fully convinced so Then the “advocate” went and got the doctor.
Stated the same thing in front of doctor that basically there was no hope of her ever recovering. (Exact opposite of what doctor said earlier).

The ****ing doctor did a 180 degree from what he had said to us earlier and said she was in bad shape and it was unlikely she would ever recover. (He acted afraid to contradict the “advocate.”)

Then he started talking about miss **** like she wasn’t there.

I had went and got a alphabet so miss **** could point to letters, “patient advocate” was still there when I got back.
My idea was miss **** could point to letters to have a say.
That idea got shot down, “advocate” had gotten doctor to sedate her cause of her “involuntary movements” before I got back.

What they did was too much.
By that point I was on verge of uncontrollable blind rage due to “advocates” lack of decency, decorum, and stripping an old woman of her dignity and told the wife, neither of us were gonna be a party to this forcing someone to die of dehydration. To say her goodbyes and we were leaving within the hour before I put the “patient advocate,” and lying weak minded doctor out of other peoples misery, or got into such a row with everyone about something not really my business i ended up in jail.

4 days of just enough sedation she couldn’t complain with no water (IV), or food before she died.
 
#35 ·
Hard to think about it let alone write it out again.
Here’s my take: (shortened version).
Death panels are real, and headed by hospital appointed “patient advocates.”

An in-law of mine had a stroke.
Little rehab and was good to go.
5-6 years later she had another stroke.
We took off to go to the hospital to visit cause we heard it was “bad.”
At hospital the next day doctor comes in and tells family that brain scans look good, but affected speech centers, and movements of left arm. Recovery would be long but prognosis was fairly good.

Miss **** could still eat if fed. Wasn’t on ventilator, could follow instructions etc.

Nurse came in after doctor left to administer medication. In-law at first refused, then nurse said “now miss ** you need to take your medication, and miss ** did.

10 minutes later the most silver tongued manipulative, inhumane, ignominious devil I mean “patient advocate” entered the room.

She asked who was responsible for end of life decisions then starts talking.
We are still in the same room with miss **** (I was their as emotional support for wife).

Patient advocate says she is appointed by hospital to look after what’s best for the patient.
She says, “now I’ve talked to the doctor, and we are at the point of looking at quality rather than quantity.”
Miss **** is no longer aware of what’s going on around her.
Miss **** has has a quality life and if it was my mother I would make it easy on her by moving her to a back room sedating her until her she passes away peacefully.

At this point miss **** starts using her good arm to gesture, point, and try to pull herself up. Started trying to twist and turn in the bed….making noises etc.

(by this point I was becoming enraged at the “advocate” stripping miss **** of her human dignity talking about ending her life while in the same room and talking about her like she was a piece of old furniture).

The “advocate” used miss **** attempts to get up, “see how bad shape she is in? She doesn’t even know what she is doing. She’s no longer all there.”

One responsible for decision still wasn’t fully convinced so Then the “advocate” went and got the doctor.
Stated the same thing in front of doctor that basically there was no hope of her ever recovering. (Exact opposite of what doctor said earlier).

The ****ing doctor did a 180 degree from what he had said to us earlier and said she was in bad shape and it was unlikely she would ever recover. (He acted afraid to contradict the “advocate.”)

Then he started talking about miss **** like she wasn’t there.

I had went and got a alphabet so miss **** could point to letters, “patient advocate” was still there when I got back.
My idea was miss **** could point to letters to have a say.
That idea got shot down, “advocate” had gotten doctor to sedate her cause of her “involuntary movements” before I got back.

What they did was too much.
By that point I was on verge of uncontrollable blind rage due to “advocates” lack of decency, decorum, and stripping an old woman of her dignity and told the wife, neither of us were gonna be a party to this forcing someone to die of dehydration. To say her goodbyes and we were leaving within the hour before I put the “patient advocate,” and lying weak minded doctor out of other peoples misery, or got into such a row with everyone about something not really my business i ended up in jail.

4 days of just enough sedation she couldn’t complain with no water (IV), or food before she died.
That's horrible!!

When my mother was in a coma in a hospital, a nurse took me out into the hall (so a bit more respectful than that ******* "advocate" you experienced), and essentially said they could give her an overdose of pain killer and kill her for us. I declined. She died on her own a day or two later.
 
