How old is too old

As many of you know I work in a Dr's office. Most of our patients are elderly. Some at 100, 88, 94,78 are in excellent health. Some at 80 are on 30 different meds a day, senile, blind, depressed without close family stuck in nursing homes.
This week two patients came in that really made me think about the value of life. Brought in by their children themselves in their 60's these patients were senile, blind, in pain, unable to take care of themselves, go to the bathroom alone etc.
They looked miserable and confused. In many with Alzheimers one needs to only look into the eyes, there is no one home. They do not recognize themselves or their children, they are angry and violent in some cases, or just docial and child like in others.
Medicine can now keep these people alive for years. Pills to control, blood pressure, diabetes, cholesterol the list goes on and on. Years ago these people would have had a heart attack and died a more natural death. Now they are the living dead. Alive but not living, day in and day out in pain and confusion. Never getting better. The drain on the family to take care of them is often overwelming. Babyboomers in their 60's having to diaper mom and dad, not able to enjoy their own retirement or build their own nest egg.
Then there is the cost on the health care system as a whole. Nursing homes, hospitals keeping them breathing for what purpose. They can't see, think, hear they are but living shells.
I know I never want to live like this. If I get to that point please give me some pills or an IV and let my pass peacefully. Let my children remember a mom who didn't pee in her pants, who know who they were and who laughed at the silliest things. I do not want to be a burden to my family or to society. The money can be used to help an animal shelter instead of keeping me alive on a feeding tube.
Would anyone be willing to sign such a form?

I've already made this clear to my family. If it ever gets to that point, no heroics please. In my last job we used to joke about getting a tattoo that said "no code".

conversely ... a family friend was diagnosed with malignant brain cancer around Labor Day ... his oncologist recommended chemo and radiation, even though he's 80, because he is a very healthy 80. Sadly, a repeat MRI showed that the chemo and radiation have basically done nothing. Other 80-year-olds might have been offered hospice, but he was offered a second-line chemo drug, again, because his health is so good. So I guess it's about more than just the number.

This is a very touchy subject in the US. There are no papers you an sign that will allow your doctor to end it all. Right now my sister is confronted with taking care of my step-mother who has Alzheimers and has become very angry and hostile in the last month. Her health is good but her mind is just gone. It has been months since she has known anyone.

I have signed a living will that stipulates not to take extraordinary means to keep me alive. I wish that there was a way for me to sign an order that would allow they to terminate my life if I ever get to that state.

My father went in a flash and i pray that I go the same way. I do not want my family pulled down prolonging my death.

I have a living will which spells out my wishes. I opted for the "do not resuscitate" clause, and no heroics are to be used to keep me alive should I lapse into a vegetative state. There is no way I want to be kept alive, simply because modern medicine has the ability to do this. When I can no longer function on my own, then it's time for me to move on. I want my family to remember me as a reasonably active and lucid person, and not be left with memories of an old lady hooked up to machines, and unaware of her surroundings. That's not living - it's only existing.

I can't answer this, as I have been pondering such things myself.

My Dad has Alzheimer's. Every day, I lose a bit more of him. He still knows who I am, but he is so confused, can't follow a conversation, read a newspaper, follow a TV show.

I wonder sometimes why I am giving him the Aricept and Namenda pills. They neither cure nor stop the progress of this horrid disease.

I can understand the insulin, he has been on that for almost 10 years now and it controls his diabetes so he can do things, be himself. I can also understand most of the other meds he is on.

But the ones for the Alzheimer's, I just don't know. The very fact that I think this way gets me upset and I cry. What kind of daughter does this make me? It is a very touchy issue here.

I'm in the same boat with my stepmom. She's going to be 80, but started showing severe dementia about 3 years ago (it was very rapid). She is also on Aricept and Namenda and she might as well be on sugar pills. I know the pharma industry is trying to come up with better meds, but until we get to the bottom of what causes Alzheimer's and other dementias it's a losing battle.

