My meeting with the Death Panel.

vanity | 04/01/2012 | chuckles

[chuckles]

Well, I've seen Sarah Palin's "Death Panel" up close.

I started not to write anything about it, but when Cheney got his new heart and the hullabaloo followed, I felt I needed to point out a few things.

My mom had a bad stroke January 29 and was left paralyzed on her left side. She also had trouble swallowing and was given a nasal feeding tube until she could be tested and worked with by a rehab team. Her medical history was she was a 3 time cancer survivor and was on coumadin for a clot in her left leg. Her first bout with cancer was colon cancer and she had 18 inches removed and a radiation follow up. Well, the radiation gave her some bouts of diarrhea and loss of some control. The second cancer, about 7 years later, was a spot on her kidney that was removed lapriscopically by freezing. The third cancer was large cell lymphoma where the colon and small bowel connect. That was removed surgically with chemo afterwards. At the time of the stroke, she was cancer free for 2 years and was living well on her own. She liked to travel, go to the "Opry" and went to Casino's in La. to play the slots.

While in ICU, they tried the "clot buster" but to no avail. After she was stabilized she went to a room for about 3 days. I was informed that she would be released to me about 8 hours before they were going to release her. They said she should go to a hospital called an "LTAC". There were 2 in the area and I was told I should pick one and they would make the arrangements for the move. I asked why not just treat her here, and the answer was Medicare says we have to move her. I knew of one of the LTAC hospitals so I picked the one I knew about. She went there for 20 days and was treated for pneumonia because when she had the stroke she was eating breakfast and apparently aspirated something. They gave her massive amounts of very powerful, and I assume expensive, antibiotics. At times she had 4 bags in her IV at once. She was able to speak and was completely "there" mentally. She remembered everything and was able to communicate well. The only problem was the left side paralysis.

I had dreams of getting her in a wheelchair and going on walks with her and trying to make her life as "normal" as possible. The handle on a one armed bandit is on the right side, so I figured she was good to go. Well, the Physician's assistant on her case made a mistake and told us she would be released on a Monday when we talked with her on Friday. I asked why because she still needed some of the rehab we were promised, and she still was running some fever. Her answer was the same as the hospital,....Medicare only pays for 20-21 days in LTAC. The next move would be home to my house( she was still paralyzed and couldn't live alone) or to a "rehab facility", commonly known as a nursing home. The PA said she still needed skilled nursing care, so unless I wanted to learn how to give her injections, change her diapers, feed her with a blender through her Peg tube, she suggested the skilled nursing facility. True to form, the administrator called Monday morning saying my mom was to be released today, what do you want to do? I asked why can't she get rehab here and it was made quite clear, Medicare won't pay. All this time I was promised some sort of rehab, they had done NOTHING. They got their Medicare money and kicked the can down the road. I had visions of a team of doctors like you see in "House" or Grey's "Anatomy" all working as a team to help my mother, but there was none of that.

I chose the nursing home near my home( I was able to visit a few because the PA made the error of giving me a weekend warning to check some out), so I could visit every day and make sure they were helping her. I got the speal from the head nurse and was shown the rehab room and told of great things they have achieved with their stroke patients. The last sentence of her speal included the "good news" that my mom would qualify for up to 100 days of Medicare payments because of her feeding tube. Then of course, it's Medicaid time. My mom had no real money and her house was on a reverse mortgage. Her private money would be exhausted in about a month.

To make a long story a little shorter, she had an infection and died 8 days into her stay at the "skilled" nursing facility.

