Want to kill your mother? Here is how one New York HMO tried to do it with my friend’s mom. Names have been changed to protect their privacy. This is malevolence as art.
Clinical Background
Mike’s mom, Betty, is 90 years old. In the past seven years she has had cancer and triple by-pass surgery. The cancer is in remission. She has mild, early stage Alzheimer’s disease that is well managed with medicine. A few months ago, Betty took a tumble getting out of bed at home (Mike and his wife live with her). Betty, it should be noted, is one tough woman who will no doubt outlive me. She’s that type of gritty pioneer woman with a triumphant spirit. However, Betty needed some PT and Rehab that required two months in a nursing home.
Her leg is stiff and needs more strengthening, but that can be accomplished at home with outpatient therapy. The stay in the nursing home has slowed Betty down a bit, but she’s mobile, lucid, and ornery as ever. Glory Be. Otherwise, Betty is in great shape.
It should be noted that Betty is a retired NY City employee with a great pension and full medical benefits.
Mike is a great guy. Engineer, Warrant Officer in the US Army, Gulf War Vet, adjunct History professor, and all-around good egg. Medicine is not his area of strength, as engineering is Greek to me. History is a common passion and we have our weekend breakfast every weekend as we discuss teaching, military history, current events, family, etc.
The Lie
Last week Mike stated in passing that his mother’s physician suggested that she really needs full-time help during the day, and that such help can be arranged by signing her into hospice care.
I almost choked on my food as he said it.
I told Mike that if he did this, they wouldn’t treat Betty’s heart if a stent was needed, do surgery if she fell again, treat the cancer aggressively if it returns, etc. Hospice is about palliative care. They’re marking her for death through withholding of treatment. Hospice is about easing one into the ground. Regina and I were adamant that he call the HMO and grill them with very specific questions.
Mike called the HMO and grilled them. They agreed (reluctantly and after great ducking and weaving) that, yes, they would not stent, bypass, do bone surgery, etc, if Betty were a hospice patient. He also pried out of them that she wouldn’t even be sent for routine follow-up testing for the heart and the cancer. No mention of these consequences was made when the paper was put on the desk before Mike, and he’s grateful that he took some time to think, and that he made such a serendipitous passing comment over breakfast.
So that’s were we are now. Euthanasia being dressed up as long-term home healthcare as an affordable means of caring for mom, so as to avoid a nursing home, with absolutely NO mention of the ramifications.
This is evil, as dirty and dastardly as it gets. If we cannot trust our physicians to be truthful, to be our advocates, then we are in trouble. Big trouble.
The only thing more unthinkable than a world without Betty in it, is a world in which Betty was murdered through treachery, because some medical economist has determined that she is no longer worth the money spent to keep her alive. But New York made a deal with Betty. New York agreed that it would see to her financial and medical needs if she helped build our city through her life’s work.
Betty kept faith, and now societal forces are breaking faith with the Betty’s of our nation. That’s because those who held out the promise were honorable people who have been supplanted by my generation. The Greatest Generation spawned the Narcissistic Baby Boomers.
Betty will be fine. We’ll see to that. The Boomers, who begin retiring this year, are about to find out that they are too slow to outrun the scorched earth campaign they’ve waged for 45 years on the American landscape.
We will be the ones to catch the full fury of euthanasia.
The fire is gaining on us, and we have no one to blame but ourselves.
Coming Home 
I knew it, knew it, knew it. We will reap the whirlwind of the 60’s by becoming free to be dead at someone else whim. Free Love, my eye. It has it’s consequences, God just let this little drama we started play itself out. He did not have to do a thing, but stand back and watch.
He has been gracious enough to warn of our stupidity, my words not HIS.
If the people of this society will not respect the integrity of the human person, especially the very young and the very old, then this society will soon join the dust heap of the failed societies of the past. The proverbial slippery slope just got steeper.
Let’s all be on the same page about hospice care: people go into hospice, can have remission or otherwise get better, and get out of hospice. Just because someone goes into hospice doesn’t mean you are helping him or her into the ground or forcing a final “decision for death” on future medical care. Often the decision for hospice is made when the doctor can honestly say he or she would not be surprised if the person would pass away in the next 6 months or so, given their present condition. “Betty” has had many complications lately, and I wouldn’t be surprised if the doctor in this case suggested hospice because of her medical situation. Hospice care can provide wonderful services otherwise not available to someone coping with a serious or chronic illness at home who has a high likelihood of continuing or worsening complications.
Another side to hospice that not many people know is that the loved ones of a person in hospice still call the EMS in medical emergencies at home to get help, for instance, if the person has trouble breathing or becomes unresponsive. When the EMS arrive, the professionals do all they can to treat the person at that moment regardless if the person is “in hospice”. Many times a form on the refrigerator that states a person’s end-of-life medical care wishes is forgotten in the frantic moments of the call, and people who don’t want certain procedures are given them anyway.
We can not assume that a person suggesting hospice care or long-term home care is suggesting euthanasia, is a personification of evil, or is a dastardly, dirty doctor.
