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Old 09-23-2014, 05:48 PM   #41
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I respect the thoughts conveyed in the article about quality of life near the end of Life. Like many of you, I have had my share of exposure to people dying of cancer and other drawn out painful terminal diseases. I pray that when it's my time it is short and painless. Of course, I would prefer it be at least in my 80's.

Interestingly, I think he used 75 yrs old because he knew that would draw attention and get people to read it. Let's face it, if he used 80 or 85 which are above the current average life expectancy most of us probably don't bother reading it.
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Old 09-23-2014, 08:00 PM   #42
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Back when DW's Mom was slowly dying of Alzheimers I remember how DW became furious when she found her Mom was still being prescribed statins and other life extending drugs. She loved her Mom dearly, but recognized that past a certain point life extending treatments weren't helping anybody.

As a result of this and other experiences with parents and older relatives we both hold views rather similar to those in the linked article. We certainly have no arbitrary age to end it all. We intend to avail ourselves of medical care for as long as it enhances our lives and if we're still enjoying life at 95+ then so much the better. But when we recognize that infirmity, immobility and the other ravages of age have taken all the fun out we both hope to have the ability and the nerve to end things quickly without the wretched extended and expensive endgame we've seen too many times already.
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Old 09-23-2014, 09:55 PM   #43
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If I die before 90, I think it would be tragic (for me, that is; most of the world wouldn't notice).
Every life is a Tragedy because in the end the main character dies.
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Old 09-24-2014, 06:52 AM   #44
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He's being interviewed.

His point is that statistically, people over 75 will see more and more debilitating.

For instance the incidence of Alzheimer's is 1/3 to 1/2..

He notes that one common reaction to the article is that people think of acquaintances already over 75 leading relatively active lives, with good health. His contention is that those are statistical outliers.

People would like to think they'll have good health and active lives until their 90s or whenever they're suppose to die and then their health will fall off a cliff in a short time right before they go. More likely is a slow and drawn out deterioration, perhaps prolonged by efforts to remain active, be healthy, etc.

It's more of a intellectual perspective than an emotional one. Especially here at ER, few people will go along with this largely intellectual exercise.
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Old 09-24-2014, 07:27 AM   #45
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His point is that statistically, people over 75 will see more and more debilitating.

For instance the incidence of Alzheimer's is 1/3 to 1/2..

He notes that one common reaction to the article is that people think of acquaintances already over 75 leading relatively active lives, with good health. His contention is that those are statistical outliers.

People would like to think they'll have good health and active lives until their 90s or whenever they're suppose to die and then their health will fall off a cliff in a short time right before they go. More likely is a slow and drawn out deterioration, perhaps prolonged by efforts to remain active, be healthy, etc.
I get his underlying stats and and agree with them but not him. I am on the fanatical edge in terms of wanting to avoid aggressive life prolonging treatments for myself. I would welcome physician assisted suicide and am unhappy that I can't set things up to provide for my quick and merciful demise if I become unable to do it myself due to a sudden trauma. I am outraged that doctors can't even legally give me a simple prescription for a life ending drug that I could administer myself in the event that I find myself on a debilitating downward path. But I don't think this guy's rant will be of much help in getting us to where I would like to be. His talk of aggressive anti-life actions like not treating infections feeds right into death panel talk and other alarmist predictions of doom if we open the door to sensible end-of-life care. I fear he is provoking the wrong discussion.
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Old 09-24-2014, 07:57 AM   #46
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I get his underlying stats and and agree with them but not him. I am on the fanatical edge in terms of wanting to avoid aggressive life prolonging treatments for myself. I would welcome physician assisted suicide and am unhappy that I can't set things up to provide for my quick and merciful demise if I become unable to do it myself due to a sudden trauma. I am outraged that doctors can't even legally give me a simple prescription for a life ending drug that I could administer myself in the event that I find myself on a debilitating downward path. But I don't think this guy's rant will be of much help in getting us to where I would like to be. His talk of aggressive anti-life actions like not treating infections feeds right into death panel talk and other alarmist predictions of doom if we open the door to sensible end-of-life care. I fear he is provoking the wrong discussion.
I agree with you 100% But our current health care system does not want to fast-track the dying process. The majority of profit is made from people over the age of 65.

Until health care is no longer viewed as an opportunity for profit, people will die slowly and badly.
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Old 09-24-2014, 08:27 AM   #47
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Where in the article does he advocate his plan for anyone but himself? How is this advocating a death panel, he's advocating for HIMSELF to choose an arbitrary age.

The controversial part is the age he chooses... and the first few paragraphs address that his family thinks he's wrong about that.
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Old 09-24-2014, 08:42 AM   #48
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My thought is that when I'm no longer "living", but just "alive", then it's time to go, but I have no arbitrary age in mind. Plus, I may or may not feel differently when I get there.
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Old 09-24-2014, 11:29 AM   #49
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He looks pretty healthy. I get the impression from the article that until he hits 75 he will get flu shots and take antibiotics etc. but will not do so after he hits his magic number? If he reaches 75 in perfect health as a result, he will probably be disappointed to live another ten years or so. I found this statement of his interesting and somewhat of a hedge:

Quote:
If I were diagnosed with cancer now, at 57, I would probably be treated, unless the prognosis was very poor.
in that the treatment would likely also prolong his life past his optimum lifespan.

