Medical Care for the Aged...To What Purpose?

[jbg]

This is a thread I am pained to write.

I love my parents dearly, both my 80 year old mother and my 93 year old stepfather (my father having died 40 years ago). Since 2007 life for them has been a tag-team roller-coaster of surgery, hospitalization, rehabilitation and return to hospitals.

In 2007 my stepfather broke his hip. After a hip replacement he was in rehab for a few weeks, and now walks only with a cane. Just before that he was still playing tennis.

During the summer of 2008 my mother had a hysterectomy, followed by chemo and radiation. During that time she broke her ankle and was then in rehab for two weeks. Treatment effectively ran about 8 months after the July 2008 surgery.

At the beginning of this year she had surgery for a recurrence of the cancer, and was in rehab. January and February 2012 gone for her. Then wash, rinse, repeat from late December until last week. A few days after she got home, my stepfather went into the hospital for circulatory problems. Results unknown. Through this my mother has gotten intermittently disoriented.

These constant crises have put my employment and that of my step-siblings in jeopardy. And for what purpose, to survive to another crisis?

Back in the day, when health care was self-funded life expectancies were shorter. But I guarantee that suffering was far less prolonged.

I don't know that I have any answers. I welcome thoughts. I am sure my family is not alone.

[Argus]

Quality of life would be the issue I would gravitate to. I have not yet resigned myself to ever dying, but I suppose, if I was in my eighties and my medical situation had deteriorated to the point I didn't enjoy life any more then continuing might be questionable. I think of those twins in, was it Belgium or Holland, anyway, deaf from birth and now faced with blindness, they decided there was no further point in living. I can't say I could have argued very effectively with them on that score. On the other hand, I have two uncles around 90. Both have had fairly serious medical issues, but seem alert, happy, and interested in life. I don't think either one is quite willing to kick off just yet, as I know I wouldn't be in their place. My mother had a series of medical conditions, including blindness, which required me to help care for her for some time. It wasn't pleasant and posed a lot of problems for me, but she certainly wasn't ready to call it a day either and I never thought for a moment she ought to. Though I have to admit there were times I fantasized about her being in a good nursing home... I don't have any learned wisdom as every situation is unique to the people involved. What is the point in keeping people alive for another few years? Well, that probably depends on whether you're one of those people, I suppose...

[Canuckistani]

Sounds like Jbg's parents still have quality of life, so they should be provided with medical treatment that makes sense. Eg. they would not be eligible for a heart transplant anyway. But the real costs come when the aged are seriously ill and bedridden, but heroic measures are taken to keep them alive. I don't agree with that, it just prolongs suffering. Repeated cancer treatment when the prognosis is poor is another one. As long as they are lucid tho, they are the ones that should get the most input into what treatment they get. Many seniors seem sensible enough to know when further efforts are futile and it's time to make their passing as easy as possible, even help it along as in Holland or Switzerland.

[jbg]

Sounds like Jbg's parents still have quality of life, so they should be provided with medical treatment that makes sense.

Intermittently at best.

Repeated cancer treatment when the prognosis is poor is another one.

My mother fits that category.

As long as they are lucid tho, they are the ones that should get the most input into what treatment they get.

The chemo robs my mother of lucidity when she has it. The issue is to whether or not to resume chemo when the low-impact hormone therapy stops working. That will be the profound decision. Edited February 3, 2013 by jbg

[Canuckistani]

Intermittently at best.

My mother fits that category.

The chemo robs my mother of lucidity when she has it. The issue is to whether or not to resume chemo when the low-impact hormone therapy stops working. That will be the profound decision.

first off, sorry for your troubles. I may face something similar in the near future.

I'm not even sure I would take chemo for myself if I had cancer, unless the prognosis was really good. I think a lot of it is personal decision here, and your parents, when lucid should be discussion this with you and your family and put some legal provisions in place for what they want if they are no longer able to make lucid decisions. And what they want period, how far they want medical measures to be taken. I think your family should listen to your parents and honor what it is they want. But really, of course, each family has to figure this out for themselves, there's no once size fits all.

