Multivitamin for elderly man?
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Elderly care & when to say enough
Comments (42)Our aging crisis: the need for a dignified death - September 14, 2013 : 6:14pm In his final published work, “Mortality,” written while succumbing to esophageal cancer, Christopher Hitchens captures in one sentence the unavoidable truth of the dying process: “I don’t have a body, I am a body.” No one understands this truism quite as well as journalist Katy Butler, who witnessed the prolonged process of dying that her once-formidable, war-veteran father underwent after suffering a stroke in 2001, devolving into dementia and then finally dying from pneumonia seven years later. As doctors pushed life-support surgeries, new medications and cutting-edge interventions, Butler and her mother didn’t pray for a cure. Instead, they wished for his death, all of which is chronicled in her troubling investigative memoir “Knocking on Heaven’s Door.” The “end-of-life crisis,” or as Butler calls it “the caregiver crisis,” has hit epidemic levels as the number of Americans over 85 doubled to 6 million since 1990. Baby boomers, like Butler, must now wrangle with what to do with sick elderly parents, asking questions of themselves they probably thought would never be fathomable: What can be done when a person lives too long? And has science gone too far in its mission to ward off death? Through her experiences with her father, Butler is unwavering in her answers. “Our optimistic science-worshiping culture wants to medicalize aging and make it nothing more than a collection of specific diseases that medicine can prevent or fix,” she writes. “But no matter what deal we make with the devil, nature outwits us. Dying can be postponed, but aging cannot be cured.” These are bitter pills to swallow and many might fall in the trap of citing Dr. Kevorkian, death panels, and agism in health care as reasons why these end-of-life conversations should never start. But Butler argues that this very fear, our culture’s unwillingness “to engage with death until it is in our faces,” is what has gotten us so deep in trouble in the first place. For example, 75 percent of elderly patients would rather die in their homes, yet 44 percent of them will die in hospitals, she writes. Last-ditch defibrillators, surgeries for incurable cancers and chemotherapy that only buys a few days continue to be the norm; while what she calls “Slow Medicine” �" home and palliative care �" remains on the fringes and is rarely covered by Medicare. Meanwhile, about a third of Medicare patients will have surgery in the last year of their life and a tenth will have a surgery done in the last month of life, she writes �" costing us an estimated $158 billion to $226 billion in medical overtreatment costs. But what is perhaps worse is the emotional and traumatic toll continual care for a dying relative takes on the survivors, which is the true core of her book. When Jeffrey, Butler’s hyper-intelligent Wesleyan history-professor dad, who lost his left arm while fighting in Italy during World War II, suffered a stroke at the age of 79, he was reduced to something much, much less: “With the memories, mind and reading comprehension of a highly educated 80-year-old; the spoken speech of a 4-or 5-year-old; and the physical dependence of a boy of 6.” He could comprehend his shortcomings, and it made him “miserable,” she writes. At one point, he even commented that he had “lived too long.” The stroke devastated not one, but two lives. “The day before [the stroke], my mother was a talented amateur artist and photographer, a woman of intimidating energy, and a spectacular housewife . . . After the stroke, she cared for my father the way she cared for my brothers and me when we were 3 or 4.” At 77, her mother had become one of the 29 million “unpaid, politically powerless, and culturally invisible family caregivers,” while Butler herself joined the 24 million baby boomers now tending to sick parents. When it became necessary for Jeffrey to undergo hernia surgery, his cardiologist suggested that they implant a pacemaker. The family agreed, unaware of the downsides of what was such an (they would only later find) unnecessary preventative treatment. Now, Jeffrey’s heart would tick on, long past his time should have been up. “Not having a pacemaker would not have guaranteed my father a quick or easy death,” she writes. “But having a pacemaker deprived him of his best chance for one.” Despite the surgery �" or perhaps because of it �" Jeffrey quickly got worse. Like about one third of those over 80, he suffered from dementia. His eyesight went, then his mobility. He began misspelling words. Then he began to see things that weren’t there. He became bladder and bowel incontinent. “I woke up some morning in a fury. Why had his doctors not let nature take its course? If the pacemaker had never been implanted, I thought, my father might well have been out of his misery, and so would my mother and me,” Butler writes. The family begged his cardiologist to turn off the pacemaker, but he refused. Other cardiologists refused, as well. In 2008, Butler’s father contracted pneumonia. Knowing that sending him to the hospital would only prolong his suffering with “life-saving” procedures, they avoided calling 911. He eventually became sick enough to be accepted into hospice care, where he finally died. Here is a link that might be useful: Our aging crisis: the need for a dignified death...See MoreGetting Elderly Drivers Off The Road...
