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128 points mykowebhn | 1 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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agent531c ◴[] No.44726098[source]
I read a comment on here a while back that highlighted EoL care as the main way The Machine has to sap resources between generations, and it makes a lot more sense when looked at through that lens. I don't see it going away any time soon since its a guaranteed process for every person that moves wealth away from the lower/middle classes into the industry at a grand scale.
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pavel_lishin ◴[] No.44726129[source]
How much of that is The Machine, and how much of that is kids & grandkids not wanting grandma to pass away?

For what it's worth, when my grandma was in the hospital with congestive heart failure, the surgeon was very clear with her and with us that "do nothing, and die" was very much an option, and a choice that she and she alone could make.

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nradov ◴[] No.44727747[source]
Often the family dynamic is that the next-of-kin who have the power to make end-of-life decisions hesitate to cut off care even when they know it is pointless or cruel because they're afraid of being criticized by other family members later. Sometimes this extends to vicious backbiting and cutting off contact. I've seen these issues break extended families apart. It takes a strong and confident person to take responsibility in this situation, and then accept the consequences.
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1. pavel_lishin ◴[] No.44728119[source]
That's true. Grandma initially wanted to get no treatment, and boy did we hear about it - the rest of her family convinced her to go ahead and undergo treatment.

I think this was the correct choice, but I have no idea.

On the one hand, she's feeling much better now, and I'm glad she's around, because I like spending time with her.

On the other hand, the recovery was pretty rough, though thankfully she doesn't really remember the truly bad parts. And she's 90 years old, and has repeatedly stated that she doesn't particularly want to go on living.

On the gripping hand, the doctor's description of letting yourself die of congestive heart failure sounded rather unpleasant, and hopefully instead of undergoing that, she'll pass away in her sleep.

On the hands that I'm running out of, maybe an even worse fate awaits.

Can't see the future. :/