I recently read one of the best articles on aging and healthcare in our soceity by Micheal Wolff in The New Yorker. The name of the article is “A Life Worth Ending”. http://nymag.com/news/features/parent-health-care-2012-5/ . It is the story of caring for an aging parent and how the dying process was drawn out without any input from family. I felt like he was talking about my husband’s mother and siblings.
“Age is one of the great modern adventures, a technological marvel—we’re given several more youthful-ish decades if we take care of ourselves. Almost nobody, at least openly, sees this for its ultimate, dismaying, unintended consequence: By promoting longevity and technologically inhibiting death, we have created a new biological status held by an ever-growing part of the nation, a no-exit state that persists longer and longer, one that is nearly as remote from life as death, but which, unlike death, requires vast service, indentured servitude really, and resources.”
If this paragraph makes you uncomfortable, you haven’t had the pleasure of visiting a skilled nursing faciltiy or nursing home. It adequately describes the majority of people living at these facilities. My work takes me to many skilled nursing/nursing homes. I have usually been hired by the family to make sure their loved one is getting proper and adequate care.
So many of the people in these facilities are a whisper of their past self. Either dementia or debilitating chronic illnese, like a stroke, have rendered them mentally and/or physically changed and handicapped. Incontinence is the norm , as well as the need for assistance with all aspects of daily living (eating,bathing, dressing, moving). There is often no light in the eyes.
For those lucky enough, family members vist regularly. Today, before finishing this blog post, I visited a nursing home. As I drove in the the facility parking lot, there was an elderly and frail woman sitting in a wheelchair. Next to her, on the bench, was her husband, holding her hand. I could feel a catch in my throat at the poignant scene I was observing. It was obvious the woman was not 100% present but the kindness and loving look in the husband’s face told the story.
There are many issues surroundingthe topic of living longer but not necessarily well. I know it pushes many buttons. As Mr Wolff discusses in his article, we drag death out as if we can win the battle. I recently had a client who’s father was in a nursing home with a chronic illness that caused dementia and was dying. He knew the end was coming but was mortified that the faciltiy had gotten several of the doctors to increase or add medications. If nothing else, it was a waste of medicare dollars.
My client called after the meeting and told me the staff had the audacity to tell him his father had improved. He said, he slammed his fist on the table and said “Do you think I am an idiot? My father is dying and no medication, surgery or prayer (client was a minister) is going to keep him alive.” He died two weeks later.
Why do some facilties strife to squeeze out the last possible breath using as many medications as possible? Is it really good medicine and use of healthcare dollars? Why is the family not consulted at every new medication recommendation? Why do medical professionals support this?
Once will asking a question about a medication at a facility, I got my answer. I was told by the very loud and unpleasant head nurse, that the doctor was the attending and he made all medical decisions. It was not the place of the family. I actually didn’t know how to respond to that statement except to ask myself if I had unknowingly traveled to a different time dimension.
Thank Mr Micheal Wolff for writing this article, being so honest and raising these questions. Many families have asked these same questions.
What gets to me most is when a staff member tells me how a person is doing better when the dementia is increasing, aggression is occuring and can no longer walk. I want to scream. But I don’t because Medicare demands that nursing home do everything they can to improve the ehalth and quality of life of all residents. It is such nonsense and so cruel to do to families.