ICU stay before death common in the U.S.

Although you shouldn't decide just based on age, we should be looking at the total person and situation when admitting to ICU for what seems like end-of-life care.
We really need to encourage our family members to "Just say NO" to futile measures. If we start with 'us' maybe we can get it to spread.

As for those who want it all, tell them you will consider their wishes when the time comes. If it's not in writing, and you are the responsible party, then you can 'consider' their wishes and make the appropriate decisions.

And don't let others bully you. I fear for my mom - her partner may want to prolong her life when she is past viable, and may not care what we all discussed years ago. As long as I am next of kin, then what I have to say will prevail. I hope that doesn't sound too harsh. BTW, mom is 82, and still dresses sharp, puts on a full face everyday, and wears 5 lbs of Bling!!!

It might help to frame the question of ICU admission similarly to how we sometimes decide what monitoring is appropriate for an ER patient. If you monitor X ... what are you going to do with the result? If the answer is "nothing" ... because to treat result X is too invasive, painful, unlikely to change an outcome, what have you ... then what is gained by monitoring X?

Families can be educated on what an ICU admission entails, including the purpose which is high tech, invasive, and yes, expensive care in the hopes of significantly altering the course of a serious illness.

Just because the talented docs/staff "can save everyone" doesn't necessarily mean they should, especially when the prognosis and quality of life is poor.

When one of my brothers mentioned to my parents "we (him& wife) believe in life saving measures, no matter what the outcome", my mother immediately appointed the family nurse (me) to make medical decisions for her and my father. They know I seen the reality of life saving measures taken too far.

And as soon as the healthcare professionals start to educate the public, our voices get drowned out by the fanatics shouting about "death panels! death panels!"
Ugh!

emphasis added by tewdles

That healthcare professionals consider death, dying, and end of life care a difficult and uncomfortable topic of discussion and patient education is, unfortunately, a large part of the problem in the USA. It is clear that physicians often have a difficult time speaking with their long term, chronically ill patients about the next step...how they desire to live out their remaining days or weeks or months. In the absence of those honest discussions medical interventions escalate as the health of the individual declines. The patient and family is often only doing what they believe their physician thinks is best for them...they have that level of trust for their doctor. When you read the multitude of posts on this site alone about DNR discussions it becomes clear that nurses feel completely un-empowered to have these discussions with patients and families without the implicit direction of the physician or the management of the hospital. The result is more or less an entire society of people who are essentially uprepared for the inevitable...death and dying. We see the aftermath of this avoidance behavior in the hospital and in the ICUs on daily basis.

It saddens me when I have a conversation, as a hospice nurse, with a patient who has terminal ______, you fill in the blank, and the family tells me that I am the first person who has spoken with them about death or dying. I wonder how someone can have a terminal illness, especially one which is chronic in nature...say COPD, and no MD, no nurse, no health professional has ever talked with them about dying. I am not advocating stealing peoples hope, I am advocating for being honest with people so that they can make informed and honest decisions. We can do better and I for one am confident that we will.

Us health care for ya...can't accept death, desperate and hedonistic to the end like we can hollywood them back.

I've flogged many an innocent person in the ICU (not sure why)

There is a difference between prolonging a death and saving a life.

Maria Shriver/Arnold Schwarzenegger's mother, at age 88, spent several days in ICU before she died. Was this the best use of healthcare dollars? The end result was the same-she died. Why did they not transfer her to Hospice?

I HAVE!!!! And Mom still won't discuss it.

I have the POA/Healthcare surrogacy - and she told me to just "handle it".

Like that's not pressure.

(the woman has listened to me on almost a weekly basis of the horrors of endstage care on the terminally ill...but by the same token, I am the one the has to make decisions on getting reroofed, contractors to use, which air conditioner to buy.....so I suppose that I should not expect anything different.

Perhaps a requirement for NS should be to get your own wishes down on paper and appoint a POA.

I had my million dollar stint in ICU in my mid 30s. It never occurred to me I would need such a document -- but you can bet I have it all on paper now (with copies to my siblings, doctor and parents).

It would be nice if people just let their elderly family members die with dignity, not in the ICU with tubes coming out of every orifice. I've seen this all to often. 89yo who is going to die regardless of what we do but family insists and has unrealistic expectations. My personal favorite was a woman with a 95yo father who was trached, with a peg tube, on a vent. She would say "Five more years dad"....To me living on a vent with a trach and a feeding tube being unable to enjoy the things you once enjoyed doing is NOT living. Sorry if this offends some people but its just how I feel. If I had to live like that, I would want to die.

Am I the only one who also thinks tattooing "DNR" on the chest is not a bad idea?