#23 ·
There is a woman on my Meal on Wheels route who was given a 6 month to live almost 4 years ago now. She still lives alone at home, and takes care of herself. We bring her a meal more because she has no family, and should have someone looking in on her than she needs the meal. She spent a couple months after her diagnosis just waiting to die, then decided that was boring and got on with living. We built her some raised beds for her garden, drive her to the store once a week, and she likes to paint. She stay busy enough, and enjoys her life.

We pass when we pass. There gets to be a time when doctors don't seem to be in the business of curing people and that's when they have no use anymore. Some people seem to worship at doctor's feet, including many politicians. They are given more power than they should be given. Many meds that are labeled as prescription only should be OTC. Can people get hurt or die by using them? Yes, but people fall off ladders and die all the time. Should they be taken away and be only used by trained professionals? I has seen many an idiot with a chainsaw. But they are not "for prescription only". Yet the medical field can control life and death items because we could hurt ourselves with it. It's a scam.

I see them as tools, sometimes useful, sometimes not. I certainly am not going to hand my life over to one. They are people, many elevated to a pedestal they don't deserve.
 
#21 ·
My eldest brother had colon cancer. Last 6 months or so he was in a hospice center. They took very good care of him. He was fed, bathed, etc. Mom had some sort of cancer (I don't remember which) She was in hospice for 30days. The first day she was lucid, and we talked. When she said she was tired, we said see you tomorrow. She went to sleep that night and passed 30 days later without waking up. I don't know if she was medicated into that state, or just slipped into a coma. She was cared for (I moved into her room, so I saw all of it) bathed, etc the entire time. She had an IV until 2 days after her kidneys ceased to function, but the still came in and gave her ice chips.
MIL had Alzheimer's. We cared for her at home with the assistance of hospice folks. She was never treated badly even when we were given "date nights" where a home care nurse would come in so we could take a break for a movie or whatever.
My thought is that it depends on the facility/home care people. I am sure there are horrible conditions out there. None of my experiences with hospice were anything but as good as can be, given the circumstances.
 
#29 ·
I don't mean to be insensitive with my comment, given the OP's situation. But, the answer is simple: you have to know when to cut your losses.

Oh, and just a pro tip for anyone having to make the decision for hospice on a loved one... Make sure that you and everyone else responsible for the decision are on the same page in understanding what hospice actually is. My wife's grandmother recently passed in hospice care in her own home. Doctor gave her 7-10 days. Day 2 after being home, her oxygen crashed dangerously low to the point death was possible. Two of the siblings started panicking and demanding that 911 be called. The other 3 siblings understood what hospice meant and insisted it was her time to go. Not a good situation to be dealing with... But she did pull through for several more days before she actually died.
 
#31 ·
I agree. When my mom went I was fortunate to afford the best care. We had to move her to a higher care place. The lady there said, "Why isn't she on hospice." It was night and day.

Me, I'm not interested in dragging things out. When it comes time I have a place picked out on the rim of the Grand Canyon with a nice view where I'll sing my death song. My life, my choice.
I have discussed this with my boys, my coffin is in the rafters of my garage, my stone is made and in place, just waiting for a final date, and I know where I'm going to have my last view of the world if I have a choice. I am not going to fight to live in a little box of an old folks home, fighting for one more day to watch The Price is Right.
 
#32 ·
So just a couple of thoughts on this topic since I went through this with my Mother.

1. The last 4 things....Death, Judgement, Heaven or Hell........ Only God knows the exact time and place when you are going to leave this earth and there is nothing you can do about it. That being said when taking medical decisions or trying to assist...... we all need to know when to say when.....make it good with God and prey for the best outcome.

2. Two standards of healthcare.... for those that have private healthcare there will be no end to tests, life support or anything else thwy can do to extract money from insurance companies and on the other side Medicare will have an average amount fo care unless you know your rights. That being said.......it's never a stupid idea to know the ins and outs of final cost healthcare and how it all works.

3. Lastly......if you dont have a last will and testament including your last wishes and how you end of life medical treatment will actually go....you better get on it

HK
 
#33 ·
I know a nurse that works for a healthcare company that also provides insurance.

They literally base care on the amount of claims/use by patient.

Meaning, if a patient is considered “high profit“ they will dissuade any high cost treatments to keep their profits high at an individual level.
 
#34 ·
The goal is not to cure you, it is to milk you. The medical industry sees a sick person the same way a diary farmer sees a pregnant cow...

Now more than ever it has become important to be as medically self sufficient as possible, to do everything in your power to keep yourself healthy- because there is more incentive to perpetually treat you than to permanently cure you.