nidena
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Post by nidena on May 6, 2020 17:55:14 GMT -5
The more old people die, the less "drain" there is on resources. Social Security pays out less. The nursing homes have more room which means they can raise the rates--if they're private--for the new occupants. I imagine current residents are grandfathered in to a rate from when they entered the facility. Just pondering on the page; don't really have any hard data to support my musings. FYI; 10,000 people turn 65 every day in America. That has been happening daily since 2011. Even if 500,000 boomers die from Covid19 It's not gonna put much of a dent in the number of 'old people' consuming SS, Medicare, or LTC/Nursing home services in America. It feels like there's "moral" component to this - America seems to have a "do everything possible" to keep the elderly alive kind of thing going. As in it's wrong morally?) to just let people who are dying - die . So, the seeming sentiments that it's ok to "let nature take it's course' with Covid19 and the elderly/infirm/existing conditions of any age - seems to contradict that 'moral value' -- that life is so important we must do everything possible to make sure people stay alive. But, then again maybe I'm wrong - there are a lot of really awful LTC/Nursing homes out there where the elderly/sick suffer maybe more than they should. So maybe it's all just 'lip service' that America actually cares about it's infirm elderly.. in which case that moral thing i mentioned above isn't really a thing. Maybe more of a Mother Theresa approach would work? Offer the sick 'comfort' and let what will be, be? ADDED: we are a couple hundred deaths away from 75K... we will be at/over 100K by the end of May... No doubt about that milestone, with all the states opening back up in the next three weeks.
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ken a.k.a OMK
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Post by ken a.k.a OMK on May 6, 2020 18:32:39 GMT -5
Maryland's governor opening some activities Thursday.
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Lizard Queen
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Post by Lizard Queen on May 6, 2020 19:13:40 GMT -5
The more old people die, the less "drain" there is on resources. Social Security pays out less. The nursing homes have more room which means they can raise the rates--if they're private--for the new occupants. I imagine current residents are grandfathered in to a rate from when they entered the facility. Just pondering on the page; don't really have any hard data to support my musings. FYI; 10,000 people turn 65 every day in America. That has been happening daily since 2011. Even if 500,000 boomers die from Covid19 It's not gonna put much of a dent in the number of 'old people' consuming SS, Medicare, or LTC/Nursing home services in America. It feels like there's "moral" component to this - America seems to have a "do everything possible" to keep the elderly alive kind of thing going. As in it's wrong morally?) to just let people who are dying - die . So, the seeming sentiments that it's ok to "let nature take it's course' with Covid19 and the elderly/infirm/existing conditions of any age - seems to contradict that 'moral value' -- that life is so important we must do everything possible to make sure people stay alive. But, then again maybe I'm wrong - there are a lot of really awful LTC/Nursing homes out there where the elderly/sick suffer maybe more than they should. So maybe it's all just 'lip service' that America actually cares about it's infirm elderly.. in which case that moral thing i mentioned above isn't really a thing. Maybe more of a Mother Theresa approach would work? Offer the sick 'comfort' and let what will be, be? ADDED: we are a couple hundred deaths away from 75K... we will be at/over 100K by the end of May... I'm not sure we really do keep the elderly going at all costs. That certainly wasn't the case when I was caring for my mother the last years of her life. She did have some costly rehab in there, but bounced back incredibly after those stints. Other than that, though, she took very basic medications to manage her heart disease. Nothing extraordinary was done. In no case was she pushed to do more intervention than the physical therapy, though a couple things were available as options. Perhaps other elderly opt for more treatment, I don't know, but my mother's healthcare workers were clear about how well people cope with the various treatments (dialysis/possibility of a feeding tube with resuscitation), and she/we opted against. Our country is all about giving people choices, so I guess you can blame the people making the choice for themselves. Perhaps sometimes the doctors don't know when to quit, but that has been far from my experience with my mother.
