Be advised that a lot of health care institutions are taking a “passively hostile” approach to older patients—and that it is likely to get much worse.
While the assumption is that this is “active hostility”, and there may indeed be some of that, the “passive hostility” is much greater, and even gives rise to active hostility.
To start with, geriatric care is increasingly like working in an animal shelter. The mood is that the life of all the patients is almost over, by one means or another, fast or slow, and that there is a long waiting list to take the place of them when they die.
The majority of patients are elderly women who have outlived their spouses, and are in a state of rapid physical and mental decay. To visit such a place is disturbing. Dozens of elderly women in wheelchairs, all lined up in the corridors, staring absently at the blank wall in front of them.
This is an awful psychological state to be in for health care workers, because it makes them prone to “false empathy”, in which they think that a patient is demented, but suffering and in pain, and they have been abandoned by their family. It is worst when they are bedridden and unresponsive.
So it is easy for them to think that “When this person dies, their bed will be available for someone else who is still awake, aware, and needs medical care. So if they will just die...”
Add to that the legal pressure placed on them for liability and responsibility over a contentious situation they have little control over. For example, disputes between children over the life and death of a parent, both sides using dueling lawyers who lean very hard on the health care workers.
Finally there is active hostility. This is now happening across the US, except in hospitals where it is very strongly discouraged. It can be seen in many emergency rooms when older patients are automatically put at the end of the line for treatment, and often told to wait for hours to see if their condition improves on its own.
For this reason, elderly patients sent to ERs should always be accompanied by a younger, and a little angry looking, relative. The squeaky wheel does get the grease.
And even though there is an extended wait, waiting for them during and after surgery, until they are comfortable and bedded down, as well as calling them around meal times, to ask if they have been fed and their needs attended, is essential. No longer assume that this will be done automatically.
With the huge number of baby boomers soon to enter the system, what is bad right now will likely become horrific.
These are some great points, but the letter to the editor from “G” probably did not address the fact some relatives—for their own financial gain—are using the courts to get power of attorney or get the probate courts to assign a guardian ad litem. Often these individuals are seeking financial gain from getting an elderly individual deemed incompetent and the courts themselves assume power of attorney which trumps not only the wishes of the families, but the patients themselves who may not have a disease which would likely result in their death. These guardians ad litem and other officials of the court have one job...and that’s to serve their own best interest.
For example, recently a 94 year young woman—who was bright and alert—was declared incompetent by a relative who went to court in Illinois. This individual embezzled hundreds of thousands of dollars from this lady who was looking forward to her 100th birthday. The court and a physician ruled in his favor, stating the woman had Alzheimer’s—which was NOT the case. She did have some short term memory loss, like many in that age bracket and younger. The woman was put in hospice care and, ultimately, died from the administration of pain-killing drugs, including morphine and phentanol.
I have never heard of a case where Alzheimer’s is painful and the diagnosis required powerful drugs like morphine. This woman was NOT in pain. All of the other family members did NOT want her in hospice care, but the one individual who embezzled money from this lady got his way and the courts were complicit in this lady’s death.
Hospice care can be a compassionate alternative to a painful, lingering death, but it should not be used to hasten death or implemented to bring on death in patients who are not terminal.
There is a Patient Self-Protection Document that everyone should fill out in place of living wills. One of the many related articles in the RFFM.org end of life series discusses this document. The document can be downloaded from the Illinois Right to Life Committee’s web site at this link: http://www.illinoisrighttolife.org/pspdoc.htm
As correctly stated in one of the above comments baby boomers will make what’s happening today look like a walk in the park for senior citizens.
Seniors should always be accompanied to an Emergency Room by someone who truly cares and the hospital staff should realize this fact from the get go. Yes, as yefragetuwrabrumuy wrote, the squeaky wheel does get the grease and I made sure I was the squeakiest wheel in the entire hospital whenever I accompanied an elderly person.
Again, some great points, but we should NEVER get to the stage where the “Final Solution” is applied in the treatment of the elderly. If light is not shined on this issue quickly, we will make the numbers of those who died in Hitler’s Germany and his death camps look miniscule by comparison.
Once more, I suggest downloading the Patient Self-Protection Document from the Illinois Right to Life Committee’s web site http://www.illinoisrighttolife.org/pspdoc.htm. I have to get on this myself and quit talking or writing about it and do it.
Dan Zanoza