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128 points mykowebhn | 3 comments | | HN request time: 0s | source
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asdfj999 ◴[] No.44725886[source]
If I could change one thing about healthcare, it would be how we handle end of life care. Sadly, hospitals are full of 80-90+ year old people who cannot walk or talk for years, advanced dementia plus many other serious comorbidities, with severe malnutrition and recurrent aspiration pneumonia, with large non-healing sacral ulcers, who shit and piss themselves, and the family continues to insist we "do everything" to help this person. It is by far the most demoralizing part of working in healthcare, in my opinion, and an astronomical amount of expenditure and effort goes into torturing these people - at the direct order of the family - only to prolong suffering a few more months.
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trhway ◴[] No.44726457[source]
>Sadly, hospitals are full of 80-90+ year old people who cannot ... and the family continues to insist we "do everything" to help this person.

so what? It is on their dime, not yours. If i'm a 90 years old and wanna drag my existence out it is my choice as long as i'm paying for it, directly or through insurance (and Medicare is an insurance too btw)

It is easy to suggest to terminate lives earlier when it isn't your life. History is full of such attempts.

One should be glad that such a large sector of economy - healthcare - has a great stable demand and a great labor market. Overwork - teach more nurses and doctors. The issue is completely self-inflicted as the labor supply is artificially constrained:

"In 2023, U.S. nursing schools turned away 65,766 qualified applicants from baccalaureate and graduate programs, according to the American Association of Colleges of Nursing (AACN)"

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n8henrie ◴[] No.44727123[source]
In my experience it is rarely the patient making this choice. Much more often the children, who are often making a big show of how much more they love mom or dad compared to the other sibs.
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1. trhway ◴[] No.44727217[source]
And the patient made that choice by establishing that family dynamics and by not having specific instructions even while seeing over decades the family dynamics they created themselves. I'd say that is an explicit clear choice. And anyway it isn't outsider's business to tell a family how to care for their own.
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2. nicoburns ◴[] No.44732991[source]
> And the patient made that choice by establishing that family dynamics and by not having specific instructions even while seeing over decades the family dynamics they created themselves.

Most people who are old today (or in the last few decades) probably wouldn't have thought about it because it wasn't something that affected their parents who likely didn't live that long in the first place.

3. n8henrie ◴[] No.44757300[source]
Very naive take.

Patients' children regularly override the patient's clearly expressed wishes once the patient no longer has decisional capacity.