Now what, you might ask, does this have to do with Dick Cheney and a heart transplant? You see the vitriol in the media about how he should have died and let a more deserving patient have the heart. He was 71, my mom was 80. IMHO, from the very first moment she entered ICU after the stroke, I was pressed about a DNR, how far do you want us to go,...that type of thing. I said I didn't want her on a ventilator, but I also wanted someone to help her if she was choking on the massive amount of mucus that she coughed up daily. I and My wife spent hours sucking it out after she would get it up from her lungs with the little suction "thingy". I wondered if a nurse checked her in the middle of the night, but of course I knew they only checked about every 4 or so hours, if that much. I spent 6-8 hours a day there and usually had to call them to help her for whatever she needed. When I came one morning, around 11am, she was panting like a dog and sweating profusely. I asked what was wrong with her? They said she had a big morning because they took her to the TV room and rehab had worked with her already that morning. I said she isn't responsive and there is something wrong! They asked well, what do you want? I said call an ambulance. The hospital was about 100 yards from the nursing home so I beat the ambulance across the parking lot to the ER. The ER nurse took her blood and she said she had a massive infection and her "numbers" were all screwed up. She had about twice the coumadin level she should have, her potassium was way off, she was dehydrated, and on and on. They gave her 1 bag of antibiotics and some saline with a vitamin K shot for the coumadin. After about an hour, they moved her to a room. I stayed with her all night. She had her blood drawn again in about 3-4 hours and the "numbers" were still "messed up". NO DOCTOR ever looked in on her and nurses visited 3 times including the blood drawing. She passed at 9:20am about 10 minutes after her "doctor" walked in the room.

Now the connection to Dick Cheney is, my mom was 80, a 3 time cancer survivor, paralyzed on one side with bouts of diarrhea. They pretty much decided she wasn't worth fixing. They didn't care. They didn't even try. They didn't know her. They didn't know her spirit. She was a fighter,....a survivor,....but they didn't want her to survive. This is the same thing they did with Terri Shiavo. They took away her personhood and made her government property. Medicare had it's guidelines and if you don't survive according to their payment schedule, you are going to be killed. The same people that thought Cheney had a long life at 71 and didn't really need to live any longer are deciding who lives and dies, and Cheney had his own money, so he lived, to their horror.

I know I have opened myself up here for the comments like She was 80 after all and probably would die of cancer, or you are blinded to the facts because she was your mother, or she really wouldn't want to live paralyzed like that. We talked about that and she said she wanted to live and would work hard to get the best result she could get. She always looked at the brighter side of adversity. But I was blinded by the sheer numbness of the medical system that they would pick who they would work hard for, and who gets thrown in the trash heap.

I'm sure there will be some that tell me if I'm not happy, I should sue, but that won't get my mother back, and I doubt that would change the system even if I win an award.

My purpose for writting is to point out, we already have Obama Care. It's been here for awhile now. If you go to an ER and roll snake eyes, you will be executed. They will leave you on a gurney to bleed out or choke on your own vomit because they don't like something about you. God help you if you are old, disabled, mentally impaired, or just ugly if you get the wrong nurse or doctor that has just had their Botox injections. If they think you have lived long enough, you are toast. Surviving cancer 3 times is just too much time and money for an 80 year old widow to be given any more attention. Maybe they saw she had voted Republican in the last election. Maybe they knew she had a shotgun in her closet. Who knows what dastardly deed gets you on the wrong side of the Death Panel. If you have some image of a gaggle of doctors and nurses gathered around you to do their best to save you, you have been watching too much TV.

[freedommom]

Your post brings back memories of my mom and her last days.

My mom had a stroke in 2008 and they inserted a feeding tube.
After a day or so they ran tests and said she was not able to swallow.

The Dr told us she would go into a coma and would die in 3 days.
We were caring for her at her home (you lose a lot of rights when you allow government nurses to visit from time to time).

He stated he was going to remove the feeding tube and she was to go home and receive hospice care until her death.

This was the hardest thing ever for our family. She did slip into a coma.
We decided from the start that our mother was never going to be alone and there was always a family member at her side till the end.

She lived for 28 days without food and water!

My 2 sisters and I were there with her and about 15 minutes
before this happened my sisters dog came in the room (she had never done this before) and looked my mom's way for about a minute tranfixed. She got under the hospital bed
exactly right under my mom.
About 5 minutes before we realized my mom had passed the dog abruptly got up and turned and looked at my mom for about a minute and then left.
What was that all about I don't know.

