Quote:
Originally Posted by Guest
pay particular attention to those changes that include less coverage for treatments of the elderly...that would be most of us...there is a philosophy in the Obama team that proposes the elder of the USA don't really need all the care and treatment as they are closer to meeting thier maker and hence don't need as much as the younger, th poorer, the illegals, the minorities, etc.
The devil is in the details which the current administration is purposely short on.
One thing is certain, aging and the aged are not partisan attributes....eh?
BTK
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I don't believe the comment "there is a philosophy in the Obama team that proposes the elder of the USA don't really need all the care and treatment as they are closer to meeting thier maker and hence don't need as much as the younger, th poorer, the illegals, the minorities, etc." is accurate.
There are in fact decisions that should be addressed regarding care. Not to belabour the point, but how many are aware, or willing to be aware of some of the practices we have in health care?
There are tens of thousands of people well beyond 70 that are severly demented, completely bedbound, suffering from multiple comorbidities such as diabetes, coronary artety disease, cancer, chronic bedsores and others that are kept "alive" with surgically placed feeding tubes because they can no longer function at the most basic levels. Many if not most of these people will have multiple hopsitalizations in their last year of life, including ICU care and even artificial ventilation. For the overwhelining majority these interventions are simply minimally life prolonging. Realize that up to 30 percent of ALL mediacre dollars are spent on the last year of life. Realize that if you arrest over the age of 70, even in the hospital with access to quick care your chances of ever leaving the hospital alive, much less surviving at one year out are dismall. Your chances of being "kept alive" with all of the technology we have, perhaps for weeks in the ICU with little or no change in the ultimate outcome are pretty high unless you EXPLICITLY spell out your wishes to your family.
Should we be spending money and putting people through things that we know will not appreciably change their outcomes? Should we resucitate terminally ill patients when they arrest knowing that they have weeks, or at best months to live? Is it morally and ethically the right thing to do?
These are some of the tough questions facing us, questions that european and other countries have long since addressed on different levels. Besides the moral/ethical dilemma of putting people through this, there is a cost associated with it well into the billions. At what time do we aquiesce to God's time clock?
I believe these are some of the questions being brought foward. Not a pan-withdrawl of care from the elderly, and certainly not so we can provide more care for those dastardly illegals, poor, and minorities.
These are not societaly pleasing questions but they do need to be addressed. If you really want to go through this how long should you be able to? At what point is it ok for the doctor to say to the family "I will not put your mother/grandmother through this pain and discomfort anymore?"
As an aside if you don't (or do) want to go through these things YOU MUST SPELL OUT YOUR WISHES. Cookbook living wills are rarely worth the paper they are written on due to their general terms, and to the families that refuse to honor them as the patient desired. Yes, make an advanced directive and be EXPLICIT in what you do and don't want done. Do you want to be resucitated(brought back if you arrest)..being shocked, chest compressions, having a tube placed in your throat and placed on a ventilator, having a tube put in to feed you, receiving IV fluids if that is all that is keeping you alive? Not the easiest things to address with family but make your wishes known so they can be honored. And for the love of God appoint someone that you trust, and that you know loves you and knows and will respect your wishes as your MEDICAL POWER OF ATTORNEY. I cannot begin to tell you the strife and conflicted ethics resulting because people don't take the time to do this. If your doctor has not mentioned it you mention it to him.