Jump to content

Accepting aging and disability

Posted

Specializes in Family Nurse Practitioner.

Another thread mentioning that the boomers aren't interested in going to nursing homes got me thinking. I'm finding that there are older people I have encountered say in their 70s and 80s who don't appear to have done much along the lines of accepting and planning for their inevitable decline. After a long blessed life of good health they seem shocked that things are now going down hill and resistant to accept they might have to leave their home. Maybe its me but I'm doubtful that many people just die naturally in their sleep at their own home.

dream'n, BSN, RN

Specializes in UR/PA, Hematology/Oncology, Med Surg, Psych. Has 27 years experience.

I live in an area where we have a warm climate in the winter and that has a large influx of the elderly during those months. I have seen very sad stories of couples that can't care for themselves, living together in their winter home without any family/friends around. When one goes down hill the other spouse has no close-by support. Although, occasionally both of the spouses are pretty demented and you wonder how in the world they live on their own. Seen some heartbreaking stories of spouses alone in this area after the other spouse has a severe CVA and will forever more be unable to return to their longstanding Northern community; mostly where their children/grandchildren/life-long friends are.

classicdame, MSN, EdD

Specializes in Hospital Education Coordinator.

I suppose no one likes to think they will never be independent. And the baby boomers (me too!) are all about personal freedom. But it seems to me that once you accept the challenge of being dependent you accept that you are in the dying process. No wonder people put it off.

Jules A, MSN

Specializes in Family Nurse Practitioner.

How sad and bound to get worse as our population continues to love longer. :(

How sad and bound to get worse as our population continues to love longer. :(

I was thinking we might not be living longer. Not with the incidence of type 2 and now heart disease in kids. Someone posted about their LTC patient caseload, out of all of the patients he/she was responsible for, 22 needed finger sticks. That had to be at least half, right?

As one of those thus unprepared (and married to another), I can tell you that it's not for lack of knowledge, forethought, or caring. Since what was laughingly known as my retirement account dropped 60% in the late unpleasantness and the home equity is almost maxed out, we have decided that even with the LTC insurance (which costs me a fortune), the best thing is to avoid any treatment for anything that might possibly kill us.

Jules A, MSN

Specializes in Family Nurse Practitioner.

As one of those thus unprepared (and married to another), I can tell you that it's not for lack of knowledge, forethought, or caring. Since what was laughingly known as my retirement account dropped 60% in the late unpleasantness and the home equity is almost maxed out, we have decided that even with the LTC insurance (which costs me a fortune), the best thing is to avoid any treatment for anything that might possibly kill us.

But without solid documentation refusing treatment unfortunately you are likely to end up getting it.

Fortunately, we know this better than most. Documentation is cheap, and in our house, abundant.

During our admission process we always ask if the patient has an advance directive and it's very surprising to me that 99% of the older population doesn't even know what that is. I feel like we're in an era that pushes people to be prepared for worse case scenarios. I know my parents have a living will, advance directives, a planned POA if the time comes when they need one, etc., etc. I guess I'm misinformed in that area or the baby boomers just were never pushed to be as prepared for life threatening situations as today's generations are.

As for financials, I can understand why one would not be as prepared in this category, especially in this economy. Plus I can't think of anyone that wants to get older and end up in a nursing home. If and when older adults get to that stage of their life it takes time to adjust to the idea of moving into one and often times it's too late by that point. Not enough money, insurance won't cover it, they're too sick, they're not sick enough... It's a crazy crazy business-run world we live in.

OCNRN63, RN

Specializes in Oncology; medical specialty website.

As one of those thus unprepared (and married to another), I can tell you that it's not for lack of knowledge, forethought, or caring. Since what was laughingly known as my retirement account dropped 60% in the late unpleasantness and the home equity is almost maxed out, we have decided that even with the LTC insurance (which costs me a fortune), the best thing is to avoid any treatment for anything that might possibly kill us.

It's funny you said that, because I was just thinking, I will let my cancer kill me before I go into a nursing home. I can't think of a more horrid existence than being stuck in a home.

OCNRN63, RN

Specializes in Oncology; medical specialty website.

But without solid documentation refusing treatment unfortunately you are likely to end up getting it.

