Anonymous
07/13/2023 14:26
Subject: Bias towards elderly who will not go quietly
I think a lot of you can't imagine the trauma of CPR on an 80 year old. It's incredibly violent on the body.
Anonymous
07/13/2023 14:24
Subject: Re:Bias towards elderly who will not go quietly
I just went through this and CPR would involve crushing my parent’s chest and ribs.
I also refused a feeding tube so they could lay in bed hallucinating a few months longer.
People need to visit hospice care before they make ridiculous wide sweeping… I wanna stay alive at all cost proclamations.
The reality is they won’t decide, you will no matter what they say.
Unless you are a sociopath you will make a best decision based on quality of life.
I also refused a feeding tube so they could lay in bed hallucinating a few months longer.
People need to visit hospice care before they make ridiculous wide sweeping… I wanna stay alive at all cost proclamations.
The reality is they won’t decide, you will no matter what they say.
Unless you are a sociopath you will make a best decision based on quality of life.
Anonymous
07/13/2023 14:23
Subject: Re:Bias towards elderly who will not go quietly
I know exactly what you are talking about, OP. It is further complicated by race. My best friend’s father, with stage 4 cancer, refused to sign a DNR because he felt that with one, doctors would give up on him the minute he showed up in the ER as an elderly Black man. He liked his life, even with Stage 4 cancer.
It meant that when he eventually went, with a heart attack, his wife and children had to be in the room while they did violent CPR for an extended period. But although that was hard to watch, it was completely in line with his wishes. And frankly, having been close to the family this whole time, their entire experience has made me rethink me own DNR. I’m not sure I trust the system any more. There were times that he came back from where the family was pressured to act as if he’d had a DNR — and he lived for several months longer. They were good months, yes with the pain of cancer but also with family and love. I am glad he had them, and so is the family. It was eye opening.
It meant that when he eventually went, with a heart attack, his wife and children had to be in the room while they did violent CPR for an extended period. But although that was hard to watch, it was completely in line with his wishes. And frankly, having been close to the family this whole time, their entire experience has made me rethink me own DNR. I’m not sure I trust the system any more. There were times that he came back from where the family was pressured to act as if he’d had a DNR — and he lived for several months longer. They were good months, yes with the pain of cancer but also with family and love. I am glad he had them, and so is the family. It was eye opening.
Anonymous
07/13/2023 13:57
Subject: Bias towards elderly who will not go quietly
What you are referring to OP is rationing of care. And all it takes is one doctor or health care provider who just decided in their own opinion they've done enough and let your parent die.
This happened to my father. He was like your parents, did not want to die. He was only 76 when he passed but he did absolutely everything the doctors had told him to do, was a model patient (even ate a renal diet which is a nightmare of epic proportions) , was willing to be on dialysis forever if it meant seeing his grandchildren grow, and it only took one random doctor who decided it was too difficult to redo his port and for my father to reschedule for him, within 24 hours, to go into full renal failure (bc no port = no dialysis) and quickly die.
This happened to my father. He was like your parents, did not want to die. He was only 76 when he passed but he did absolutely everything the doctors had told him to do, was a model patient (even ate a renal diet which is a nightmare of epic proportions) , was willing to be on dialysis forever if it meant seeing his grandchildren grow, and it only took one random doctor who decided it was too difficult to redo his port and for my father to reschedule for him, within 24 hours, to go into full renal failure (bc no port = no dialysis) and quickly die.
Anonymous
07/13/2023 13:46
Subject: Re:Bias towards elderly who will not go quietly
Anonymous wrote:I’m on your parents’ side. They still feel there is value in living. No one has the right to overrule them and decide that their life has less significance because of their age. That’s a terribly slippery slope that I think we should be wary about. If someone can determine that old people might not derive sufficient benefit from their life to justify the possible inconvenience to others, what’s to say that’s where the line gets fixed? What about people with serious illnesses, physical disabilities, mental illness, cognitive impairment, chronic disease, addiction, poverty, people who aren’t likable, people who are just different, people whose death can benefit someone else?
Every life is precious. When we start marginalizing lives and trying to decide which are worthy of continuing, all lives are imperiled.
