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.
Agreed, no argument there. But you’ve just described a small mass casualty incident, and I was talking about every day. In my real but admittedly suburban world, when I take an elderly patient to the ER, they go first in line in part because they tend to call with serious conditions and in part just because they are elderly and almost anything could potentially be serious with them.
Agreed, but see post 59.
But lets be very wary of what the agenda is here.
I don't think there was an agenda in the report. It seems like a government agency is attempting to put together guidelines in a worse case scenario, and some "journalist" blows it up. Just the way I see it.
Hey seriously. They might have an agenda to kill all of us at a certain age, but if that happens, there is nothing I can do about it. I die and pray that Our Lord thinks I was a good and faithful servant.
There’s something better than this and I pray I get there.
Nice, mature reply. Did you not see this on the posting page? Please: NO profanity, NO personal attacks, NO racism or violence in posts.
I disagree. We can do smething about it, but it has to start now, not when they spring it on us.
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It’s a good idea for those of us who are older and have some resources to be able to shelter in place and stay away from crowds in a pandemic.
When first discussion of the SuperFlu (H5N1) came up, my family reviewed resources and decided at what stage the grandkids come live in the country with me, and at what stage their parents join us.
That obviates the need for triage: a plan to keep the family healthy. Our exact preparations are private, of course, but they do include plenty of fresh and stored food.
It’s a disaster plan for anything, really—come earthquake in the New Madrid, come terrorist nuke attack, come pandemic, whatever, we try to plan and be ready. Then triage is not so scary—everyone stays away from contamination, everyone lives (if at all possible).
So, because there’s sort of a plan to uniformly triage people in the case of a pandemic or other disaster in which life-saving treatment is scarce in a manner that will save the most lives, this is just a camel’s nose for the REAL agenda which is to withold treatment for old people altogether without such a disaster and move to a Logan’s Run world?
How about plans to quarantine cities in the case of a highly contageous and fatal infectious disease outbreaks....that just the camel’s nose for the real agenda of a total police state with Checkpoint Charlie on every corner?
.....slippery slopes are fun.
I’d say the “agenda” here is to have plans in place to save the highest number of lives in certain extreme scenarios instead of flying by the seat of the pants when the shi’ite DOES hit the fan.
Amen!
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.
************************************************************
Some of those recommendations leave way too much leeway for diagnosis.
Critical injuries can heal.
How severely burned?
What level on mental impairment is *severe*?
Just what would someone call *uncontrolled diabetes?
How much loss of lung capacity?
The potential for abuse of this is makes it totally unacceptable.
Occasionally there is no black or white. In extreme circumstances, there is grey. That is reality not a nose under the tent.
To be quite frank, your post shows you didn't comprehend what I wrote. Please go back and read it again.
Agree 100%. In fact, every American should do so, because a pandemic or a really bad terror attack could leave us all on our own for days, maybe weeks. Iagine if they managed to nuke four or five major cities on one day, for instance.
When first discussion of the SuperFlu (H5N1) came up, my family reviewed resources and decided at what stage the grandkids come live in the country with me, and at what stage their parents join us.
You're very wise.
1. I said we should be wary and I provided examples of libs using extreme situations to cloud moral issues. I didn’t scream “IT’S A CONSPIRACY, RUN FOR YOUR LIVES!”
2. Take a look back at the last 100 years or so of Aerican history and tell me there weren’t plenty of reasonable-sounding ideas that turned out being used by the libs as leverage to screw society up.
3. Do you really think we need a national triage plan such as this? Are American doctors really so dumb that if we’re short on doses they wouldn’t be able to figure it out?
Well, this is America, land of the self reliant... :D
I may have missed it - but did anyone mention choice by the people?
Perhaps some people would willingly for their own reasons choose to pass on the medication so another may live.
We expect the military to make those decisions daily.
The Brooke Astor case comes to mind, although the mother & son involved were much older.
One commentator, however, foresaw amoral, financially profligate younger generations disposing of their parents like garbage to get ahold of the inheritance. Euthenasia will be the rage.
Scarce medical resources in a disaster are allocated according to who can survive.
As for me, if a pandemic occurred and there were scarce resources, I think they ought to be used on the young. It makes sense.
I freely admit that I am strongly opposed to ageism--especially when the objects of this proposed discrimination would "includ[e] [otherwise] healthy people above 85"--but the discrimination does not stop there. Those who are either physically disabled or mentally handicapped would also be among those unapproved for rescue. If that is not reminiscent of the ghastly practices of Nazi Germany, I simply cannot imagine what might be.
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