[Topaz]

Boy, this memory, I trying to forget but in 2008, my mom died of cancer, she didn't take treatment for two reasons, one the doctor said she was too old for treatment, (80) and she would have to travel 2 hours, each way for the treatment. She had a tumor in her lung and it was a fast growing kind, she lasts 6 months. my dad the same year, died 6 months later because he found it hard to live without her after being married for 60 years but knowing each other since public school. Anyway, he stopped taking his meds and died when a blood vessel broke in his brain and the sad thing was he was all alone when it happen. My dad never ever wanted to go to a nursing home. Now, on the other hand, my own hubby has had cancer went through treatments but he says,he never do it again. It's especially hard if you have to travel 2 hours for treatment and there's the cost of travelling and it just adds to the stress level.

[BubberMiley]

These constant crises have put my employment and that of my step-siblings in jeopardy.

My condolences. Have you mentioned to your mother that her continuing existence might be interfering with your career? Maybe you should let her know.

[eyeball]

My Mom is all alone back in Ontario and everyone else has either moved out west or died. I'm struck by the difficulties of bringing her out west to be closer to all of us not the least of which includes the loss of benefits in Ontario that will be difficult to recoup or obtain in BC.

Ontario seems more than happy to wash their hands of her while BC is loath to take her. Oh well, it's not like I suddenly became disillusioned about the notion I lived in a real country instead of a loose confederation of fickle interests.

[jbg]

first off, sorry for your troubles. I may face something similar in the near future.

I'm not even sure I would take chemo for myself if I had cancer, unless the prognosis was really good.

The first round of chemo, during 2008-9 after the initial surgery was definitely worthwhile. She had a good 2 1/2 years after that. Where the "rubber meets the road" is really the January 2012 operation and the ensuing chemo. If the diagnosis had been accurate rather than botched, we as a family may have made different decisions.

My condolences. Have you mentioned to your mother that her continuing existence might be interfering with your career? Maybe you should let her know.

That is a harsh comment.

The answer is, of course not. THe problem is more with the parade of her friends, and some in the family, who call me when I'm at work and ask why I'm not in her apartment changing a light bulb. The problem is more guilt-inducing relatives.

[BubberMiley]

That is a harsh comment.

Then why did you make it?

[guyser]

THe problem is more with the parade of her friends, and some in the family, who call me when I'm at work and ask why I'm not in her apartment changing a light bulb. The problem is more guilt-inducing relatives.

Condolences.

Those are the ones who need to be told to fuck off. Yes, using that language. I went through it and had the guilt thing too , and I guarantee you their head will swivel and hear you.

[jbg]

Condolences.

Those are the ones who need to be told to fuck off. Yes, using that language. I went through it and had the guilt thing too , and I guarantee you their head will swivel and hear you.

My employer gave me the same advice. That is still hard advice to take.

[guyser]

My employer gave me the same advice. That is still hard advice to take.

Take it !

Heres the skinny though, the same people who guilt you will not or do not get off their arse to help, they bitch from the sidelines like some nutter in the stands.

Once you unload a few F bombs or whatnot on them, they'll either wise up and pitch in (for which you can then mend fences) or they'll drop off into oblivion where they belong.

It not as if you have enough on your plate right now....sarcasm.

[Guest American Woman]

My Mom is all alone back in Ontario and everyone else has either moved out west or died. I'm struck by the difficulties of bringing her out west to be closer to all of us not the least of which includes the loss of benefits in Ontario that will be difficult to recoup or obtain in BC.

Ontario seems more than happy to wash their hands of her while BC is loath to take her. Oh well, it's not like I suddenly became disillusioned about the notion I lived in a real country instead of a loose confederation of fickle interests.

What kind of benefits does she get in Ontario that she wouldn't be able to get in BC?

[Guest American Woman]

THe problem is more with the parade of her friends, and some in the family, who call me when I'm at work and ask why I'm not in her apartment changing a light bulb. The problem is more guilt-inducing relatives.

Perhaps you should refuse to take their calls while you're at work. Let them know beforehand that you won't be taking personal calls - and then stick to it.

[jacee]

Perhaps you should refuse to take their calls while you're at work. Let them know beforehand that you won't be taking personal calls - and then stick to it.

And/or let them go to voicemail and respond only if necessary.