Doctors do this all the time. It’s why when a 75 year old needs a lung transplant they don’t get one - they give it to the younger healthier patient who who will get better/longer use out of it.
You may not like it, and think that everyone will be treated the same, but that’s just not the way it is.
Anonymous
07/13/2023 13:44
Subject: Re:Bias towards elderly who will not go quietly
I think something like 90% of medical spending is on people in their last few years of life. So, I think hospitals and Drs are plenty willing to do complex, expensive surgeries and procedures on people with only a few years (or months) left.
That said, if you're a frail 85yo, you're not going to recover from surgery or another major intervention like a healthy 35yo. You're more prone to infection, you lack muscle and strength, you have other health problems. A good Dr should be honest about that. And I don't think Drs who are honest about the likelihood of a surgery being successful are being ageist or biased.
That said, if you're a frail 85yo, you're not going to recover from surgery or another major intervention like a healthy 35yo. You're more prone to infection, you lack muscle and strength, you have other health problems. A good Dr should be honest about that. And I don't think Drs who are honest about the likelihood of a surgery being successful are being ageist or biased.
Anonymous
07/13/2023 13:40
Subject: Bias towards elderly who will not go quietly
One thing^^
Anonymous
07/13/2023 13:39
Subject: Bias towards elderly who will not go quietly
OP, what you are not getting is your parents are healthy and have a quality of life. You/they may think differently if, for example, they get severe dementia and have no idea who they/you are, cannot feed or care for themselves and are clearly suffering.
Anonymous
07/13/2023 13:38
Subject: Bias towards elderly who will not go quietly
I am sorry, what? So they are old and should just die already instead of taking meds and such?
Once thing they did wrong is that they raised a narcissist! Yes, you will do the same, heck you will do worse when old.
Once thing they did wrong is that they raised a narcissist! Yes, you will do the same, heck you will do worse when old.
Anonymous
07/13/2023 13:35
Subject: Bias towards elderly who will not go quietly
Anonymous wrote:Anonymous wrote:
My husband is a doctor, other relatives are doctors, and you are entirely wrong, OP. Doctors take the Hippocratic Oath. Saving lives is more than a job. It's a calling. If the patient does not have a terminal diagnosis, then it's the standard of care to do everything possible to save their lives and not discuss palliative care until it's needed.
You are shockingly ageist: just because someone is old and frail, with the normal ills of age, does not mean they're ready to be put out to sea on an ice floe. When patients are in terrible pain and death is certain... that's when they ask for a painless exit, and deserve one, at any age. Pain and hopelessness are the criteria, not age.
I hope you're a troll, actually.
I appreciate that your husband and relatives may not have this view but I fully understand the OP’s experience because I am living it also. And, fwiw, I used to work in healthcare (at a local hospital) and I have relatives who are doctors and nurses.
My parent is in his 90s and their specialist was shockingly indifferent to their care. The testing showed a treatable condition at 90 but my parent was never told that nor offered treatment. We found out years later, when it was too late to do anything.
Recently, when my parent was hospitalized, the doctor said the tests weren’t clear as to diagnosis. I asked if there are other tests - and his response was, “What test would you like me to do?” When I asked if there was medicine to help, he asked, “What medicine would you like me to prescribe?” I called the primary doctor and they gave me something to try.
In contrast, my other parent is also in their 90s and has been given treatment and options. They are divorced and in different states.
I think it is very doctor dependent but I do think some doctors write off patients because of age.
I’d be curious to know whether one of your parents is male and one female. Male patients tend to get better treatment than female patients in general, so I wonder how much that aspect may affect the difference in how each parents is treated.
Anonymous
07/13/2023 13:27
Subject: Bias towards elderly who will not go quietly
Anonymous wrote:
My husband is a doctor, other relatives are doctors, and you are entirely wrong, OP. Doctors take the Hippocratic Oath. Saving lives is more than a job. It's a calling. If the patient does not have a terminal diagnosis, then it's the standard of care to do everything possible to save their lives and not discuss palliative care until it's needed.
