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balancing end of life care
Old 10-09-2007, 08:53 AM   #1
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balancing end of life care

short story long:

a good friend inherited his aunt with alzheimer's. when his mom died (just two months before mine) first thing i said to him: "the wrong one died." so now he is without his mom and he has moved her sister here (she is in about stage 5--maybe 5/6--of 7).

the aunt is down to her last $35k plus pension and social security. friend has been trying to keep her in a local, reasonably nice facility for as long as her money will last. he thought he'd have another few years but now there is a $10-12k bill in the wings.

aunt never tended well to dental hygiene and so now my friend is paying the price by having to make her decisions for her. dentist says aunt needs deep cleaning which he is doing today. also there are cavities which friend will have fixed but also there might be other periodontal issues and a whole bunch of caps which need to be replaced.

i suggested considering what does aunt require to remain as safe, healthy and as comfortable as possible under all these circumstances: should she run out of money too soon; what would cause less pain (& fright & confusion): periodontal work or new caps or just pulling teeth; for how long will aunt be able to chew solid food?

your considered thoughts and suggestions please.
"off with their heads"~~dr. joseph-ignace guillotin

"life should begin with age and its privileges and accumulations, and end with youth and its capacity to splendidly enjoy such advantages."~~mark twain - letter to edward kimmitt 1901
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Old 10-09-2007, 09:03 AM   #2
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Your friend might have a frank conversation with the dentist, explaining these concerns and asking what the dentist would do if this were his/her mom. ("OK, Doc. I understand and if my aunt were in her early 50s, I'd agree. But given her condition/age/financial situation/etc., I can't evaluate this subjectively. What would you do if your Mom were in this same situation?")

I use this tactic often when I'm dealing with medical professionals on behalf of my 88-year old dad and find it pretty effective.
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Old 10-09-2007, 10:31 AM   #3
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also consider a second opinion - maybe someone with expertise in working with this patient population. I would imagine that even getting this work done, at this stage of the disease, could be difficult, and as you seem to feel, may not all be necessary.
I would not have anyone adopt my mode of living...but I would have each one be very careful to find out and pursue his own way, and not his father's or his mother's or his neighbor's instead. Thoreau, Walden
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