Human euthanasia is an incredibly thorny ethical issue, and also sort of a catch-22. An individual could, say, have a euthanasia order (were it legal, of course) but the family could put the kibosh on it, potentially. Same with DNRs, living wills, etc. There should never be some fixed age, anyway; it is a personal and family decision.

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Originally Posted by Freedom

I can't answer this, as I have been pondering such things myself.

My Dad has Alzheimer's. Every day, I lose a bit more of him. He still knows who I am, but he is so confused, can't follow a conversation, read a newspaper, follow a TV show.

I wonder sometimes why I am giving him the Aricept and Namenda pills. They neither cure nor stop the progress of this horrid disease.

I can understand the insulin, he has been on that for almost 10 years now and it controls his diabetes so he can do things, be himself. I can also understand most of the other meds he is on.

But the ones for the Alzheimer's, I just don't know. The very fact that I think this way gets me upset and I cry. What kind of daughter does this make me? It is a very touchy issue here.

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First of all Sandie, let me say that I think you're a saint for what you're doing for Dad. Many people just couldn't handle it, and I don't really know if I could or not. Fortunately, Alzheimer's is something that has never hit home in my family.

My sister in law encountered a care giving situation with my brother. He suffered a massive stroke, and then cancer when he was only 59. He was left totally dependent on others for his care. He didn't want to live this way, and even begged his wife to help him end his suffering - which of course she didn't. He slipped further away every day, but his wife cared for him at home and never put him in a nursing home. She slept on the floor on a mattress next to his hospital bed so that she could hear if he was in distress during the night. She tube fed him, changed his diapers, bathed him, turned him every couple of hours, and all this done on her own with the occasional help of a visiting nurse. He lived like this for 5 years, and his last 18 months, he was comatose, and he mercifully passed on after he contracted pneumonia.

He never wanted to exist this way as he had always been a healthy and active and productive person. When is enough, enough? I wish there was an answer...........

There really isn't an answer and EVERY situation is different. I firmly believe it's in God's hands for a reason; our emotions as humans would always get in the way and we would not make the right decision. I have to believe there is a plan.

Having said that; I sympathize greatly with all of you who have had to deal with this issue on a personal level. I have not - my husband and I have lost many members of our families, but none have had dementia in any form. Well, let me clarify: Helen, my mother in law, was riddled with cancer, lived with us for her last year, and was not in her own mind at the end, but her ILLNESS was not dementia, it was cancer. She was disoriented and very hard to calm at times, and had many of the dementia issues, but not all the time.

We have very specific portions of our own wills dealing with the medical finalities; it's a necessity. I'm afraid that's all you can do.

A friend sent this to me in an email and it fits perfectly into this thread:


When an old man died in the geriatric ward of a nursing home in North Platte, Nebraska , it was believed that he had nothing left of any value.

Later, when the nurses were going through his meager possessions, they found this poem. Its quality and content so impressed the staff that copies were made and distributed to every nurse in the hospital. One nurse took her copy to Missouri .

The old man's sole bequest to posterity has since appeared in the Christmas edition of the News Magazine of the St. Louis Association for Mental Health. A slide presentation has also been made based on his simple, but eloquent, poem.

And this little old man, with nothing left to give to the world, is now the author of this 'anonymous' poem winging across the Internet.

Crabby Old Man

What do you see nurses? . . . .. . What do you see?
What are you thinking . . . . . when you're looking at me?
A crabby old man . . . . . not very wise,
Uncertain of habit . . . . . with faraway eyes?

Who dribbles his food . . . . . and makes no reply.
When you say in a loud voice . . . . . 'I do wish you'd try!'
Who seems not to notice . . . . . the things that you do.
And forever is losing . . . . . A sock or shoe?

Who, resisting or not . . . . . lets you do as you will,
With bathing and feeding . . . . . The long day to fill?
Is that what you're thinking? . . . . . Is that what you see?
Then open your eyes, nurse . . . . . you're not looking at me.