I have everything documented down to the Nth degree, and I keep a copy of that documentation in my purse, just for good measure. My parents have it, my doctor has it, my lawyer has it.

Esme12, ASN, BSN, RN

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma. Has 40 years experience.

As one of those thus unprepared (and married to another), I can tell you that it's not for lack of knowledge, forethought, or caring. Since what was laughingly known as my retirement account dropped 60% in the late unpleasantness and the home equity is almost maxed out, we have decided that even with the LTC insurance (which costs me a fortune), the best thing is to avoid any treatment for anything that might possibly kill us.
I am in the same spot as GrnTea....like many my age.....the latest debacle in 2008 essentially wiped us out. We have equity in our house but I would rather be 6 feet under ground then in a LTC. I have explicit terms all legally taken care of and my daughter has promised me that she would move with me to Oregon if I ever had to make that decision. End of story.

It's funny you said that, because I was just thinking, I will let my cancer kill me before I go into a nursing home. I can't think of a more horrid existence than being stuck in a home.

My goal was to say it so often that my kids rolllllll their eyes and recite it along with me, so I know they've got it and there will be no fighting over it:

"At some point some smartass case manager is going to tell you I'm not safe to go home. At that point, you sign me out AMA and spend what's needed for home care. I would rather trip over a cat on my own stairs and fall down and break my neck and die in my own front hall than spend three days, three weeks, or three years in a SNF."

They've got it.

Jules A, MSN

Specializes in Family Nurse Practitioner.

I suppose no one likes to think they will never be independent. And the baby boomers (me too!) are all about personal freedom. But it seems to me that once you accept the challenge of being dependent you accept that you are in the dying process. No wonder people put it off.

I agree that no one wants to think they won't be independent but the dying process is part of the living process so planning as best you can is crucial, imo.

OCNRN63, RN

Specializes in Oncology; medical specialty website.

My goal was to say it so often that my kids rolllllll their eyes and recite it along with me, so I know they've got it and there will be no fighting over it:

"At some point some smartass case manager is going to tell you I'm not safe to go home. At that point, you sign me out AMA and spend what's needed for home care. I would rather trip over a cat on my own stairs and fall down and break my neck and die in my own front hall than spend three days, three weeks, or three years in a SNF."

They've got it.

Make that three seconds in a nursing home for me.

When I had my knee replaced a few years ago, the wretched case manager at the hospital told me two days after surgery that I wasn't recovering fast enough and that they would be sending me to a SNF. I called my parents, hysterical. Bless their hearts, they went to check out the home I was going to be sent to; I still remember them trying to convince me that it wasn't "awful." Their eyes said something different.

Fortunately, I turned a corner the next day, and I was "allowed" to stay an extra day in the hospital. That was almost two years ago, and I still remember the panic I felt over just a temporary stay in a nursing home.

Ruby Vee, BSN

Specializes in CCU, SICU, CVSICU, Precepting & Teaching. Has 40 years experience.

I remember thinking that I'd rather just die of my cancer or whatever else -- pneumonia, UTI or drowning -- than live in a nursing home with dementia for years and years like either my mother or my mother in law. I have LTC insurance, and DH and I have actually talked about "what ifs". But our documentation, sadly, is lacking.

Another thread mentioning that the boomers aren't interested in going to nursing homes got me thinking. I'm finding that there are older people I have encountered say in their 70s and 80s who don't appear to have done much along the lines of accepting and planning for their inevitable decline. After a long blessed life of good health they seem shocked that things are now going down hill and resistant to accept they might have to leave their home. Maybe its me but I'm doubtful that many people just die naturally in their sleep at their own home.

You would be correct.

No Stars In My Eyes

Specializes in Med nurse in med-surg., float, HH, and PDN. Has 43 years experience.

So, yes to the documentation, but my plan is to do the eskimo death, essentially. Take some hoarded pills around midnight on the coldest night of the winter, put on a thin, wet nightgown, and when sufficiently drowsey, go outdoors and ....that's all she wrote!

A better choice than a nursing home.

Don't tell me 'what if it's summer?' or 'what if you can' do it that way because of a stroke,' or whatever else could occur. The above scenario is fiction, (so far).

Edited by No Stars In My Eyes