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Health care advocate in old age
Old 06-26-2010, 06:19 PM   #1
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Health care advocate in old age

Rather than post this where the topic came up, I started a new thread.

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Originally Posted by youbet View Post
There is an important difference between having a child care for you and having a child advocate for you.

What I'm counting on is that my son, ....

If the time comes when I'd trust a professional advocate to look out for me more than I'd trust DS, certainly not the case currently, I'll hire a professional and set up the appropriate trusts.

I hope I'm right about this. In our extended family, and in our inner circle of friends, there is a strong track record of kids being the best advocates for their elderly parents. I know that history is probably influencing me. But, your have to put your trust somewhere.
This article in the NYTimes talks a little bit about this topic: A Pacemaker Wrecks a Family's Life - NYTimes.com

I think the article helps show that even the best laid plans, don't always come to fulfillment. Does any body have experience where a professional advocate was used and cost effective?
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Old 06-26-2010, 06:33 PM   #2
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Crap, I need to find someone nearby to say when to pull the plug.
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Old 06-26-2010, 06:44 PM   #3
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Isn't your last month of health care more costly than the previous 5 to 10 years' combined?

http://ajrccm.atsjournals.org/cgi/co...full/165/6/750
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Old 06-26-2010, 08:36 PM   #4
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Crap, I need to find someone nearby to say when to pull the plug.
Wow. I was going to say "that's what living wills, advance care directives, etc are for". But the man in the article had those things and they didn't cover the situation he found himself in.
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Old 06-26-2010, 09:27 PM   #5
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Quote:
Originally Posted by LOL! View Post
Rather than post this where the topic came up, I started a new thread.



This article in the NYTimes talks a little bit about this topic: A Pacemaker Wrecks a Family's Life - NYTimes.com

I think the article helps show that even the best laid plans, don't always come to fulfillment. Does any body have experience where a professional advocate was used and cost effective?
Tragic story and unfortunately played out way too often. The only "professional" advocates I know of are those assigned by the state for those who lack the ability to make decisions for themselves and have no family to shoulder the responsibility. Your first line of defense is to be sure to have a living will filled out and accessible and be sure your doctor(s) and places where you get healthcare know your wishes. In addition be sure your immediate family know what you would and would not want. The most tragic cases I see are where the patient has made an informed decision about their end of life care which is clearly documented in the medical record but when the patient becomes incapacitated one (or more) of the immediate family in the "heat of the moment" decide they want their loved one to be a "full code".

The culture in medicine is slowly getting away from the sense that withdrawal of care (in the articles case turning off the pacemaker) is in some way actively causing the patients death and the antithesis of what a physician does. Hopefully RIT will chime in as he, I'm sure, has had a great deal of experience in helping patients and families make these decisions as a Hospitalist and would know of resources for information.

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Old 06-26-2010, 11:35 PM   #6
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My conclusion from the article is that having children to step in and assist during tough times is a good thing. Clearly the author, Katy Butler, and her brother were a significant help to their mother during the difficult years. Clearly the kind of children all parents hope their own will be when help is needed. I was surprised, however, that although Katy mentioned that her parents were upper middle class, there was no mention of in-home care help. Did Katy's mom really have to handle all the hands-on care herself to the point of exhaustion? Or was this an effort to be "frugal?"

The issue of whether withdrawing care (turning off the pacemaker) would have been appropriate or if our medical system promotes extending lives of severely ill patients too aggressively is another topic........
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Old 06-26-2010, 11:48 PM   #7
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Does any body have experience where a professional advocate was used and cost effective?
I attended a presentation by a representative for a elder care advocate company. It seemed like a useful service, especially for those without family willing to do it or for those whose family doesn't have the necessary knowledge or time to acquire it. Or if you can afford to pay someone handle the details, do the leg work and just report in to your trusted family member.

I can't find the brochure right now, it's around here someplace. But I Googled up a number of similar companies like this one:

http://thegeriatriccareconsultants.com
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Old 06-27-2010, 09:06 AM   #8
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I read the article a week ago. Ms Butler did mention in-home care. Let me see if I can find a relevant quote.

Quote:
Half need help with at least one practical, life-sustaining activity, like getting dressed or making breakfast. Even though a capable woman was hired to give my dad showers, my 77-year-old mother found herself on duty more than 80 hours a week.
Quote:
At home in California, I searched the Internet for a sympathetic cardiologist and a caregiver to put my Dad to bed at night.
Quote:
Finally, he was weak enough to qualify for palliative care, and a team of nurses and social workers visited the house.
So I infer that they had some help, but not a full-on, live-in-the-home aide or nurse.
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Old 06-27-2010, 09:21 AM   #9
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When I was younger, I worked as a nurse's aide in a small town hospital. Most of our patients were old and infirm direct from nursing homes. Many had disinterested family.

I remember a lady who was discharged into the care of her family. A hospital 60 miles away called us the next day. She was found in their emergency room with our hospital wristband still on her, but no family members to be found. They had dumped her there.
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Old 06-27-2010, 01:15 PM   #10
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Yep. Having trusted and loyal family at end of life would certainly be a blessing compared to what you describe. But that alone does not excuse one from proper financial planning so as to not burden others beyond managing resources in your best interest.
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Old 06-27-2010, 04:04 PM   #11
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Family Value: When Bankers Tackle Elder Care - WSJ.com
is an article about banks helping with Elder Care. I'm not sure it is cost effective with
Quote:
Wells Fargo's Elder Services program, for example, charges up to 2% a year in total fees on a $1 million minimum.
but if your neighbors move in (read the article) and take all your money, that makes a mere 2% seem like a bargain instead.
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