I'll tell you who I am. . . . . . As I sit here so still,
As I do at your bidding, . . . . . as I eat at your will.
I'm a small child of Ten . . . . . with a father and mother,
Brothers and sisters . . . . . who love one another.

A young boy of Sixteen . . . . with wings on his feet.
Dreaming that soon now . . . . . a lover he'll meet.
A groom soon at Twenty . . . . . my heart gives a leap.
Remembering, the vows . . . . . that I promised to keep.

At Twenty-Five, now . . . . . I have young of my own.
Who need me to guide . . . . . And a secure happy home.
A man of Thirty . . . . . My young now grown fast,
Bound to each other . . . . . With ties that should last.

At Forty, my young sons . . . . . have grown and are gone,
But my woman's beside me . . . . . to see I don't mourn.
At Fifty, once more, babies play 'round my knee,
Again, we know children . . . . . My loved one and me.

Dark days are upon me . . . . . my wife is now dead.
I look at the future . . . . . shudder with dread.
For my young are all rearing . . . . . young of their own.
And I think of the years . . . .. . and the love that I've known.

I'm now an old man . . . . . and nature is cruel.
Tis jest to make old age . . . . . look like a fool.
The body, it crumbles . . . . . grace and vigor, depart.
There is now a stone . . . . where I once had a heart.

But inside this old carcass . . . . . a young guy still dwells,
And now and again . . . . . my battered heart swells.
I remember the joys . . . . . I remember the pain.
And I'm loving and living . . . . . life over again.

I think of the years, all too few . . . . . gone too fast.
And accept the stark fact . . . . that nothing can last.
So open your eyes, people . . . . . open and see.
Not a crabby old man . . . Look closer . . . see ME!!

Cassiesmam,

I'm with you. If I have to go into a nursing home, sitting in a wheelchair in the hallway, drooling away...CALL DR. KEVORKIAN!!! I do NOT want to living in a wheelchair or a hospital bed for that matter, having to have my diaper changed. If I don't have all my faculties, I've already got a will both regular and living so there is no mistake about it. Unless you can make me whole again and give me a few more years of happiness, then pull the damn plug. As they say, stick a fork in me, I'm done!!!

Quote:

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Originally Posted by Freedom

I wonder sometimes why I am giving him the Aricept and Namenda pills. They neither cure nor stop the progress of this horrid disease.

I can understand the insulin, he has been on that for almost 10 years now and it controls his diabetes so he can do things, be himself. I can also understand most of the other meds he is on.

But the ones for the Alzheimer's, I just don't know. The very fact that I think this way gets me upset and I cry. What kind of daughter does this make me?

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It makes you human, Sandie, and a very good daughter, too; one that is probably exhausted. It isn't easy to take care of an elderly parent but especially one w/Alzheimers. Your questions are painful to ask yourself but oh so natural and understandable. :love:

Tis a lovely poem and so right for many. But for others with no mind left or in a coma its a nightmare.
When my mom had her car accident on 9/11/94 she broke her neck and slipped into a coma. She was life flighted to Metro and came as close to death as anyone can and still come back. Her heart stopped three times on the way to the hospital.
After 8 or 9 days in ICU we still had no idea nor did the Dr's what the outcome would be. I remember a nerosurgeon named Brian who I spoke with about my mom's injury. Because she was without oxyogen for over three minutes they knew there was brain damage but didn't know how much. Brian said to me IF your mom lives and IF she is not a quad she problably will not remember any recent history. She will not recongize you or your brother that part of the brain that has damaged and will most likely prevent that. What she will remember is her childhood and being a young adult. I wept..................
I told Brian that if all my mom could remember was her early life then I could not do that to her. Concentration camp at 17 losing 10 brothers and sisters plus her parents, her home and everyone she knew by 21.
What kind of a life would that be? A living hell. She died 11 days later. Once I told Brian about her early life things changed, I felt that they slowed their efforts to bring her back, it was the right thing to do, Brian was so kind and understanding. I loved my mom more then life itself. I would never let her suffer like that.
She herself used to say "there are worst things then death" mom knew what she was talking about.
I stood by her bed and told her it was ok to go. Hardest thing I ever did but the right thing. If she could not remember her children or grandchildren there was no point.
I know John Demjanjuck (sic) is being tried now. I asked mom what she thought oh so many years ago when it first started and she believed he was Ivan. Perhaps some people will get peace with his trial, able to tell their stories. The horrors never leave, 60 years later they are still fresh in a persons mind.
If asked if we would go through what those poor immigrants did in WW11 or choose a quick painless death I would choose the latter.