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pulmonarymd
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Post by pulmonarymd on May 6, 2020 19:20:25 GMT -5
FYI; 10,000 people turn 65 every day in America. That has been happening daily since 2011. Even if 500,000 boomers die from Covid19 It's not gonna put much of a dent in the number of 'old people' consuming SS, Medicare, or LTC/Nursing home services in America. It feels like there's "moral" component to this - America seems to have a "do everything possible" to keep the elderly alive kind of thing going. As in it's wrong morally?) to just let people who are dying - die . So, the seeming sentiments that it's ok to "let nature take it's course' with Covid19 and the elderly/infirm/existing conditions of any age - seems to contradict that 'moral value' -- that life is so important we must do everything possible to make sure people stay alive. But, then again maybe I'm wrong - there are a lot of really awful LTC/Nursing homes out there where the elderly/sick suffer maybe more than they should. So maybe it's all just 'lip service' that America actually cares about it's infirm elderly.. in which case that moral thing i mentioned above isn't really a thing. Maybe more of a Mother Theresa approach would work? Offer the sick 'comfort' and let what will be, be? ADDED: we are a couple hundred deaths away from 75K... we will be at/over 100K by the end of May... I'm not sure we really do keep the elderly going at all costs. That certainly wasn't the case when I was caring for my mother the last years of her life. She did have some costly rehab in there, but bounced back incredibly after those stints. Other than that, though, she took very basic medications to manage her heart disease. Nothing extraordinary was done. In no case was she pushed to do more intervention than the physical therapy, though a couple things were available as options. Perhaps other elderly opt for more treatment, I don't know, but my mother's healthcare workers were clear about how well people cope with the various treatments (dialysis/possibility of a feeding tube with resuscitation), and she/we opted against. Our country is all about giving people choices, so I guess you can blame the people making the choice for themselves. Perhaps sometimes the doctors don't know when to quit, but that has been far from my experience with my mother. In my experience, patients and families opt for far more aggressive care than I and my partners are recommend. They opt for icu care and interventions when the best outcome is living in a nursing home. There are about 2 dozen cases patients living on ventilators in a local nursing home, many full codes. I could go on. Study after study shows that patients and doctors suffering from the same illness die differently. Physicians more frequently opt for palliative care in similar circumstances. There is a reason such a large percentage of healthcare dollars are spent at end of life. I applaud what your mother chose, but that is more unusual in my experience
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Post by Deleted on May 6, 2020 19:29:20 GMT -5
Have you read Athul Gawande's "Being Mortal"? Fantastic book and while I couldn't get into the first half, on improving nursing homes, the second half on palliative care really hit home. It was what my mother and DH both chose, given fatal diagnoses at advanced ages with only a tiny chance of success from aggressive treatment. Totally different take on the subject- Freakonomics had a wonderful piece called "Glorious Sunsets" about a theoretical insurance company called "Glorious Sunsets", which would offer the terminally ill a % of the savings if they elected palliative care instead of aggressive care that had little chance of working. You couldn't do it, of course- rich people would end up having more options than poor people who wanted to leave something for their families- but it does make you think.
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saveinla
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Post by saveinla on May 6, 2020 19:43:02 GMT -5
My dad recently passed away (last month) and we knew he did not want to be on a ventilator. He was 92 and was really missing my mom who had passed away almost 2 years ago.
When the hospital asked us if they wanted us to intervene - they gave us the options, but said he would not do well even if he came back after that. We decided to not intervene and he passed away quietly in a few hours.