Comments (37)BDDT, with my dad about 4 years ago. He was far more cooperative than many of your parents have been. He had two accidents in a week plus a few others in the preceding couple of years. Mom did most of the driving until she broke her elbow. She was out of commission and he drove more resulting in the two final accidents. Mom agreed and we hired a caregiver who drove for them 5 days a week. Definitely expensive, but Dad used senior door 2 door transportation and discount taxi coupons. He agreed to a full neurological workup which after six weeks the doc INSANELY said that he was fine to drive. Mom wisely had the caregiver drive around the neighborhood with dad. She came back and said unequivocally that he was not capable. Only one more time did he attempt to drive. I was called by the cleaning lady and rushed over, just in time. I explained that he had worked very hard all his life for a comfortable retirement. Was he going to jeopardize all it? What kind of life did that elderly man have after he killed ten people at the Santa Monica Farmer's Market? After that we sold his car. He's never attempted it again. Sadly there is NO public transportation in their area of Los Angeles, but he's not physically capable now of getting on a bus unassisted. MIL had her license suspended recently. She's 90 and fully capable, but nearly hit a pedestrian who called the cops, MIL got a citation and a notice to appear for a competency hearing. She had to take another driver's test and failed. She too is complaining about the inequity. She's fiercely independent and doesn't want to rely on anyone. She's had another hearing and has to go for a full medical eval. If she passes then she has to get a learner's permit and take 6 hours of lessons. She thought that she could just send in the med form for the doc to fill out. We're a bit more removed in this situation so we're letting the DMV sort it out. Finally, my friend's FIL refused to stop driving (he had some dementia) and they put a club on his steering wheel so that he couldn't drive!...See MoreWhy Do People Call Active Elderly People...
Comments (52)I truly don't understand how or why anyone is offended at ma'am. It is a sign of respect to others. Weren't you raised to say yes/no ma'am and yes/no sir to others in response to questions? I was taught to say it to any command, reprimand from an adult, I.e. no running in the school as well as general questions from anyone I didn't know, I.e. waitress asking, are you done with that plate? Age has never been a factor. If the cashier who is clearly younger than I am in the store asks if their is anything else I need, I reply with, "no ma'am", if I need help from that clearly younger man in the store I don't say, "excuse me young man (to me, THAT is patronizing) I say, excuse me sir" Maybe it is regional? I've only ever had a few people get upset and say something to the effect of I'm no ma'am/sir!!! Which just makes me think, obviously or you wouldn't act that way....See MoreFull time caregiver for elderly person
Comments (16)A dear friend had this for her husband when he was ill and dying. When he died, her children insisted she continue to have the 24/7 help and she did. The day woman was wonderful; the night people, not so much. Their job description required them to stay awake all night and be available if she called for help. They would just go to sleep and when she called them to help her to the bathroom, they didn't come, she would try to get their by herself and a fall inevitably occurred. I can't tell you how many different helpers the agency provide for the night shift and nearly all were not good at all. My in-laws had always had a live-in cook/housekeeper. When their wonderful woman finally retired after over 40 years with them, they hire another woman, but she would only work M-F - no weekends. They had someone come from an agency for the weekend, but it was not always the same person. They were not required to stay awake all night, but there was a "baby monitor" so my FIL could call if he needed help getting to the bathroom. The weekend help often ignored his calls and multiple falls were the result. My late mother had many friends who had in-home caregivers, and by the time she had died, they had all managed to steal all her silver and jewelry - and there was a lot of it. I would strongly advise using an agency where the workers are bonded, and locking up anything valuable and high "portable". Even then, someone needs to keep a close watch to be sure they are actually caring for the person and not also robbing her blind. Many children object to this kind of care as they don't want to have to be involved with hiring them (one still must be involved, even when using a reputable agency), and it is nearly always far more costly than assisted living in a home. In some cases, it is not - the home may be more. After my MIL died, my FIL announced to his two children that he was going to move to a retirement home in a nearby town. The "walk-in the door" fee was $500,000 and if one dropped dead two hours later, none of this money was returned. There was also a monthly charge. My DH and his sister looked at one another and both thought "That's a LOT of money and we will inherit that much less!" He was nearly 92 at the time. It also meant that my SIL would have a 30-40 minute drive each way to see him on a daily basis. That is how she approached him - it would be a huge inconvenience for her, and she WAS going to visit him daily. She still had two school-age children at home and it would have been very inconvenient. FIL was a dear, dear man and there was no way he was going to inconvenience his beloved daughter (my DH did not leave nearby). We were very glad he made this decision for innumerable reasons. It gave DH and his sister 13 months to clean out a very large house in which they had lived for over 50 years. My husband would drive down from Maine for the weekend, and they tackled the huge 3rd floor attic, the basement, and all closets with things not in use. It took them all that time to go through all this. And he only lived another 13 months. Sometimes reality must come into these decisions....See More- 5 years ago
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