Posted on 05/06/2008 7:51:17 AM PDT by Sam's Army
Plan for long life, without pandemic NANCY STANCILL Should doctors let people older than 85 die in a flu pandemic?
A Monday news story saying a U.S. task force recommends denying lifesaving care in a pandemic or other disaster to some folks -- including healthy people above 85 -- was unsettling.
They're talking about my mother, soon to be 86. My friend Karen's father, who is 92. Another friend's grandmother, 102.
These people live life joyfully, with their minds and hearts intact. My mother relishes foreign travel. Karen's father loves bird watching. The 102-year-old grandmother plays a mean hand of bridge.
Financial planners, who routinely urge clients to base their planning on living to 95 or more, were aghast when I told them the news.
"I hope that none of my clients ever have people who want to make that decision for them," said Paul Boggs, a certified financial planner with R.P. Boggs and Co. in Lake Wylie, S.C. "That doesn't sit easy with me."
He said he has clients who are active in their 90s, including a few who still work daily at their companies.
Diane Davis, a certified financial planner in Charlotte, said she is amazed at such a recommendation, given that medical advances are increasing longevity all the time.
"A lot of us baby boomers would have an issue with that," she said.
It seems counterintuitive that the task force, influential physicians from universities, medical groups and government, would recommend letting people over 85 die in a flu pandemic.
The proposed guidelines are designed to be a blueprint "so that everybody will be thinking in the same way" in a disaster, Asha Devereaux, a critical care physician from San Diego and lead writer of the report, told the Associated Press.
Task force members said the idea is to allocate scarce resources, such as ventilators, medicine and doctors and nurses, in a uniform way. In addition to those over 85, the guidelines would cut out people with severe chronic disease and mental impairment.
Eighty-five doesn't seem so old anymore, especially when today's young folks have a heightened chance of living to 100.
The United States has about 54,000 centenarians, a number that has risen steadily over the last decade. One longevity expert predicts as many as 840,000 centenarians in 2050.
Cindy Anderson, a certified financial planner with Anderson Financial Planning in Charlotte, said she uses the age of 99 when mapping out strategies for folks in their 50s and 60s.
"My software won't go any higher," she said. "I have clients whose parents are dying in their 90s. I'd rather the clients die with money than without."
That got me thinking about money. If you have enough of it, it's an antidote to the loss of power people often experience in old age. And that got me thinking about saving.
So what's the trick to making money last into your 90s or beyond?
Don't withdraw more than 4 percent yearly from your savings after you retire, all three planners said.
"If you start hitting your principal early, that's a tough situation," said Boggs.
Other advice:
• Buy good supplemental health insurance. Don't rely solely on Medicare as you age.
• Get a financial checkup each year after you retire, so you can apply the brakes if you're spending too much of your nest egg.
• If you can afford it, buy long-term care insurance in your 40s or 50s. You may never need it, but if you do, you'll have the resources to avoid poor-quality care.
• Plan for inflation in some areas, such as utilities, taxes and food. But planners also note that some expenses, such as travel and entertainment, may decline in your 90s.
"As clients get older, they spend money in different ways," said Anderson. "They often stop spending a lot of money on shopping and the symphony."
Nancy Stancill's On the Money appears in the Observer Sundays and Tuesdays. Reach her at 704-358-5066 or at nstancill@charlotteObserver.com
ON THE MONEY
Disaster care report A task force charged with looking at health care in a flu pandemic or other disaster says lifesaving care may need to be rationed.
The task force's recommendations for who would not get treatment include:
• People older than 85.
• Those with severe trauma, which could include critical injuries from car crashes and shootings.
• Severely burned patients older than 60.
• Those with severe mental impairment, which could include advanced Alzheimer's disease.
• Those with a severe chronic disease, such as advanced heart failure, lung disease or poorly controlled diabetes.
Unintentionally funny, because of the sheer arrogance.
Right now, the United States has about 105,000 ventilators. Of these, 100,000 are needed in a typical flu season.
This means if H5N1 maintains anything like its 60% mortality rate, *with* ventilators for the other 40% infected, it is likely that mortality could rise to 75%, *without* ventilators.
And since the adults, from age about 20-40 are hit worst, much of the world that remains will be under 20 and over 40.
That is, there will be a “lost generation”.
Granted, because there will still be significant mortality among the under-20 young and over-40 age group, the situation will develop:
1) Doctors can tell from a lung X-Ray who will live and who will die.
2) The under-20 young will be more inclined to survive *with ventilation*, so they will get priority care with ventilators.
3) Adults over-40 will probably not have much access to ventilators except the politically powerful and wealthy, but the majority might be able to reduce the severity of the disease with immunosuppressant drugs. This age group will also be most likely to survive by disease avoidance through self-segregation.
4) People in the categories of the article might actually be better off than most, especially if they have older health care providers. That is, younger people will be out and about more, exposing themselves to the disease; but older and infirm people would have to have the disease transported to them.
All told, the very idea of triage in such a pandemic is almost laughable. It will NOT be up to doctors as to who will live and who will die. All they can do is look at the X-Rays, and give those young children who can survive the ventilators they need to survive.
As a final irony, those who survive the disease will to a great extent have lifelong severe lung damage. So there will be lots of survivors who are as crippled as people who have emphysema. They will be the long term victims of the killer influenza.
I suppose the only plus side will be after the plague is done, there will be many years of great prosperity around the world. High wages, low prices, much less government, and fewer and smaller wars.
Shortages and rationing are an inevitable end result of socialized anything.
Under normal circumstances, yes, but in a disaster they have the training, the ability, and the legal authority to decide who will benefit from treatment, and will therefore survive with treatment, and who will not.
With scarce resources (there are only so many doctors, rooms, medicines and hours) not treating the walking dead is essential for the survival of the maximum number of people
In a disaster, really.
It's not so much denying care to patient A who will die regardless, nor denying care to patient B who will live regardless, it is making sure that patient C who will only survive with treatment gets treatment.
There are some green weenies who want to do just that. Only it is a lot younger than 85.
That, and there are abundant resources to treat everyone who walks, crawls or is wheeled into an ER on any given day.
It's only when resources are scarce (think socialize medicine or a disaster) that real triage (as opposed to scheduling) becomes a necessity.
I'd put good money on them being able to regrow health lungs in 20 years.
bump
I’d not heard the term “Electric Strawberry”, but it does fit.
My late father stood guard during the Cold War (1955-1956) in Hawaii with
The Tropic Lightning.
After being drafted at age 26 (and married), then put through
hotter-than-hell summertime basic training at the ironically-named
Fort Bliss...a year in Hawaii
WAS PARADISE!
http://www.25idl.army.mil/divhistory.asp
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