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pulmonarymd
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Post by pulmonarymd on May 6, 2020 19:47:02 GMT -5
Haven’t read it, but read papers on this frequently. Patients and families say the right things beforehand, but, they frequently do not follow through. Some of it is fear, which I do understand. It’s the aggressive care for patients with advanced dementia or other causes of severe neurologic day dysfunction that is mind-boggling. Doing it to return them to continue declining health does not make sense. We could provide palliative care and save significant sums in regards to healthcare spending. If we want to reign spending on healthcare, we need to have this discussion
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pulmonarymd
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Post by pulmonarymd on May 6, 2020 19:48:04 GMT -5
My dad recently passed away (last month) and we knew he did not want to be on a ventilator. He was 92 and was really missing my mom who had passed away almost 2 years ago. When the hospital asked us if they wanted us to intervene - they gave us the options, but said he would not do well even if he came back after that. We decided to not intervene and he passed away quietly in a few hours. That is how I would word it if I was having the discussion
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nidena
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Post by nidena on May 7, 2020 3:12:55 GMT -5
The more old people die, the less "drain" there is on resources. Social Security pays out less. The nursing homes have more room which means they can raise the rates--if they're private--for the new occupants. I imagine current residents are grandfathered in to a rate from when they entered the facility. Just pondering on the page; don't really have any hard data to support my musings. FYI; 10,000 people turn 65 every day in America. That has been happening daily since 2011. Even if 500,000 boomers die from Covid19 It's not gonna put much of a dent in the number of 'old people' consuming SS, Medicare, or LTC/Nursing home services in America. It's interesting to think that all the Boomers will be 65 or older in just nine years. By that time, I doubt we'll have any of the Greatest Generation and very little of the Silent Generation. They'll all be, at least, 84. My dad is one of the first-year Boomers, born in late '46. My mom passed one month, to the day, before her 66th birthday in 2018. But, yeah, with those generations numbering in the millions, 500,000 make much of a dent. BUT, for the Boomer Generation, any that joined the military would have increased chance of exposure and that may expedite their passing. Like, Vietnam and Agent Orange...that kind of thing. Not really COVID-related, I just think that Boomers and Gen X will die at a faster rate due to being subjected to more chemical inside and outside of our bodies. Just a thought. Again, no hard data 'cause, although it's probably out there, I've no inclination to dig right now. lol.
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Deleted
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Post by Deleted on May 7, 2020 9:36:48 GMT -5
I'm interested to see if people's views change now that the US news is finally reporting the children getting sick in NY and around the world. They don't seem to care about low-income, clearly non-essential workers or old people. Will they care about children dying or getting seriously ill? (Probably not)
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Wisconsin Beth
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Post by Wisconsin Beth on May 7, 2020 9:40:16 GMT -5
I'm interested to see if people's views change now that the US news is finally reporting the children getting sick in NY and around the world. They don't seem to care about low-income, clearly non-essential workers or old people. Will they care about children dying or getting seriously ill? (Probably not) If they didn't care about family separations at the border, they're not going to care about kids around the world getting sick.
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Deleted
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Post by Deleted on May 7, 2020 10:16:19 GMT -5
I'm interested to see if people's views change now that the US news is finally reporting the children getting sick in NY and around the world. They don't seem to care about low-income, clearly non-essential workers or old people. Will they care about children dying or getting seriously ill? (Probably not) If they didn't care about family separations at the border, they're not going to care about kids around the world getting sick. The kids are getting sick in the US. This has been happening internationally, but it seems to have eluded the US news media until this week. Separations at the border are okay, because those are brown kids, don't ya know? These are American children... (sarcasm) www.nbcnewyork.com/news/local/15-nyc-children-sickened-with-rare-covid-related-illness-here-are-the-warning-signs/2404162/
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NastyWoman
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Post by NastyWoman on May 7, 2020 10:19:38 GMT -5
I'm interested to see if people's views change now that the US news is finally reporting the children getting sick in NY and around the world. They don't seem to care about low-income, clearly non-essential workers or old people. Will they care about children dying or getting seriously ill? (Probably not) If they didn't care about family separations at the border, they're not going to care about kids around the world getting sick. True that, but they will be devastated when THEIR child gets ill and dies. And they will be furious because "someone should have told us", "someone should have done something about this". Their grief will be real but they will fail to see their own hypocrisy and their own complicity.
