Many people sign a form to have body tissue or organs donated to others after their death. They often have this information recorded on their driver’s license to expedite procedures necessary in case of an accident. But far fewer choose to donate their whole body for scientific research — despite the fact that this type of donation is vital to help train new doctors, as well as to develop cures for diseases.
One of the diverse topics concerning aging is whether older people would prefer to update or remodel their current home — often referred to as aging in place — or look into assisted living. Many surveys, including one from AARP, indicate that most aging Americans would rather stay in their own homes.
In the following email interview, Romilla Batra, M.D., chief medical officer at SCAN Health Plan, a not-for-profit, senior-focused organization that offers one of the largest Medicare Advantage plans in California, updates us about current thinking when it comes to the pros and cons of each type of planning. Dr. Batra is a board-certified internist with more than 15 years of experience as a medical director, clinician, and educator.
Minding Our Elders lets you know that you are not alone, that you are not going to be perfect, but you can get the job done, You do the best you can, and that is good enough. We can't be Carol, but we can learn from her going before us. What a friend to have. What a gift she gave us. – CM Jones
Dear Carol: My parents were married for 56 years before Mom died. Dad eventually moved into assisted living. His mind is good, though he had a stroke years back so he uses a cane. He can still drive. My sister works part time, yet Dad is at her house every day from breakfast until evening. I live 50 miles away, but help out on weekends. I’m afraid that, because of Dad's grief, we’ve overdone the caregiving. We’ve talked with Dad, but he doesn’t see the problem. How do we convince him that we love seeing him but he needs to take advantage of his new home and give us some space? – Steve
Would you prefer a hot dog or hamburger? Ketchup, mustard, relish? Chips, salad, dessert? All were available during the annual barbecue picnic at the nursing home where my parents, my uncle and my mother-in-law lived at different times. While people also enjoyed the monthly birthday dinners and holiday festivities hosted by the nursing home, the summer barbecue was one of the most anticipated events of the year.
As you watch your parents or other beloved elders age, sometimes worry becomes inevitable. Should they have housing upgrades? Can they continue to live independently? Your intention isn’t to take over their lives, but you may genuinely want to start the conversation about possible future changes. How do you do this without causing a backlash?
For most seniors, moving from their home of many years into an assisted living facility is difficult. For some, it's nearly paralyzing. Even if they are moving to a very nice assisted living environment, the move will likely mean a significant loss of space, especially if they are leaving a house. Downsizing – the term often used for weaning ourselves from long-time possessions – can be hard for anyone. When it's more or less forced upon someone because of age or infirmity, the process becomes even tougher.
Many people would consider losing their sight one of the worst potential losses that they could encounter. While most of us will not suffer from complete blindness, millions currently suffer from some form of visual impairment, with numbers growing rapidly as we age. According to the National Eye Institute (NEI), older adults represent the majority of the visually impaired population, with visual impairment included among the 10 most prevalent causes of disability in the U.S.
This is National Healthcare Decisions Week (formerly "Day"). This book is a wonderful guide for deciding what you would want in the future. (Full disclosure: I wrote the foreword to the second edition).
"Code Blue!" A voice cries out in the Emergency Department. "Is there a doctor who can 'tube' a patient in Cardiac Cath Lab?"
These beginning lines of "Wishes To Die For: Expanding Upon Doing Less in Advanced Care Directives," by Dr. Kevin J. Haselhorst, prepare the reader for an adventure in self-examination.
The first chapter, titled "Self Determination," describes the author's own internal battle to balance his training as a doctor who cures at all costs with the wishes of his patients. Through his book, Haselhorst gently encourages us, the potential patients, to examine our right to decide how and under what circumstances we will be allowed a natural death.
In "Wish 10: Pre-Stamp Three Coins in the Fountain," Haselhorst writes, "I cannot remember the last time that I wished for a feeding tube, dialysis or ventilator." The author is not negating the importance of these treatments, but he is stressing that we must keep a record of our wishes up to date. He challenges us to examine what we really want at each stage of life. Any of the above efforts to increase our chances for survival may be a correct choice under some circumstances, but there often comes a time in our lives where less treatment is in our best interest. Unless our current wishes are made known, we may not be able to choose the manner in which our life comes to a close.
While reading the book I highlighted, underlined, and clipped colored markers on pages, thinking to myself that I must include this quote or that paragraph as I wrote. Before long, I realized that scores of quotes would be needed to do this work justice. The complete book with everything in context is needed before the reader can grasp the manner in which Haselhorst guides readers through their own journeys of self-examination.
That being said, what Haselhorst writes toward the closing of his book comes close to summing it up. He says that, "Death with dignity is only realized through the empowerment attained from engagement (of the patient)."
To address this belief, Haselhorst has designed a wristband similar to the well-known Livestrong Foundation wristband. The difference is that this band is bright yellow on one side and embossed with the words "Alpha care," meaning that the patient wishes doctors to keep trying all routes to keep him or her alive. The reverse side is a subdued blue and embossed with the words "Omega care" indicating the patient's wish to be allowed a natural death. With a twist of the wristband, a patient can communicate his or her current thoughts.
"Wishes To Die For" is an intellectual book, best-absorbed chapter by chapter. In my opinion, it's well worth taking this journey with the author to help us clarify our own beliefs. For more about Haselhorst and his work, visit www.wishestodiefor.com. The book "Wishes To Die For" is available at Amazon.com.
Previously published as a Minding Our Elders column for the Forum: Carol Bradley Bursack is the author of a support book on caregiving and runs a website supporting caregivers at www.mindingourelders.com. She can be reached at firstname.lastname@example.org.
You're close with your parents and you see them needing help. You've watched their decline, but so far you've handled it and they've stayed in their home. You've hired out the yard work and much of the housework. But it's time now for something different. Dad's often confused and Mom's diabetes isn't being cared for properly. You are wondering, should they move in with you? Years back, having one or both parents move in with the family was relatively common. My grandmother moved in with our family when my brother and I were teens and our little sister was a toddler. My parents built a new home that could accommodate privacy for Grandma as well as a family with teenagers and a toddler. It worked.
An amazing book of stories that will touch your heart and encourage you, especially if you are a caregiver. Carol Bradley Bursack also has an excellent web site devoted to the elderly and their caregivers. - Carol Heilman
Of course, we don't always make the right call regarding every circumstance. But we do our best. I'd hazard a guess that the most painful decision for most of us to make is whether or not it's in our loved one's best interests to place him or her in a nursing home. If it is also in our best interest, then the guilt looms even larger.