TO CAREGIVERS: Why Our Loved Ones Can't Die With Dignity.

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    Sep 07, 2013 10:32 PM GMT
    Excellent interview with author Katy Butler about being a caregiver to her elderly parents. Important for anybody who is (or might be) in this position.


    Excerpt:My motive was that 24 million Americans are helping care for aging parents... understand that the medical system is morally as well as sort of institutionally broken, and that you're on your own and you need to think this stuff through and make your own choices, because these are not choices you can defer to the system.


    Sept 2013 Mother Jones Interview

    http://www.motherjones.com/media/2013/09/interview-katy-butler-knockin-heavens-door-end-life-care-overtreatment

    June 2010 New York Times Magazine

    http://www.nytimes.com/2010/06/20/magazine/20pacemaker-t.html?pagewanted=all&_r=1&
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    Sep 08, 2013 5:43 AM GMT
    A tougher call on the pacemaker than with some other issues, but I think I'd side with the cardiologist who refused to turn it off.

    If it was some sort of pill to stop taking, that's one story, or some sort of drug that required invasive blood tests periodically such that the testing was causing discomfort, then I could see withholding those meds as not so much an intervention to cause death but as a way to make the patient more comfortable with what's left of their life.

    I'm not entirely sure how I feel about this specifically as I never considered it before but turning off a mechanical device implanted like a pacemaker seems on par of undoing, say, a bypass operation. You wouldn't say, oh, well, because this artery wasn't there before but is there now by artificial means, then we can just rip it out and end his life because he'd have been dead without it anyway.

    You wouldn't do that, so I don't know if you can justify turning off a pacemaker either. That's the type of thing that should go into the decision making process when considering those sorts of corrective procedures in the first place.

    I'm pretty sure someone must have called no take backs.
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    Sep 08, 2013 8:19 PM GMT


    *sighs* That pacemaker story was chilling, and the lesson in there was that if Dad had gone ahead with the pacemaker back when he was hale and hearty with no problems but the too-slow heartbeat, Bradycardia, much of what occurred later may not have happened or occurred in much lesser degrees. However, he refused.

    My Mom, at 75, had the same problem that the author's mother had, but unlike that Mom, mine went ahead with the valve surgeries. It's been 5 years, Mom still lives out at that big farm, drives into town, goes to movies, operas, etc and is fiercely independent.

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    Sep 09, 2013 2:38 AM GMT
    theantijock saidA tougher call on the pacemaker than with some other issues, but I think I'd side with the cardiologist who refused to turn it off.

    If it was some sort of pill to stop taking, that's one story, or some sort of drug that required invasive blood tests periodically such that the testing was causing discomfort, then I could see withholding those meds as not so much an intervention to cause death but as a way to make the patient more comfortable with what's left of their life.

    I'm not entirely sure how I feel about this specifically as I never considered it before but turning off a mechanical device implanted like a pacemaker seems on par of undoing, say, a bypass operation. You wouldn't say, oh, well, because this artery wasn't there before but is there now by artificial means, then we can just rip it out and end his life because he'd have been dead without it anyway.

    You wouldn't do that, so I don't know if you can justify turning off a pacemaker either. That's the type of thing that should go into the decision making process when considering those sorts of corrective procedures in the first place.

    I'm pretty sure someone must have called no take backs.


    Yes, its tough when the person is mentally unable to make the decision. If its the kids making the decision, you have to get everybody on some level of agreement. That often ends badly.

    I tell people that a Durable Power of Attorney, Living Will and Healthcare Surrogate are more important than a Last Will and Testament. They affect what happens when you're alive.

    This is especially true if you're gay. You can be in a LTR...but your next of kin is always considered the decision maker when you are incapacitated. Evil siblings or cousins can come out of the woodwork and find a way to clear out your bank account or put you in a nursing home. Have a POA and HCS in place, naming a friend you can trust implicitly.

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    Sep 09, 2013 4:01 PM GMT
    I understand and agree with everything said by you guys but I would add that advanced directives do not absolve us of the responsibility for our own lives.

    In writing out instructions so that your surrogate is able to think as you think and to decide as you would have decided were you still able, you have to first consider what are their capacities and limitations with regard to another person's life.

    I could take my own life, but I don't know if I could take yours. I don't know offhand what those conditions might be. That situation might depend on how, say, how you got there. Did you suddenly find yourself suffering so terribly that only death would bring relief. Or did you have some window of opportunity to exit before the suffering got so terrible but that you yourself did not take advantage of?

    So you can direct me how to make you comfortable and I know to keep you safe but can a person leave such instruction that they get to enjoy their life to the full while leaving their loved ones in a state of guilt?

    And as to the pacemaker, I mentioned an extreme case of an artery. But what if one day the pacemaker is made of flesh and what if it derived its power from our own nervous system. What if it wasn't so much a battery but a governor. Okay to give permission to rip it out then? Tough questions and we're just starting to understand this stuff.
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    Sep 09, 2013 4:12 PM GMT
    Tangiers said
    This is especially true if you're gay. You can be in a LTR...but your next of kin is always considered the decision maker when you are incapacitated. Evil siblings or cousins can come out of the woodwork and find a way to clear out your bank account or put you in a nursing home. Have a POA and HCS in place, naming a friend you can trust implicitly.

    Good point. This should be expanded on here as it is only alluded to on these two threads:

    Gays in nursing homes:
    http://www.realjock.com/gayforums/794295

    Two Men, 58 Years and Counting. A Love Story:
    http://www.realjock.com/gayforums/3430010