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formerroomate99
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Post by formerroomate99 on May 7, 2020 10:21:30 GMT -5
Haven’t read it, but read papers on this frequently. Patients and families say the right things beforehand, but, they frequently do not follow through. Some of it is fear, which I do understand. It’s the aggressive care for patients with advanced dementia or other causes of severe neurologic day dysfunction that is mind-boggling. Doing it to return them to continue declining health does not make sense. We could provide palliative care and save significant sums in regards to healthcare spending. If we want to reign spending on healthcare, we need to have this discussion My grandmother has been on hospice for a couple years. Other than oxygen and routine medications, she isn’t going to receive any advanced care. So she is never going see a doctor like you, even though her COPD and breathing problems would justify it. A Nurse Practitioner supervises her care. That’s it.
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Opti
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Post by Opti on May 7, 2020 10:47:04 GMT -5
FYI; 10,000 people turn 65 every day in America. That has been happening daily since 2011. Even if 500,000 boomers die from Covid19 It's not gonna put much of a dent in the number of 'old people' consuming SS, Medicare, or LTC/Nursing home services in America. It's interesting to think that all the Boomers will be 65 or older in just nine years. By that time, I doubt we'll have any of the Greatest Generation and very little of the Silent Generation. They'll all be, at least, 84. My dad is one of the first-year Boomers, born in late '46. My mom passed one month, to the day, before her 66th birthday in 2018. But, yeah, with those generations numbering in the millions, 500,000 make much of a dent. BUT, for the Boomer Generation, any that joined the military would have increased chance of exposure and that may expedite their passing. Like, Vietnam and Agent Orange...that kind of thing. Not really COVID-related, I just think that Boomers and Gen X will die at a faster rate due to being subjected to more chemical inside and outside of our bodies. Just a thought. Again, no hard data 'cause, although it's probably out there, I've no inclination to dig right now. lol. Life expectancy 1950-2020 US plus other country stats. www.macrotrends.net/countries/USA/united-states/life-expectancy
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oped
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Post by oped on May 7, 2020 10:50:17 GMT -5
My grandmother was one of the ones P is talking about.
About 6 years before her death she had heart surgery... routine, outcomes expected to be good, at least 2 more years prognosis... cost more than she every made in her life, but I thought it was warranted and she lived 6 more years.
End days. Experimental approach, very little chance, of very minimal outcomes, probably cost a quarter of a million dollars to have her end up on machines. Not fucking worth it. My aunt insisted.
There is a reason Medicare pays 1/3 of its outgo in any given year for the people who die in that year. And we need to have the conversation.
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Opti
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Post by Opti on May 7, 2020 11:06:53 GMT -5
Its hard to get most loved ones to let go. Its an emotional thing not a logical one. There are quite a few people in Assisted Living and Skilled nursing facilities that go into hospice. Many of those PMD, will not see. That fact that they end up at a hospital means that more people are likely to try for extreme measures than less.
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Deleted
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Post by Deleted on May 7, 2020 11:40:49 GMT -5
My husband died last fall of congestive heart failure. He was in and out of hospitals and ERS during the summer. The quality of his life rapidly went downhill. Many of you shared that journey with me. He had mild cognitive difficulties that accelerated at the end until he could no longer remember how to form the letters to sign his name. However, he was clear throughout that he wanted "everything possible" done for him. I had to beg him to go on hospice because he felt like everyone was giving up on him.
He wanted to live. He made that very clear. His quality of life was sh*t, but he wanted to live. I kept a journal that I reread from time to time, and I wrote, "I wonder if I have signed his death sentence" when I persuaded him to go on hospice. I understand now why loved ones are hesitant to make life/death decisions like that for other people.
He was on hospice only 3 weeks before he died.
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Blonde Granny
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Post by Blonde Granny on May 7, 2020 12:33:26 GMT -5
My husband died in Dec. 2015. He was in constant pain and way too many meds, but the VA kept pushing them and he kept taking them, including 5 insulin injections per day and another 20+ individual pills.
Was it overkill? yes......but this is what happens when all of this was caused by to the service he provided to his country. Vietnam and agent orange has a way of taking the lives of veterans when they are old and not young.
When his bi-pap was removed along with his IV of ativan and morphin, his death occurred within 15 minutes.
