When are you too old to 'fix'?

[Anonymous]

Anonymous wrote:

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.

The horrible person is the selfish one that "wants every treatment possible" regardless of the cost.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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.

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

And?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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.

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

And?

I mean that saying 25% of medicare spending is in the last year of life is expected because people are sickest before they die, at any age. Problem is, there's no way to know a year prior that anyone is going to die. So for this statistic to mean anything, the money spent needs to be aggregated on something known a year prior, like age.

Or maybe you didn't understand the joke? After you find the lost item you stop looking, so it's always in the last ace you look.

[Anonymous]

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.

Dealing with this issue with my 86 year old mom. She had open heart surgery to correct a congenital heart valve condition over 20 years ago but now has developed a symptom of heart failure. She is facing several invasive tests to properly diagnose this new development and has already said that she doesn’t want the invasive surgery that is typical of the diagnosis.

I told her bluntly that she will not be forced by her doctors to have surgery that will involve risks of anesthesia and extensive recovery. She was getting more agitated and worried about facing surgery. She needed to hear that at her age, she has to really think through risks and pros + cons. Right now she’s active, independent and in otherwise great health.

[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.

Dealing with this issue with my 86 year old mom. She had open heart surgery to correct a congenital heart valve condition over 20 years ago but now has developed a symptom of heart failure. She is facing several invasive tests to properly diagnose this new development and has already said that she doesn’t want the invasive surgery that is typical of the diagnosis.

I told her bluntly that she will not be forced by her doctors to have surgery that will involve risks of anesthesia and extensive recovery. She was getting more agitated and worried about facing surgery. She needed to hear that at her age, she has to really think through risks and pros + cons. Right now she’s active, independent and in otherwise great health.

If she knows she’s not going to get the surgery, then why should she go through the invasive tests?

[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're a disgusting ghoul. I know you don't care, but you are. NP

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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.

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

"Medicare spending?" ROFL. You know who the vast majority of people who even qualify for Medicare are, Jan? Use your brain.

[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!"

That's odd, I saw way more comments that indicated it was wrong to keep kids out of school just to save someone's grandma who was going to die soon anyway, as if people in their 70s and 80s should have been sacrificing their own lives so their grandchildren could be in a classroom rather than inconveniencing their parents by learning at home for awhile.

Except that kids didn’t learn much while schools were closed, because (1) online school is a farce and (2) most parents work, so can’t hover over their kids every second. So, we did irreparable damage to many kids for… what, exactly?

Remember, these are children. The future of society. Put another way, I hope that if I am lucky enough to live a long life, I can appreciate that my needs don’t come before those of those who have their entire lives ahead of them.

The kids who didn't learn are the parents who threw tantrums and didn't try, barring extreme special needs, in the DCUM demographic. Bzzt! Try again.

[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!"

That's odd, I saw way more comments that indicated it was wrong to keep kids out of school just to save someone's grandma who was going to die soon anyway, as if people in their 70s and 80s should have been sacrificing their own lives so their grandchildren could be in a classroom rather than inconveniencing their parents by learning at home for awhile.

Except that kids didn’t learn much while schools were closed, because (1) online school is a farce and (2) most parents work, so can’t hover over their kids every second. So, we did irreparable damage to many kids for… what, exactly?

Remember, these are children. The future of society. Put another way, I hope that if I am lucky enough to live a long life, I can appreciate that my needs don’t come before those of those who have their entire lives ahead of them.

So what? Your kids are your kids. No one else's family owed them sacrificing the lives of their family members because you were Big Mad your kid wasn't in a physical school building.

[Anonymous]

Anonymous wrote:

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're a disgusting ghoul. I know you don't care, but you are. NP

You're a selfish pig. I know you don't care, but you are.

[Anonymous]

Anonymous wrote:

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.

Dealing with this issue with my 86 year old mom. She had open heart surgery to correct a congenital heart valve condition over 20 years ago but now has developed a symptom of heart failure. She is facing several invasive tests to properly diagnose this new development and has already said that she doesn’t want the invasive surgery that is typical of the diagnosis.

I told her bluntly that she will not be forced by her doctors to have surgery that will involve risks of anesthesia and extensive recovery. She was getting more agitated and worried about facing surgery. She needed to hear that at her age, she has to really think through risks and pros + cons. Right now she’s active, independent and in otherwise great health.

If she knows she’s not going to get the surgery, then why should she go through the invasive tests?

PP is asking a good question. The tests may be standard operating procedure for the doctor but if you aren't going to act on the results, it does not make sense to get the tests. I won't let my mom get any preventive or screening tests at this point.

[Anonymous]

I am 50, and I need both hips replaced, but I am not a candidate for surgery because I have other health problems that would make surgery too risky.

[Anonymous]

Anonymous wrote:

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.

I wish you would name your hospital so we know not to take our elderly parents there.

I have a relative who had two emergency cardiac valve surgeries (not open-heart surgeries) in her 90s at Cornell medical center in NY. She is still alive a year later. She never pooped on the floor, as in the example you stated. She was discharged from the hospital straight home (no time in rehab). Yes, she can get herself dressed, sit, stand, walk on her own. She reads a lot, takes walks and enjoys her family. Yes, it took a few weeks before she was fully mobile and, one year out, I do see a bit of a loss in memory (she had none before the surgeries) but I’m glad we chose to have the surgery done on her and she’s doing well.

I am writing this because there may be people who don’t know that heart valve surgery can be an option even for people in their 90s.

[Anonymous]

Anonymous wrote:

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?

Hospitals aren't liable for taking life-saving measures, including CPR. CPR is standard operating procedure. Hospital and doctors are going to be liable if they DON'T do CPR, unless there's a DNR (do not resuscitate) order.

But yes, CPR routinely breaks ribs and cracks sternums (because to do CPR right, you have to compress the chest by two inches). A very significant percentage of people who get CPR end up with broken ribs or a cracked sternum. The standard percentage given is 30% of patients but there's research showing that the real number is quite a bit higher:

However, a 2015 study published in Resuscitation suggested that this percentage is quite a bit higher. The study analyzed autopsy data from 2,148 patients who received CPR for non-trauma-related cardiac arrest, and the statistics were as follows:

Skeletal chest injuries were found in 86% of men and 91% of women.
59% of the men and 79% of the women had sternum fractures.
77% of the men and 85% of the women had rib fractures.
33% of the men and 12% of the women had sternocostal separations.

It’s clear from the above data that women are more likely to receive skeletal chest injuries than men. In addition, the study found that older patients were more at risk of these kinds of injuries than younger. Existing health conditions such as osteoporosis, which weakens the bones, can also result in a higher chance of injuries.

Source: https://www.cprcertified.com/blog/what-happens-if-ribs-break-during-cpr

Then there's the internal organ damage, bleeding, and bruising. It's really no joke. Make sure your elderly parents have whatever end-of-life, including DNR orders, and that you or someone else responsible has a healthcare power of attorney.

[Anonymous]

Anonymous wrote:

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.

DP. I understand the emotional reaction, but our “all the treatment regardless of the cost or likely outcome” to elder and end of life care is a significant part of why healthcare costs as so astronomical in this country. Other countries will more affordable healthcare tend to take a more realistic view of what is worth doing based on the likely outcome. That’s not just by doctors/insurers, but also by patients. Americans seem to believe on some level that if they just get enough healthcare, they will live forever. But it’s not true.