I got caught with a new job, ass*ole boss, two parents with cancer and grandmother dying the same year.

Make decisions about what you can and can't do,take what time you're entitled to, let people know, and let the guilt go.

And take the time and opportunity to say the good things you want your parents to know. I told my Grandmother to give my love to my brother who died young. It helped her let go.

My sympathies jbg.

[jbg]

Perhaps you should refuse to take their calls while you're at work. Let them know beforehand that you won't be taking personal calls - and then stick to it.

Maybe not a bad idea, but not practical since I don't know what may be a communication of an offer of something constructive such as a hospital visit. Sometimes they need the name or room number at the hospital.

One such call though was definitely a guilt call. One of her friends called me last February at work and asked why I wasn't at the hospital. And after she dialed my work number.

Another more recently was two of my stepsisters calling and suggesting I overnight with my mother for what was supposed to be a one night hospital stay for my stepfather. That one night stay is now 10 days and counting. A long time to leave my wife and two kids.

[jbg]

My sympathies jbg.

Thanks.

And by the way, I would like to steer the thread back to the subject. My concern is that much though not all of the medical care for the aged leads to miraculous, expensive rescues, for what purpose? To lurch to another expensive crisis?

I recognize that neither Santa Claus nor my parents nor myself is paying for this Bacchanalian excess of medical care. No person or family in their right minds would fund this for anyone other than a person aged from child to prime of life.

[jacee]

Thanks.

And by the way, I would like to steer the thread back to the subject. My concern is that much though not all of the medical care for the aged leads to miraculous, expensive rescues, for what purpose? To lurch to another expensive crisis?

I recognize that neither Santa Claus nor my parents nor myself is paying for this Bacchanalian excess of medical care. No person or family in their right minds would fund this for anyone other than a person aged from child to prime of life.

It's averaged over a lifetime. We all have lighter and heavier use times.

Your time will come to decide you don't want to burden the taxpayers with your hip replacement or chemo.

Some people have clauses in their will re 'no heroic measures', etc.

All tough calls.

Moments of quality time are what count.

Edited February 6, 2013 by jacee

[eyeball]

What kind of benefits does she get in Ontario that she wouldn't be able to get in BC?

It's the time it takes to become eligible in BC. What she has to forgo in Ontario she'll have to wait from 9 - 12 months to apply for here. She'll also lose the fixed rate that she's been paying for rent for quite some time now. We have programs to help recently landed immigrants in Canada to bring their elderly family members from afar to be closer to them in Canada and I think some sort of federal mechanism to help with the migration of seniors within Canada is something we should try to do for the same humanitarian and rational reasons.

One big point of the exercise is to try and locate Mom closer to us so we can provide more immediate hands on assistance to her instead of subsidizing her from here and hoping she's actually getting the care she needs. If anything this should help alleviate or reduce the need for public spending.

I realize BC will take on a liability when Mom moves here but then Ontario will also realize a break. I think some sort of federal bridging or equalizing mechanism should be in place that try's to rationalize that exchange of provincial liability so that the Canadian in question is not unduly or even prohibitively impeded from doing what's natural for families around the world. It's a fairly sizable crack in our provincial health systems that our national health care system should either fill with funding or a law that compels provinces to better facilitate doing the right thing by their and our citizens.

[Bonam]

1. People calling to guilt trip you in the kind of situation you are in are complete imbeciles and you probably should just cease all communication with them permanently or at least until after any current difficulty is long since over with.

2. Medical care for the aged is for the same purpose as for those less aged. To help them get better so they can return to normal life. If that is no longer possibly or likely, if the patient is lucid, they are generally free to decline such care.

[jacee]

We have programs to help recently landed immigrants in Canada to bring their elderly family members from afar to be closer to them in Canada …

Family reunification immigration is barely possible now, and not subsidized.

About 6 per cent of all immigrants to Canada are parents and grandparents of existing immigrants. But family-unification applications have far outstripped available spaces, creating a backlog of 165,000 applicants and wait times of seven years, which will lengthen to 10 years by 2018 if there are no changes.

“That is why it is absolutely essential that we bring in a temporary pause on applications,” Mr. Kenney said.