Quote:

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Originally Posted by Medusa

A friend sent this to me in an email and it fits perfectly into this thread:


When an old man died in the geriatric ward of a nursing home in North Platte, Nebraska , it was believed that he had nothing left of any value.

Later, when the nurses were going through his meager possessions, they found this poem. Its quality and content so impressed the staff that copies were made and distributed to every nurse in the hospital. One nurse took her copy to Missouri .

The old man's sole bequest to posterity has since appeared in the Christmas edition of the News Magazine of the St. Louis Association for Mental Health. A slide presentation has also been made based on his simple, but eloquent, poem.

And this little old man, with nothing left to give to the world, is now the author of this 'anonymous' poem winging across the Internet.

Crabby Old Man

What do you see nurses? . . . .. . What do you see?
What are you thinking . . . . . when you're looking at me?
A crabby old man . . . . . not very wise,
Uncertain of habit . . . . . with faraway eyes?

Who dribbles his food . . . . . and makes no reply.
When you say in a loud voice . . . . . 'I do wish you'd try!'
Who seems not to notice . . . . . the things that you do.
And forever is losing . . . . . A sock or shoe?

Who, resisting or not . . . . . lets you do as you will,
With bathing and feeding . . . . . The long day to fill?
Is that what you're thinking? . . . . . Is that what you see?
Then open your eyes, nurse . . . . . you're not looking at me.

I'll tell you who I am. . . . . . As I sit here so still,
As I do at your bidding, . . . . . as I eat at your will.
I'm a small child of Ten . . . . . with a father and mother,
Brothers and sisters . . . . . who love one another.

A young boy of Sixteen . . . . with wings on his feet.
Dreaming that soon now . . . . . a lover he'll meet.
A groom soon at Twenty . . . . . my heart gives a leap.
Remembering, the vows . . . . . that I promised to keep.

At Twenty-Five, now . . . . . I have young of my own.
Who need me to guide . . . . . And a secure happy home.
A man of Thirty . . . . . My young now grown fast,
Bound to each other . . . . . With ties that should last.

At Forty, my young sons . . . . . have grown and are gone,
But my woman's beside me . . . . . to see I don't mourn.
At Fifty, once more, babies play 'round my knee,
Again, we know children . . . . . My loved one and me.

Dark days are upon me . . . . . my wife is now dead.
I look at the future . . . . . shudder with dread.
For my young are all rearing . . . . . young of their own.
And I think of the years . . . .. . and the love that I've known.

I'm now an old man . . . . . and nature is cruel.
Tis jest to make old age . . . . . look like a fool.
The body, it crumbles . . . . . grace and vigor, depart.
There is now a stone . . . . where I once had a heart.

But inside this old carcass . . . . . a young guy still dwells,
And now and again . . . . . my battered heart swells.
I remember the joys . . . . . I remember the pain.
And I'm loving and living . . . . . life over again.

I think of the years, all too few . . . . . gone too fast.
And accept the stark fact . . . . that nothing can last.
So open your eyes, people . . . . . open and see.
Not a crabby old man . . . Look closer . . . see ME!!

---

Thanks Medusa,

I am trying to 'touch' some of these very folks here Christmas day, by playing some music for them.