Maybe instead of picking on all us old people who don't need to be hanging around anymore and just take up space and money....how about we go around towns and find all these punks hanging around the street corners doing nothing except waiting for unemployment.money to arrive...what good are they providing to our country?
Stop picking on us retired folks.....
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pulmonarymd
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Post by pulmonarymd on May 7, 2020 12:56:24 GMT -5
My husband died in Dec. 2015. He was in constant pain and way too many meds, but the VA kept pushing them and he kept taking them, including 5 insulin injections per day and another 20+ individual pills. Was it overkill? yes......but this is what happens when all of this was caused by to the service he provided to his country. Vietnam and agent orange has a way of taking the lives of veterans when they are old and not young. When his bi-pap was removed along with his IV of ativan and morphin, his death occurred within 15 minutes. Maybe instead of picking on all us old people who don't need to be hanging around anymore and just take up space and money....how about we go around towns and find all these punks hanging around the street corners doing nothing except waiting for unemployment.money to arrive...what good are they providing to our country? Stop picking on us retired folks..... I’m not picking on old people. But, we as a society are unwilling to have difficult conversations. We spend a lot of money for care that does not improve quality of life or health metrics. We, as a society needs to decide if we want to pay for it. If so, then all the complaints about cost need to go away. However, if we do not want to pay, we need to have difficult conversations where we decide what we are willing to sacrifice. As we can see in the current situation, we need to invest in public health. Where does that money come from?
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Deleted
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Post by Deleted on May 7, 2020 12:59:23 GMT -5
It's ironic really.
We will spend millions upon millions of dollars for end-of-life care to keep granny breathing, but we won't endure financial hardship as a country to keep potentially tens or hundreds of thousands of grannies from prematurely dying from COVID19 along with all too many of their caregivers.
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souldoubt
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Post by souldoubt on May 7, 2020 13:16:10 GMT -5
Over 30 million people have filed for unemployment, some individuals are out of money to pay for necessities, small businesses are going belly up, the longer this goes on bigger businesses will as well, cities/states are facing massive deficits and the feds have already committed trillions while they'll spend more before this is over. That isn't financial hardship it's the recipe for a depression if it goes on long enough. If that happens the elderly, poor and a lot of middle class people are likely to look back at the initial lock downs as the good old days.
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Deleted
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Post by Deleted on May 7, 2020 13:32:17 GMT -5
Over 30 million people have filed for unemployment, some individuals are out of money to pay for necessities, small businesses are going belly up, the longer this goes on bigger businesses will as well, cities/states are facing massive deficits and the feds have already committed trillions while they'll spend more before this is over. That isn't financial hardship it's the recipe for a depression if it goes on long enough. If that happens the elderly, poor and a lot of middle class people are likely to look back at the initial lock downs as the good old days. Perhaps, the US should have done like the UK and paid 80% of people's salaries so they could stay home and reduce exposures while building a proper testing and tracing program. Instead, the US props up corporations and screws people out of income so they are essentially forced to work despite the risk. Instead, we are going with a screw those who get the virus we want a robust economy plan. We will see how that goes. Unfortunately, fewer people will get to see the end result as otherwise would have.
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Deleted
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Post by Deleted on May 7, 2020 14:22:41 GMT -5
For me, it won't be a problem. I have a DNR, and it's filed with my doc. Kids won't be fighting over whether to let me go, won't have to make a decision, won't forever feel like they killed me.
When the Green Hornet was at UK Hospital, they had a copy of his DNR. When he was admitted, I told them he had a DNR, and they told me they needed a copy. I took it to them. He coded 17? 18? times, but they never said a word. One of the nurses mentioned it in passing one morning. What? I asked what about the DNR? She looked. They "couldn't find" it. I took them a copy. He was in the hospital for 78 days and suffered way more than was necessary for way too long.
