When are you too old to 'fix'?

[Anonymous]

Anonymous wrote:

Anonymous wrote:Sometimes people/patients/families fail to accept normal aging/end of life processes. Doing invasive treatments that will not prolong someone’s life statistically but will expose them to pain and risk of disabling complications may not be good for them. Patients may die during surgery or of post op complications. Everybody thinks the percentages will go in their favor, but some people with be in that percent of those who die. Physicians have to act in the best interest of the patient even if the patient may not agree. She could doctor shop and maybe find someone else if she likes. Often elderly patients with health issues will die of something else before the disease process takes them.

Doctors also acti in the best interest of the hospital...

I'm not the pp you are responding to.

Yes of course. It's necessary. Hospitals and medical care need to be available to EVERYONE, not just the extreme elderly that want to live forever.

[Anonymous]

I know Louis CK was cancelled but he had a funny bit about how even in your 40s a lot of complaints about aches and pains just lead to a shrug from doctors.

Doctors typically have an economic insensitive to overtreat so if they are discouraging a treatment, that tells you something.

[Anonymous]

I think this is more grey in your 70s. 60s you still treat most things. 80s maybe not if it's too invasive.

My Dad is 81 and this makes me sad to think about. Thankfully, he's very healthy. He did treat very early stage prostate cancer a few years ago. My mom is mid-70s and also very healthy. But I can imagine her refusing invasive treatment for sure.

[Anonymous]

Anonymous wrote:I know Louis CK was cancelled but he had a funny bit about how even in your 40s a lot of complaints about aches and pains just lead to a shrug from doctors.

Doctors typically have an economic insensitive to overtreat so if they are discouraging a treatment, that tells you something.

I remember that bit well and both my husband and could not stop laughing.

[Anonymous]

Sometimes it's not safe. General anasthesia can cause permanent decline in many elderly.

Some things are just inhumane. A mastectomy on a 90 year old? Why?

No doctor is required to operate or medicate on someone if it's futile.

[Anonymous]

I recently spoke with a ER doctor about my 75-year-old mother's wishes about resuscitation. He told me that across the entire population (so, old/young, healthy/unhealthy) the success rate for CPR is only 10-13%. It's also hugely traumatic to the body, particularly for an elderly person.

This shocked me. Like another poster said, I think we have a misperception from tv/movies about how successful and tame some medical procedures are. This doctor suggested it would be more humane NOT to do the full code. Intellectually I agree, although it's a terrible decision to make.

[Anonymous]

Yes and when you do all these lifesaving procedurs to leave someone a miserable mess unable to care for himself, there is usually an adult child with kids and stresses now stuck with guilt, resentment, sadness and exhaustion even if the person just goes into a nursing home. You slowly kill the adult child who's heart breaks trying to bring some joy to a parent who is barely alive and the grandkids are the ones who truly suffer with a burned out and exhausted parent and a grandparent who is barely what you call living. This isn't right. Our parents changed our diapers and fed us for only so many years and we can spend decades dealing with a hostile, weak, ailing, pain-stricken barely living parent trying to what...keep them alive so they can lash out more and drown in misery?

[Anonymous]

Anonymous wrote:Yes and when you do all these lifesaving procedurs to leave someone a miserable mess unable to care for himself, there is usually an adult child with kids and stresses now stuck with guilt, resentment, sadness and exhaustion even if the person just goes into a nursing home. You slowly kill the adult child who's heart breaks trying to bring some joy to a parent who is barely alive and the grandkids are the ones who truly suffer with a burned out and exhausted parent and a grandparent who is barely what you call living. This isn't right. Our parents changed our diapers and fed us for only so many years and we can spend decades dealing with a hostile, weak, ailing, pain-stricken barely living parent trying to what...keep them alive so they can lash out more and drown in misery?

Wow. You need therapy. I'm sorry for whatever happened to your parent(s), but you need to get over the anger.

[Anonymous]

Anonymous wrote:I recently spoke with a ER doctor about my 75-year-old mother's wishes about resuscitation. He told me that across the entire population (so, old/young, healthy/unhealthy) the success rate for CPR is only 10-13%. It's also hugely traumatic to the body, particularly for an elderly person.

This shocked me. Like another poster said, I think we have a misperception from tv/movies about how successful and tame some medical procedures are. This doctor suggested it would be more humane NOT to do the full code. Intellectually I agree, although it's a terrible decision to make.

The stats on CPR are even worse than that; it’s hardly ever successful in the field and even in a hospital setting with a full code team, CPR is only successful <10% of the time and the vast majority of resuscitation success stories are left permanently incapacitated after the resuscitation. A very very small percent like 2% actually fully recover and walk out of the hospital like on Grey's Anatomy and other medical TV dramas.

[Anonymous]

Anonymous wrote:I recently spoke with a ER doctor about my 75-year-old mother's wishes about resuscitation. He told me that across the entire population (so, old/young, healthy/unhealthy) the success rate for CPR is only 10-13%. It's also hugely traumatic to the body, particularly for an elderly person.

This shocked me. Like another poster said, I think we have a misperception from tv/movies about how successful and tame some medical procedures are. This doctor suggested it would be more humane NOT to do the full code. Intellectually I agree, although it's a terrible decision to make.

So this is the common advice from medical professionals now. I don't doubt that it has risks but it seems that there is more to it than that. Perhaps the hospitals don't want to additional liability and potential for lawsuit if they injure a person during CPR?