He will probably update his feelings as the years pass. It will be interesting to read his future thoughts.
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Old 09-24-2014, 11:34 AM   #50
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He might indeed change his mind when he gets closer to 75, but I don't think the exact age was the point of the article (prob chosen deliberately low to increase readers/provoke discussion). I think his POV is sound, the only question is at what age? Those here who hope to live to 90, 100 or some other stated relatively advanced age, may also regrettably change their minds (re: prolonging life) when they get closer to that age.

And it's pretty well documented that one of the reasons for much higher health care costs in the USA is end of life health care costs, often for patients whose quality of life has all but disappeared. As a country, we may have to confront the issue one of these days.
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Old 09-24-2014, 11:50 AM   #51
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I agree with you 100% But our current health care system does not want to fast-track the dying process. The majority of profit is made from people over the age of 65.

Until health care is no longer viewed as an opportunity for profit, people will die slowly and badly.
True. So sad.
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Old 09-24-2014, 12:20 PM   #52
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A number of us have stated that we don't want to prolong our life after we hit a certain point - pain, dementia etc. But what have we done to facilitate that? Most of us probably have some kind of generic living will, but that's hardly enough.

For me, that's the biggest impact of this article. To begin the thought process to determine what we would accept & what we wouldn't before it is out of our control.

An easy example for me - if I am diagnosed with Alzheimer's and there is no cure on the horizon, I would stop all other diagnostic tests (for cancer, cardiac etc) and probably refuse other treatments too. I would have to make some kind of binding directive to accomplish that. I just don't see the point in living with full blown, incurable Alzheimers. But that's ME. Other scenarios are much harder - at what age would I refuse a heart bypass? I don't have to stick with the decision, but I think I'll make a better one if I think/research about it before I am forced to make it quickly.
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Old 09-24-2014, 12:50 PM   #53
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And it's pretty well documented that one of the reasons for much higher health care costs in the USA is end of life health care costs, often for patients whose quality of life has all but disappeared. As a country, we may have to confront the issue one of these days.
Oh, I hope not. This is an issue better left to individuals and families. Each person likely defines their quality of life differently than others. I like empowering the individual rather than leaving it up to a country to define as a matter of social policy. Not sure that was your point so if I've misunderstood then my bad.

And to the extent this guys article is really just his reflection on what he would do in his individual situation then fine. To the extent it is an attempt to push society towards that direction I'm not a big fan of that.
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Old 09-24-2014, 01:21 PM   #54
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Oh, I hope not. This is an issue better left to individuals and families. Each person likely defines their quality of life differently than others. I like empowering the individual rather than leaving it up to a country to define as a matter of social policy. Not sure that was your point so if I've misunderstood then my bad.

And to the extent this guys article is really just his reflection on what he would do in his individual situation then fine. To the extent it is an attempt to push society towards that direction I'm not a big fan of that.
I didn't advocate "leaving it up to a country." It should be left to individuals and families. But right now way too many elders don't have directives in place ***, and (too) many families avoid the decision and choose continuing care beyond when it arguably makes sense even for the patient - facilitated in part by a system where costs are largely unknown. At some point, we may have to confront the issue of end of life care costs instead of avoiding the issue(s).

Quote:
Over 2/3 of the adult population have no Living Will or other advance directive.
*** If true, it's inexcusable IMO.
http://www.americanbar.org/content/d...thcheckdam.pdf
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Old 09-30-2014, 10:48 AM   #55
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I want to be able to celebrate 75 with a triple axel.
Beats the hell out of a triple bypass!
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Old 09-30-2014, 11:21 AM   #56
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To refuse a flu shot at any age is nuts because someone with the flu is a vector of a contagious disease.. flu shots provide 'herd immunity' for those who are susceptible. As pneumonia isn't generally contagious passing on that one at the end of life is appropriate.
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Old 09-30-2014, 03:35 PM   #57
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I want to make 100 years. If I do, I will still be around when Mr Emanuel dies. Good luck Zeke.

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Old 09-30-2014, 08:32 PM   #58
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I know quite a few people who agree with this sentiment, that they value quality of life and do not want to extend their own life to great old age if it involves debilitating or painful conditions. Power to them and everyone should be entitled to their own opinions and even some measure of control over their own destiny. For myself, I am of as opposite opinion as possible. Not that I seek out a debilitating or painful future for myself, but if that does happen in my future, I want as much of that future as possible and I will find a way to make the most of it that I can.
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Old 10-01-2014, 02:15 AM   #59
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Beyond quality of life, it's interesting those who advocate for as long a life as possible don't even casually address who pays for all that very costly end of life care. The patient rarely if ever pays it all, the majority of those costs are passed on to others in premiums and taxes. How much should others pay to artificially extend the life of another for days/weeks/months?
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Old 10-01-2014, 02:28 AM   #60
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Every life is a Tragedy because in the end the main character dies.
I've always felt that mine was quite ribald!


I have been fortunate so far, so my current stance is that I want to live and will fight tooth and nail for it.
I do however realize that my view may change quite sharply if I was in a situation where my quality of life was very very bad, although sometimes when that occurs you are not in the position to do anything about it right?
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