You are shockingly ageist: just because someone is old and frail, with the normal ills of age, does not mean they're ready to be put out to sea on an ice floe. When patients are in terrible pain and death is certain... that's when they ask for a painless exit, and deserve one, at any age. Pain and hopelessness are the criteria, not age.
I hope you're a troll, actually.
I appreciate that your husband and relatives may not have this view but I fully understand the OP’s experience because I am living it also. And, fwiw, I used to work in healthcare (at a local hospital) and I have relatives who are doctors and nurses.
My parent is in his 90s and their specialist was shockingly indifferent to their care. The testing showed a treatable condition at 90 but my parent was never told that nor offered treatment. We found out years later, when it was too late to do anything.
Recently, when my parent was hospitalized, the doctor said the tests weren’t clear as to diagnosis. I asked if there are other tests - and his response was, “What test would you like me to do?” When I asked if there was medicine to help, he asked, “What medicine would you like me to prescribe?” I called the primary doctor and they gave me something to try.
In contrast, my other parent is also in their 90s and has been given treatment and options. They are divorced and in different states.
I think it is very doctor dependent but I do think some doctors write off patients because of age.
Anonymous
07/13/2023 10:26
Subject: Bias towards elderly who will not go quietly
I think doctors vary, but their attitude definitely impacts the care they provide. I knew a lady dying of lung cancer. She had a doctor heading up her care who kept good track of things, made sure she got radiation to relieve her pain, sent her to a pain clinic to try to get the best balance between pain relief and consciousness, and was always sympathetic and encouraging. That doctor was transferred and the new one, who had a much better resume, was significantly more detached and “cookbook” in his approach. And then there was the ER doc who took one look at her and sent her home with some percocets and a prescription for liquid morphine — buh bye.
The idea that “we” spend money for people’s care is a fiction created to improve insurers’ bottom lines. People spend their own money, or their own benefits, and insurers collect premiums according to their own actuarial tables and experience.
Too many people die, not because they are in intractable misery, but because somebody else feels miserable looking at them. There are few slopes more slippery than “mercy killing.”
The idea that “we” spend money for people’s care is a fiction created to improve insurers’ bottom lines. People spend their own money, or their own benefits, and insurers collect premiums according to their own actuarial tables and experience.
Too many people die, not because they are in intractable misery, but because somebody else feels miserable looking at them. There are few slopes more slippery than “mercy killing.”
Anonymous
07/13/2023 09:43
Subject: Bias towards elderly who will not go quietly
Yes, this is confusing. What you’ve described is a bias against elderly who refuse to go quietly, not bias toward them.
To be fair, a lot of people seem to have trouble with the word bias and also discriminate/discrimination, as witnessed by all the threads about affirmative action in college admissions.
To be fair, a lot of people seem to have trouble with the word bias and also discriminate/discrimination, as witnessed by all the threads about affirmative action in college admissions.
Anonymous
07/13/2023 09:37
Subject: Bias towards elderly who will not go quietly
Anonymous wrote:Absolutely terrible thread title, BTW.
+1
I think a lot of people (myself included) have been confused by the title and your original post. As a result, you seem to be getting a lot of criticism from people who agree with you.
I suggest you go to the Website Feedback forum and ask Jeff to change the title to something that better expresses your perspective.
Anonymous
07/13/2023 09:32
Subject: Bias towards elderly who will not go quietly
Boy, this is OP and I guess people really misunderstood what I was trying to say.
I expect no inheritance from them and I would like them to live as long a life as they are able. I spend a lot of time intervening with doctors and talking to them to try to suss out what they want and making it happen.
I don’t believe that the doctors don’t care but they do see a lot of people in bad end of life situations that they wish had been avoided. Rather than frankly laying out the pros and cons there’s often just this vagueness in how they talk.
I expect no inheritance from them and I would like them to live as long a life as they are able. I spend a lot of time intervening with doctors and talking to them to try to suss out what they want and making it happen.
I don’t believe that the doctors don’t care but they do see a lot of people in bad end of life situations that they wish had been avoided. Rather than frankly laying out the pros and cons there’s often just this vagueness in how they talk.