[WorkingClassFilth]

I agree with the experience and conclusions of most of your post. My mother recently came home after a three month stint in the ER—>nursing home system beginning with triple pneumonia. After two days in the hospital, she was put on a ventilator. From that point, things tended to go downhill through what I would call benign neglect. Her naso-gastric tube was found to be misplaced and she had been without nutrition for three days. After failed attempts to place it again, she went without nutrition again for three days.

If not for family involvement (a physician and an OT among us) I firmly believe she would have been allowed to pass. The casualness of her treatment and default points were clear and less medically informed families would have been clueless. She is 88 and, arguably, she has had a long, full life. However, with intensive family involvement, proper medical care and very hard work on her part, she is now back and living about 80% of what she was before the episode. I suspect, though don't have evidence, that policies and attitudes regarding care and cost are already in place - cultural death panels, if you will.

The culprit, IMPO, is our loss of Judeo-Chiristian values, due in large part, to gub’mint via the separation of church and state myth. After that, factor in defacto gub’mint control of medicine already via dollars spent /not spent in medicare and medicaid. Finally, thanks to gub’mint, the devalued dollar combined with escalating medical costs (again, gub’mint and lawyers) tend to drive the economic sterility of a utilitarian policy philosophy.

Paging Doctor Peter Singer...paging Doctor Peter Singer...

[tbw2]

Part of this problem may be the low reimbursement rates of Medicaid and Medicare - they cannot afford to provide quality care when paid so little. The major problem, though, is that employer based health insurance typically stops paying for your care past age 65, saying you have to sign up for Medicare.
A partial solution for individuals would be:
1. Don’t sign up for Social Security, so you don’t get stuck in Medicare / death-care.
2. Get long term care insurance so you don’t have to use Medicaid to pay for a nursing home (so better quality care in a nursing home).
3. Get private health insurance that covers you as an elder OR sign up for a medical sharing ministry (to meet insurance requirements) OR self-insure for medical costs (lots of savings).

[Caipirabob]

I am so sorry for your loss. Prayers up to her, you and yours...

[Stegall Tx]

Part of this problem may be the low reimbursement rates of Medicaid and Medicare - they cannot afford to provide quality care when paid so little.

Thank you for posting this. I have been astounded that my mother keeps finding good doctors who are willing to essentially treat her for nothing. Of course, they are overcharging their regular patients in order to give my mother her treatments at Medicare rates.

[elcid1970]

I’ll soon be 64 and I am convinced that I will not enjoy the `luxury’ of death by natural causes.

Oh well, most of us Vietnam vets still know how to shoot.

;^)

[yefragetuwrabrumuy]

A serious suggestion to everyone with elderly and/or disabled parents: America has been becoming increasingly toxic to the elderly and disabled, and it will almost certainly become much, much worse, no matter who is in charge, for several reasons.

Government involvement in health care, the baby boomers all coming of age, a general lack of people willing to care for geriatrics in medicine, and a huge lack of people to do the day to day maintenance. Add to this collapsing medical ethics that views suicide and homicide as good alternatives to the “hassle” of continuing care.

So it is time to consider “The Mexican Option”. Don’t just dismiss this in an offhand manner.

Mexico’s health care is a lot more capitalistic than health care in the US. Their medical schools do not intentionally restrict the numbers of doctors they graduate, like schools in the US, and they have an abundance of skilled nurses and a great abundance of nurses aides and other workers.

And a large percentage of them speak English. So what does Mexico offer that the US does not?

1) Far less expensive, but capable surgeries, diagnosis and treatment. Far less expensive hospitalization and nursing home, as well as ordinary retirement housing. Far less expensive pharmaceuticals.

2) Much more, and less expensive, medical labor, so that there is a team of people for just a few patients, especially to take care of the little things that matter like cleaning, laundry, food preparation, even around-the-clock sitting.

3) Respect for the elderly and infirm. Mexican families almost never send their older members to nursing homes, as this is culturally discouraged as disrespectful. They also have a much better regard for the elderly as a whole, so tend to be good caregivers, unlike much of the care found in the US.

4) The ridiculously high expense of nursing home care in the US is so bad, that some elderly and at least partially ambulatory people have figured out that for about the same money, they can lead much better lives aboard cruise ships. Better food, adequate medical care from the ships medical staff, maid service, etc. Opposed to sitting in a wheelchair for hours every day staring at a painted block wall, or lying in bed staring at the ceiling.