[Anonymous]

Great guide to help make end of life decisions

https://www.lcplfa.org/sites/default/files/documents/GS3-resource%201%20CPR%20article%20from%20CSA%20Journal.pdf

[Anonymous]

Anonymous wrote:

Anonymous wrote:Yes and when you do all these lifesaving procedures to leave someone a miserable mess unable to care for himself, there is usually an adult child with kids and stresses now stuck with guilt, resentment, sadness and exhaustion even if the person just goes into a nursing home. You slowly kill the adult child who's heart breaks trying to bring some joy to a parent who is barely alive and the grandkids are the ones who truly suffer with a burned out and exhausted parent and a grandparent who is barely what you call living. This isn't right. Our parents changed our diapers and fed us for only so many years and we can spend decades dealing with a hostile, weak, ailing, pain-stricken barely living parent trying to what...keep them alive so they can lash out more and drown in misery?

Wow. You need therapy. I'm sorry for whatever happened to your parent(s), but you need to get over the anger.

You need to look at why the anger makes you so uncomfortable. This is the reality too many people face. I have gotten plenty of therapy while dealing with aging parents deteriorating over many years. My therapists has heard many stories like this and encourages people to share their experience. You cringe and can't stand to hear what it does to families. Consider yourself lucky if your situation was far different.

[Anonymous]

Anonymous wrote:My parents have complained that the doctors treat them like they are 'expired' and not worth fixing. The doctors have told them they can't (or won't) try to address certain health problems they have. Instead they're told it's old age, just live with it. Has anyone else heard of this type of refusal to treat? What's the cutoff age?

I'm a nurse on a cardiac surgery unit. I don't know how many people are declined surgeries, but I do see who was accepted. 60s and 70s are most common. I can't recall a time when I had a patient who was over 90. Early 80s and 50s might be equally represented. A good outcome is not guaranteed to anyone at any age. Sometimes and certainly not rarely there are complications like stroke or worse. Being fit prior to surgery is no guarantee of a good outcome. We have two patients on our unit right now that have been in the hospital for 30+ days. Spending the majority of your day in bed and/or a chair for that long takes a toll on your skin, muscles, and fitness level. If this was your parent, who would take care of them when they eventually went home? Is your other parent up for the challenge? Are your parents strong enough to help each other out of a chair? Are they flexible enough to get on the floor and scrub the trail of poop or pee because the spouse can no longer get to the toilet fast enough? Are they able and willing to follow post surgery medication regiments, diets, and exercise?

Recovery is not easy especially if one already has mobility issues. If you weren't fit before surgery, you could be looking at weeks of rehab after discharge. After rehab, one often becomes a burden to their family because mobility issues only get worse following a long hospital/rehab stay. So many patients tell me that recovery is harder than expected even though they're told multiple times by multiple people that it will be painful and difficult.

Lastly, there are only so many surgeons, nurses, hospital rooms, etc. Everything in a hospital is a limited resource. One of the surgeons usually does 3 surgeries per day. There needs to be space and staff in the operating room, ICU, etc. for each of those patients. Like I said earlier we have a few patients with long stays. The average stay is around 4 or 5 days. If one patient is in the room for 30 days due to complications that means 5 or so other patients couldn't get their procedure done because there is not a hospital bed available.

[Anonymous]

Anonymous wrote:

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Anonymous wrote:

Anonymous wrote:https://www.theatlantic.com/magazine/archive/2014/10/why-i-hope-to-die-at-75/379329/

I agree with a lot of what this guy says. IMO "we" do too much to prolong life, with no quality of life. I saw a lot of comments during the early Covid days along the lines of "We all have to lock down or else my 97 year old grandmother with (lists 7 or 8 serious-terminal health conditions) might DIE!"

But who are you to say whether someone has quality of life? My mom with cancer said she wanted to live as long as possible and wanted every treatment possible. Maybe someone else would look at her and say her quality of life wasn't worth it, but it's her life and should be her choice.

If she's paying for it out of pocket, sure.

By that line of thinking then every obese person should pay oop as well.

Nope. False analogy.

NP. I don’t know… We can’t help aging. We can however often do quite a lot to help being obese or a smoker.

Old people rarely contribute to society, even in a basic way. They can’t work as well as they could when they were younger, they don’t have children or other dependents, they suck up tons of social resources, what used to be basic interventions are dangerous and risky, etc. These would be factors considered by an organ transplant team and is why there are age cutoffs for organ transplants and it’s rare an older person would be selected anyways.

Most importantly we spend a shit ton of money earmarked for healthcare on the final year of life. It’s some crazy percentage of total expenditure. You want free universal healthcare? Decide when we stop providing healthcare to old people (they can pay out of pocket) and just give them some morphine as they die of wtv ailment. You’ll need to know that before any plan works.

I'm gonna need numbers on this, or you're just blowing smoke.

I'm not the pp you are quoting, but from JAMA: "In fact, about one quarter of all Medicare spending goes toward care for people during their last year of life."
https://jamanetwork.com/channels/health-forum/fullarticle/2760146

This sounds like the joke that you always find something lost in the last place you look for it. They specifically mention cancer treatment, which can happen at any age

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:https://www.theatlantic.com/magazine/archive/2014/10/why-i-hope-to-die-at-75/379329/

I agree with a lot of what this guy says. IMO "we" do too much to prolong life, with no quality of life. I saw a lot of comments during the early Covid days along the lines of "We all have to lock down or else my 97 year old grandmother with (lists 7 or 8 serious-terminal health conditions) might DIE!"

But who are you to say whether someone has quality of life? My mom with cancer said she wanted to live as long as possible and wanted every treatment possible. Maybe someone else would look at her and say her quality of life wasn't worth it, but it's her life and should be her choice.

If she's paying for it out of pocket, sure.

You or the insurance companies do not get to decide that. Also, you are a horrible human.