Kathy,
Betty’s cancer went into remission 5 years ago. She had heart surgery 4 years ago. She has nothing that makes her even close to being terminal. The only This particular HMO is known for their awful physicians.
It’s telling that they admitted that they would not pay for routine cardiology or oncology follow-up. That’s the dagger at the throat. The HMO also stated that it would be difficult to change Betty’s status if the family wished to pull her off of hospice. But I return to the cancellation of cardiological and oncological follow-up.
If enhanced care were the goal, then just provide it. But there is a trade-off in care on hospice that allows treatable conditions to go undetected until its too late. The only active medical issue apart from early Alzheimer’s is a bum leg, which is hardly cause for hospice status.
“The Boomers, who begin retiring this year, are about to find out that they are too slow to outrun the scorched earth campaign they’ve waged for 45 years on the American landscape.”
How come so much that is wrong with society is attributed to the Boomers? During the 60’s we were at best young adults in our early twenties. The real reins of power were held by the older folk who either passively stood aside for change or were actively complicit in all that has gone on.
Boomers didn’t begin to effectively take contol of society until they hit their late 30’s to early 40’s. So if theres a scorched earth campaign of 45 year duration it was begun by earlier generations.
Gerard,
This comes as no surprise and I anticipate getting worse. Thanks for bringing it to our attention.
Don
Four years ago when my then 90 year old mother went into the hospital with sever kidney and urinary tract infections and critical aortic stenosis one of the treating physicians was steering us to hospice. As it turns out this same physician was one of the directors of a local hospice, and that same hospice was one of those she recommended.
Thankfully one of my siblings was a nurse so she knew all of the procedures and “shop talk” and the real time meanings and implications of the various options being discussed.
Of course with Obamacare most, if not all of those decisions which are now controlled with a great deal of input from the family will become the property of mandates and guidelines handed down by Obamacare operatives.
Kathy, my understanding, and what I confirmed after looking up several definitions online, is that hospice is indeed end-of-life care with the focus of keeping the patient comfortable without actively seeking a cure.
Saying someone can go into remission from cancer while on hospice care is doublespeak. How would that remission occur without active treatment? Sure there are rare cases of spontaneous remission from all kinds of diseases, but they are just that: rare.
Chemo- or radiation-therapy would not be administered as part of hospice, as the whole definition of hospice revolves around palliative care. Palliative care focuses on reducing the severity of symptoms of a disease while not actually treating a disease.
So, sure someone “can” go into remission during hospice care, but it would be a fluke, and not the intended outcome, and that’s where the problem lies.
Hospice is a good thing. But like this case, it will get distorted and misused in order to save money and end “burdens”. Part of the problems is the artificial “criteria” that has become established, which is you need to have less than 6 months to live in order to get the medicare benefit (doesn’t sound like Betty, regardless). That’s what drives the mindset about refering to hospice, not necessesarily criteria or concern for the totality of the patient’s situation. And unlike what Kathy wrote, you do not go into hospice with intentions of getting out. The intentions is to be comfortable until you die.
I support euthanasia and assisted suicide — for myself, and for any others who want it, and I have a living will that lays everything out clearly for my family. (I know that because I am relatively young, doctors would make extraordinary efforts to save my life, so it’s important that they know I don’t want them to.)
But I know that very often, people don’t make such plans, and those responsible for their care take it day by day, step by step.
I have to say, if I were Mike, I would put Betty in hospice care — based on my own grandmother’s experience.
She had hospice workers visiting her for years, as her Alzheimers worsened. During this time, she left the house for doctor’s appointments, and received treatment for both her ongoing cornonary issues and bladder cancer.
Hospice care is exactly that — palliative care. It doesn’t mean other care is automatically withheld, although sometimes families do decide to to withhold it.
Why on God’s green earth the doctor would waste hospice resources and send Betty there is beyond me?
She needs a support worker who can come in bath her and see to her other needs. She also needs someone who will cook meals, take her out etc. It would be great if she were with another senior so that she has companionship.
The other option is a nursing home that has various options for living arrangements. For example, many nursing homes have apartment style suites for seniors and then as they require more care and develop mobility issues they are moved to the appropriate type of living arrangement.
My own father developed an autoimmune disease when he was 84. We took him to several different doctors as well as many nearby hospital emerg wards. He was written off because of his age. His disease spread rapidly and involved huge fluid filled blisters that bled and gradually encompassed his entire body except his face. We were told he would eventually be covered in this blisters which would then spread inside his body and kill him.
Finally we returned to a nearby hospital in desperation and the doctor on call happened to have a good friend who was a gerontologist. She was horrified that doctors refused to treat someone who was lucid and otherwise healthy simply becuase he was too old. The next day he saw the gerontologist who promptly put him on meds. Within 3 weeks his disease was well managed. He will be 91 on Jan 23!
The amazing thing is that his autoimmune disease is very common in seniors over 80 with the telltale reddish black spots on the skin.
An 84 year old man is a human being. He deserves to be cared for and treated.
Its terrifying that I will have to be so vigilant as my parents age. We truly cannot trust our own doctors anymore. The culture of death has contaminated everything. What scary times we live in.