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Health March 2013

Aid for Age

Plan Now for End of Life Treatment

By Tait Trussell

You don’t have to leave this world in pain, indignity, or confusion while ringing up thousands of dollars to hang desperately to life for a few more hours or days.

These days, most seniors can die in peace at home, rather than being hooked up to an array of tubes in a hospital bed, ignorant of what’s being done for them, and sometimes in pain to an extent they can’t express.

It’s a grisly subject, but a gift you can give yourself is lessons in how to die in dignity under the best circumstances.

Some 2.4 million Americans die every year. Many are in hospitals connected to ventilators and intravenous contraptions, confused by actions taken by doctors and nurses and probably frightened.

But it doesn’t have to be that way. You don’t have to leave this world in pain, indignity, or confusion while ringing up thousands of dollars to hang desperately to life for a few more hours or days.

We can focus more on dying with dignity. Pain can be managed very well today, and most Americans, if they choose can die at in a familiar setting or at home and surrounded by loved ones. Many, in and out of the medical field, believe we need a culture change in what is currently the most common approach to death.

The cost of health care costs twice as much per capita as health care of most other countries.

The Congressional Budget Office (CBO) says the category of federal spending that is increasing most rapidly as a share of the economy is health care dominated by Medicare, for the elderly, and Medicaid, for the poor. In 2012, CBO estimated that federal and state governments would spend $1 trillion on these two programs, a figure that will nearly double over the next eight years as the elderly population grows.

A major reason why the U.S. spends nearly twice as much per capita on health care as our competitors in the world market, but sometimes gets poorer results, is that five percent of Medicare patients who die every year consume nearly one-third of those costs in the final month of life.

Doctors and lawyers say everyone should have a living will. It’s a legal document a person uses to make known his or her wishes regarding life-prolonging medical treatments. It is also referred to as an advance directive, health care directive, or a physician's directive.

A living will should not be confused with a living trust, which is a mechanism for holding and distributing a person's assets to avoid probate. A living will informs your health care providers and your family about your desires for medical treatment in the event you are not able to speak for yourself.

For example, I have a document that says: “If I am no longer able to make my own health care decisions, this form names the person I chose to make these choices for me (my wife, and then my sons, if she is unable to”….When both these things happen and my attending doctor finds I am no longer abler to make health care choices and another health care professional agrees, “I wish to limit life-support treatments but want my doctor to give me enough medication to relieve pain and keep me clean and warm.”

The requirements for a living will vary by state. So, you will likely want to have a lawyer prepare your living will, if you haven’t done so. Attorneys who practice in the area of estate planning include a living will and a health care power of attorney in their package of estate planning documents. If you need to write or update a will or trust, you can take care of your living will at the same time.

The alternative to the kind of final days many people suffer through is hospice. This is end-of-life care provided by health professionals and trained volunteers. Hospices give medical, psychological and spiritual support. The goal is to give people who are near death peace, comfort, and some sense of dignity.

Caregivers in hospice can control pain and other symptoms so a person can stay alert and as comfortable as possible. Usually a hospice patient is one who is expected to live six months or less. Hospice care is prescribed by a doctor. The care can take place in your home in a hospital, nursing home or in a hospice center.

 

Tait Trussell is an old guy and fourth-generation professional journalist who writes extensively about aging issues among a myriad of diverse topics.

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