[azishot]

Will remember your mother, you and your family in my prayers. Thank you for sharing with us.

[Paleo Conservative]

4) The ridiculously high expense of nursing home care in the US is so bad, that some elderly and at least partially ambulatory people have figured out that for about the same money, they can lead much better lives aboard cruise ships. Better food, adequate medical care from the ships medical staff, maid service, etc. Opposed to sitting in a wheelchair for hours every day staring at a painted block wall, or lying in bed staring at the ceiling.

My mom is moving to a retirement community that is like a an apartment complex combined with a country club plus a skilled nursing facility. The Executive chef previously was in charge of food service on cruise ships and appeared on more than 100 episodes of Martha Stewart.

[SaraJohnson]

I am so sorry you went through this carelessness and lost your mom. Thanks for the heads up.

[petercooper]

bttt

[E. Pluribus Unum]

My mother died in 92 and the care was better then, that is only twenty years ago!

The more control the federal government has over the health care system, the worse it gets.

Just wait until they have total control.

[WildHighlander57]

Paleoconservative, all

Your stories echo what happened to my mom. She fell and got a subdural hematoma. She aspirated somthing because the fall affected her swallowing. She had other conditions (kidney and lung) that got aggravated by the injury. The doctors pressured me to put her into the subacute wing of the hospital in spite of one of the conditions requiring hospitalization ( subacute is not a nursing home, its the stage in between ) I had POA and pushed back, but to no avail. She had COPD that got worse... they then pushed her out from subacute into a nursing home. They couldn’t find a home that had enough percent oxygen so they ended up hooking TWO oxygen concentrators together in order to give enough air to her.
She died a week after going into the nursing home.
That was ten year’s ago......I am still angry about it. The subacute facility had the nerve to have a big display showing a young lady that had had a similar injury and the facility had given her hyperbaric treatments which cured her.

[winkadink]

Thanks for sharing with us. I am 80 years old (young?) and have COPD. No cure there. And I will remember your mother and you in my prayers.

I am sorry you lost your Mother. I lost my Mom several years ago and still miss her. I wish you and your family good memories of her.

[yefragetuwrabrumuy]

The bottom line is pricing. How much will that set her back, and take into account Medicare and insurance, both of which may be drying up soon.

It may not be a bad idea that, assuming the worst, which in this case is increasingly likely, that you all have a ‘plan B’ and a ‘plan C’.

[fella]

“we already have Obama Care. It’s been here for awhile now.”

So true.

Please forgive my crudeness for the truth is often told in jest.

However with “Zero-Care” the system is streamlined and highly improved, in a MBA-think sort of way, that not only improves the governments bottom line so that more of it’s ‘care’ can be doled out to more retired people but will allow those who “complete their treatment” to ‘will’ their real and personal property to the governments’ proxies for redistribution. All for the greater good.

On a side note; “Zero-Care” is greatly interested in Hollands’ highly inovative moble euthansia units. To be called “Specialized Natural Unliving Facilatating Forces” or “SNUFF” in the United States.

[Student0165]

I am so sorry about your mom, chuckles. I can hear your frustration and your pain in your post. Your post brought tears to my eyes.

[Rides_A_Red_Horse]

I’m sorry for your loss.

It’s one thing to let someone pass without “heroic measures.” Letting them deteriorate through neglect is something completely different.

The bastards won’t be satisfied until we mirror North Korea in every way.

[Shery]

Thanks for the post. Moving back to the US after 26 years of federal service as educators in military kids’ schools, we are finding this out, as well. No one wants to take Medicare age people.

Fortunately for my mother-in-law, who has had a recent hip surgery and now will have to go for another procedure, the doctor has been very willing to take her and do what it takes to get her back on her feet...at the age of 86. She’s always been independent and wants that back, if at all possible. I am so grateful she has a doctor that sees her as a person, regardless of her age! And, yes, prayer does help!

[Mike Darancette]

Chuckles?