Seniors For Living

Back in November, 60 Minutes tackled a controversial and timely topic: “The Cost of Dying,” and the topic has stuck with me. That’s because end-of-life issues are taking a more prominent place in discussions about health care.

As per the report, Medicare paid $50 billion for doctor and hospital bills during the last two months of patient’s lives – an amount that surpasses the budgets for the Department of Homeland Security and the Department of Education. About 20 to 30 percent of these expenses have no meaningful impact; most bills are paid by the federal government – no questions asked.

Few issues are as undeniably bipartisan as death/dying, yet the way we go about the process (i.e. hospice & palliative care, ventilators, feeding tubes, etc.) and paying for care at the end of life has become highly politicized. Everyone will ultimately face death, albeit in different ways and at different times. So how can the federal government rein in costs like the aforementioned $50 billion? Check out the article for deeper analysis of this thorny topic.

Dr. Ira Byock, who treats and counsels patients with advanced illnesses, puts it plainly in the 60 Minutes report:

“Families cannot imagine there could be anything worse than their loved one dying. But in fact, there are things worse. Most generally, it’s having someone you love die badly.”

Sort of changes your whole perspective on death/dying, doesn’t it?

Although it’s an uncomfortable subject, family members should definitely hash out these action plans, especially when they are gathered together, before they find themselves facing a tough situation. So when the Sunday dinner plates have been packed away, call the family members back to your home to talk about it. It may be difficult to get the dialogue rolling – who wants to break the ice on that subject? – but these conversations are absolutely crucial. If you ever find yourself pacing through the ER or the ICU while a loved one is in limbo, you won’t feel quite as helpless if you know your loved one’s wishes.

Ever heard of Five Wishes? Check out http://www.agingwithdignity.org/five-wishes.php for an excellent tool that makes discussing your wishes for the end-of-life much more palatable. Five Wishes lets your family and doctors know:

• Who you want to make health care decisions for you when you can’t make them.
• The kind of medical treatment you want or don’t want.
• How comfortable you want to be.
• How you want people to treat you.
• What you want your loved ones to know.

Also, revisit last year’s Seniors for Living post on “The D-Word: Discussing Death” for more ideas on starting this complicated yet critical conversation in your home.

-Michelle Seitzer