The moratorium ...

For those who waiting to immigrate or to get on the list, the new 10-year visa will allow parents and grandparents to stay for as long as two years at a stretch. However they must, if required, take a medical exam first; they must purchase private medical insurance while in Canada, and their children or grandchildren must be able to demonstrate that they can support the visiting relative.

http://m.theglobeandmail.com/news/politics/ottawa-notebook/immigration-minister-hits-pause-on-family-reunification-applications/article619236/?service=mobile

I wish you were right.

[Bonam]

Family reunification immigration is barely possible now, and not subsidized.

About 6 per cent of all immigrants to Canada are parents and grandparents of existing immigrants. But family-unification applications have far outstripped available spaces, creating a backlog of 165,000 applicants and wait times of seven years, which will lengthen to 10 years by 2018 if there are no changes.

"That is why it is absolutely essential that we bring in a temporary pause on applications," Mr. Kenney said.

The moratorium ...

For those who waiting to immigrate or to get on the list, the new 10-year visa will allow parents and grandparents to stay for as long as two years at a stretch. However they must, if required, take a medical exam first; they must purchase private medical insurance while in Canada, and their children or grandchildren must be able to demonstrate that they can support the visiting relative.

http://m.theglobeand...?service=mobile

I wish you were right.

What's wrong with the present situation? It seems quite reasonable that if someone wants to bring in their aged parents or grandparents, that they (or the parent/grandparent) should then be responsible for financial support and medical care. It does not make any sense to allow immigrants to freely bring over various aged relatives which would then be a substantial drain on the system.

[Guest American Woman]

It's the time it takes to become eligible in BC. What she has to forgo in Ontario she'll have to wait from 9 - 12 months to apply for here. She'll also lose the fixed rate that she's been paying for rent for quite some time now. We have programs to help recently landed immigrants in Canada to bring their elderly family members from afar to be closer to them in Canada and I think some sort of federal mechanism to help with the migration of seniors within Canada is something we should try to do for the same humanitarian and rational reasons.

Makes sense to me; I'm sorry to hear about the problems you've encountered with trying to move your Mom closer to you.

One big point of the exercise is to try and locate Mom closer to us so we can provide more immediate hands on assistance to her instead of subsidizing her from here and hoping she's actually getting the care she needs. If anything this should help alleviate or reduce the need for public spending.

Makes sense.

I realize BC will take on a liability when Mom moves here but then Ontario will also realize a break. I think some sort of federal bridging or equalizing mechanism should be in place that try's to rationalize that exchange of provincial liability so that the Canadian in question is not unduly or even prohibitively impeded from doing what's natural for families around the world.

Absolutely. I definitely agree that the federal government should provide the care that your Mom is receiving in Ontario - and would continue to need upon her move - until it becomes available to her in BC.

It's a fairly sizable crack in our provincial health systems that our national health care system should either fill with funding or a law that compels provinces to better facilitate doing the right thing by their and our citizens.

I agree. Thank you for your response/explanation.

[Guest American Woman]

Maybe not a bad idea, but not practical since I don't know what may be a communication of an offer of something constructive such as a hospital visit. Sometimes they need the name or room number at the hospital.

You could allow certain calls to go through, or perhaps screen them. Once the unnecessary calls are regularly ignored, I'm guessing they would dwindle in number.

One such call though was definitely a guilt call. One of her friends called me last February at work and asked why I wasn't at the hospital. And after she dialed my work number.

This is why calls should be screened. As long as they can get away with it, people like this friend of your mother's will continue to make these calls. Totally unnecessary calls.

Another more recently was two of my stepsisters calling and suggesting I overnight with my mother for what was supposed to be a one night hospital stay for my stepfather. That one night stay is now 10 days and counting. A long time to leave my wife and two kids.

You could turn such situations back at them. Over night for a night or two, then call them to tell them that you will be returning home and it's up to them to take their turn if they don't want your mom left alone at the hospital with their dad. As long as they can get you to do it, they will shirk their responsibility - which is why you have to make statements, not ask. And stick to it. They'll eventually get the message - likely sooner rather than later, once they realize you aren't going to back down.

I wish you and your family well.