Faraway eyes.......

I can go both ways on the issue.

I too have seen the suffering and the 'not quite there' part of people who 'live' (if you can call it that) for years just for the sake of being alive. Mostly due to doctors not being able to handle letting someone go when it's in their best interest.

However I have a great aunt that about 20 years ago had to be hospitalized with heart problems and underwent surgery. They said she was dead for a period of time (I want to say 3-4 minutes) and they brought her back. She's now in her mid 80's and until the last few years had been living a full life with no brain damage from the experience. Her other health problems have caused her to be more house bound the last few years. Her one son lives with her at her home to help her with things, do the cooking/cleaning, and drive her to her dr. appts (she can no longer drive). But she still has a ready joke to tell and can laugh at herself even. We've had 20 years (hopefully more to come) with her that we would not have if they had not recussetated (sp?) her.

So I can't really say one way or the other is right in every situation, I think it depends.

How many of us would want a living will and a DNR so we don't become a living veggie?
I for one.
Are we keeping mom and dad alive for us or because it's best for them? Sometimes the thought of letting them go is too much to bear so we keep them alive even when they no longer know who we are, why............ To repair past wounds, to makeup for lost time?
How many times can we say goodbye, give them last rites?
Do for them as we would want done for us I believe would be best.
I don't want my children to go through that, seeing a veggie who used to be a mom.
I want my kids to have a happy life, live, love, laugh. I can give them one last gift with a DNR. They don't have to keep telling me I am loved, I already know. My body is an empty shell but my love will always be with them. That is what I have told my kids, what my mom told me.

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Originally Posted by Marigold2

Would anyone be willing to sign such a form?

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I would, but of course if I were unable to make the decision my husband would do that for me. We have no children so the decision would be his alone and I trust him to do what he feels is the right thing.

We are going through the alzheimer's disease with my husbands mom right now. It is so sad to see her slipping away.
I've told Mark many times if I ever get like that I hope he puts me in a nursing home. I wouldn't know the difference and I wouldn't want him to waste what's left of his life trying to take care of me.

At 80 when Mama was discovered to have cancer, she already had dementia but the one things she was constant and firm about was, she didn't want surgery or treatment for her cancer. She clearly said she had a great life, enjoyed every minute of it but she was fine with "going" on and was ready. I respected that no matter how much the doctors pressed me to have her declared incompetent and get her that surgery. I have told my kids I hope they will respect MY wishes when my time comes like I did for Mama.

They said Mama had only a year without the surgery and it would be a long and painful death for her but I am here to tell you, they were wrong. She had GOOD quality of life up to the day she died and was even up and out of bed the day she died. If she'd had that surgery, she would never have gotten out of bed again. She did it HER WAY and to me that was the right way. She was at peace with her pending death, not afraid of it at all. I have said many times, while she was dying was some of the best times we ever had together.

My biggest fear all my life was being unable to care for myself, being completely helpless and a burden on my family. I hope when my time comes, I can do it with the peace and grace that my Mom did.

Having worked in a hospital before I have seen the lengths to which the medical establishment will go to keep someone alive (particularly if their children demand it). I have always been very clear that I do NOT want that to happen to me. The quality of life is bad and generally people are in more pain and discomfort than if they had not received treatment.

I believe in DNR order and living wills. I just wish that everyone else did

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Originally Posted by pomtzu

I have a living will which spells out my wishes. I opted for the "do not resuscitate" clause, and no heroics are to be used to keep me alive should I lapse into a vegetative state. There is no way I want to be kept alive, simply because modern medicine has the ability to do this. When I can no longer function on my own, then it's time for me to move on. I want my family to remember me as a reasonably active and lucid person, and not be left with memories of an old lady hooked up to machines, and unaware of her surroundings. That's not living - it's only existing.

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As I posted earlier in this thread...........
I carry a copy in my wallet, and my son has a copy here at home.