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emma1420
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Post by emma1420 on May 7, 2020 15:40:35 GMT -5
Have you read Athul Gawande's "Being Mortal"? Fantastic book and while I couldn't get into the first half, on improving nursing homes, the second half on palliative care really hit home. It was what my mother and DH both chose, given fatal diagnoses at advanced ages with only a tiny chance of success from aggressive treatment. Totally different take on the subject- Freakonomics had a wonderful piece called "Glorious Sunsets" about a theoretical insurance company called "Glorious Sunsets", which would offer the terminally ill a % of the savings if they elected palliative care instead of aggressive care that had little chance of working. You couldn't do it, of course- rich people would end up having more options than poor people who wanted to leave something for their families- but it does make you think. That's an amazing book. Focusing on the quality of life and the choices that the individual gets to make, I think often gets lost when caring for the elderly and those who are terminally ill.
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skeeter
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Post by skeeter on May 7, 2020 17:03:02 GMT -5
For me, it won't be a problem. I have a DNR, and it's filed with my doc. Kids won't be fighting over whether to let me go, won't have to make a decision, won't forever feel like they killed me. When the Green Hornet was at UK Hospital, they had a copy of his DNR. When he was admitted, I told them he had a DNR, and they told me they needed a copy. I took it to them. He coded 17? 18? times, but they never said a word. One of the nurses mentioned it in passing one morning. What? I asked what about the DNR? She looked. They "couldn't find" it. I took them a copy. He was in the hospital for 78 days and suffered way more than was necessary for way too long. God, I'm sooooo sorry you and your DH went through such an unnecessary ordeal. Sounds like you both went through hell
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nidena
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Post by nidena on May 7, 2020 18:56:22 GMT -5
It's interesting to think that all the Boomers will be 65 or older in just nine years. By that time, I doubt we'll have any of the Greatest Generation and very little of the Silent Generation. They'll all be, at least, 84. My dad is one of the first-year Boomers, born in late '46. My mom passed one month, to the day, before her 66th birthday in 2018. But, yeah, with those generations numbering in the millions, 500,000 make much of a dent. BUT, for the Boomer Generation, any that joined the military would have increased chance of exposure and that may expedite their passing. Like, Vietnam and Agent Orange...that kind of thing. Not really COVID-related, I just think that Boomers and Gen X will die at a faster rate due to being subjected to more chemical inside and outside of our bodies. Just a thought. Again, no hard data 'cause, although it's probably out there, I've no inclination to dig right now. lol. Life expectancy 1950-2020 US plus other country stats. www.macrotrends.net/countries/USA/united-states/life-expectancyIs that just mean expected life expectancy? Or mode expected life expectancy? It doesn't say and I don't know how those things are calculated.
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formerroomate99
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Post by formerroomate99 on May 7, 2020 19:03:52 GMT -5
Boy that’s a tough position to be on Southern season. My grandmother’s been telling me for 20 years that she wanted to die. So there was no resistance to putting her on hospice, and it save me from having to spend Hours at doctors offices and emergency rooms, when I’m juggling a demanding job and three small kids.
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nidena
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Post by nidena on May 7, 2020 19:19:59 GMT -5
Have you read Athul Gawande's "Being Mortal"? Fantastic book and while I couldn't get into the first half, on improving nursing homes, the second half on palliative care really hit home. It was what my mother and DH both chose, given fatal diagnoses at advanced ages with only a tiny chance of success from aggressive treatment. Totally different take on the subject- Freakonomics had a wonderful piece called "Glorious Sunsets" about a theoretical insurance company called "Glorious Sunsets", which would offer the terminally ill a % of the savings if they elected palliative care instead of aggressive care that had little chance of working. You couldn't do it, of course- rich people would end up having more options than poor people who wanted to leave something for their families- but it does make you think. Yay! New books for my "To Read" list.
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thyme4change
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Post by thyme4change on May 8, 2020 9:58:29 GMT -5
I bet the tax payers a million or more during my FIL's last year. And it was a miserable year. I'm not entirely sure why he held out so long and continued to get treated. My DH thought maybe he didn't think my MIL was ready to be alone. Or maybe it is just nature to defend your own life.
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