The prestigious New England Journal of Medicine just reported (September 29, 2011) that 20% of all nursing home patients with Alzheimer’s and other advanced dementia are sent to hospitals for questionable reasons in their final months. Once hospitalized, patients end up with tube feedings, IV’s, and intensive care that prolongs their lives, and at a cost of $4 billion per year.
Why are these people referred? Because Medicare pays three times as much to nursing homes that take these people back after a brief hospitalization. The fault does not lie with the nursing homes; lots of them operate on narrow margins so there is a tremendous incentive to hospitalize dying people. We share responsibility, because as a culture and as families we say life at any cost is worth it.
Advanced dementia is a terminal illness. If you love someone with this disease do not hospitalize him or her at the end. The hospital is the worst place to put dying people. These patients are unable to recognize relatives, confined to bed, and can’t swallow. In the hospital tubes and machines may keep them alive for weeks or months. Is this the care and dignity you want to give to your loved one?
Get together as families; make an advance directive before the nursing home makes the decision, and be sure it’s clearly charted Do Not Hospitalize.
Let your loved ones die where they are surrounded by the familiar; let them go in loving peace, rather than sustain them in mechanical life.
I say this for all my Relations, Mi Takuye Oyacin
If you’re in the Phoenix area this weekend come to see me at a premiere benefit performance of The Healing Doc Meets The Mask Maker. Check it out on my website.
Thank you so much for your article on Dying with Dignity. Like so many others facing parents growing old before our eyes, last year my siblings and I had to face the fact our father was dying. One of his final wishes was to die in his own home. Diagnosed with bone cancer in July 2010, we decided as a family to keep Dad at home. We alternated staying with him from July through his death in November. It was a trying time for all to watch Dad deteriorate before our eyes. And having to deal with doctors who offered him hope of life extension with Chemotherapy and drugs was painful. After two rounds of chemo and his illness taking his body away, we said enough was enough. Pain meds made him somewhat comfortable and we each had our time to talk to Dad about our life together and to make sure he was able to pass on to the next life with dignity and pride in his children. We had time to express our love and to say thank you for our lives. I only wish more people would understand how precious time is to a dying person and to not give false hope but comfort in knowing they are loved and respected.
As for my thoughts, as long as cancer and treatment of it is a very profitable business, there will be no cure for cancer. Watching a treatment center of 35 chairs filled twice, sometimes 3 times a day with each patient billing being in the neighborhood of $2,500 or more, where’s the incentive to cure cancer? Yes there are doctors who really care and those who want to find the cure, but there are far too few of them. I for one am tired of financing a new Mercedes for doctors who push Chemo knowing that the patient has very little time left. Instead of being constantly sick from the chemo, let’s give them the quality of life, not the quantity of insurance payments and new cars.
Yes, I am disillusioned with medicine, but I still have hope that someday there will be someone who will stand up and find a cure instead of just another treatment.
Thank you Carl, for the years I have been reading your posting, sometimes laughing, sometimes crying but always, always I keep reading.
Jeanette Bogart
Die with dignity. AMEN Carl