Sunday, July 1, 2012

Health Care My Mother

 I warned my mother not to go into the "old folks home" and argued with my siblings and took what actions I could to forbid it, but ultimately it was her choice. After she went in, my efforts switched to making it as comfortable as possible for her.  She was in probably the best "retirement home" in Seattle, but it does not matter.  You cannot make a fundamentally flawed idea good.

The first couple of years were as advertised, but lonely for my mom inasmuch as once esconsced, the most vociferous of her children urging her commitment to the home began to find less opportunity to visit.  Further, all old folks all the time can be pretty dreadful, even if you are one yourself.

What few sociology courses I took for my masters degree detailed how intergenerational interaction is crucial to raising the well-rounded person, and elders live longer and better if they are in inter-generational settings. We deny our young the opportunity to be all they can be if we ship our elders off to concentration centers, and we deny our elders the best situation at the same time.  We may have the power to violate these human standards, but not the right.

The facilities were superb and the staff the best in the business.  I am not being coy when I say the orderlies who actually do the heavy lifting etc are interesting people from far off lands. What I liked is they seemed genuinely to respect and care for my mother, something I doubt would be much present among my countrymen doing the work.

After a couple of years her health deteriorated and I came back from a trip to find she had been committed to the hospital part of the home, which is often a one way trip.  I was astonished at how far she had declined in what was less than a week.  She was in and out of consciousness and the first thing she said when she did recognize me was "thirsty..."  My mom was fading fast. Much worse off than when she was brought in.  She had no appetite, extensive bruising, and of course thirsty.

I spent a lot of time the next few days finding out what happened, but the problem is what with the state rules on medical records, one cannot know what is going on with mom. Now let me pause and note, that even in the very best of facilities, there is only so many people to deal with so much need.  If no one cares about the old folk, then neither can the staff, much.  Once I had showed up, and begin making firm inquiries and attending to my mother myself (she was always thirsty) the staff responded with far more attention.  I and a brother formed a sort of tag team.

My mom began to rally, and I took a few moments when she was clear and rational to make an end run around the system and have my mom get her medical records in front of her for me to read.  There was terror in the management's eyes, but resolve in mine.  They had to give in (although I was reported to my siblings.)

I can see why it is in the state's best interest to keep anyone from seeing your medical records.  It has nothing to do with privacy and everything to do with complacency and complicity.  My mother was being loaded up with Aricept, a taxpayer-funded anti-alzheimers drug.

Now this was curious.  My mother worked in the medical labs at the University of Washington for years, doing science.  So in the mid-1970s a call for volunteers for a cohort study of alzheimers was made, my mom signed up.  Twice a year she would meet the doctors who put her and her cohort through tests to look for alzheimers symptoms.  To the day she died, never a symptom.

So I inquired as to how come she was being given Aricept when she did not have Alzheimers.  "O, we do not know if anyone has alzheimers truly until after they are dead and we can autopsy the brain to find the disease."  Very good.  But if she had no symptoms of Alzheimers, why was she being given a drug to treat the symptoms of Alzheimers? "O, alzheimers shows a collection of symptoms that can be different from person to person, so we never really know."  OK, but if for forty years she has been examined by the leading alzheimers doctors in the world and never showed any symptoms of alzheimers, why was this being prescribed?  This was a trickier question for them.  The Aricept dosing stopped immediately.  My mother recovered her appetite quickly.  She was strong enough to get her own water.  The bruises went away.  The side effects of Aricept are lack of appetite and widespread bruising. If you do not eat and are denied water, you slip into a painful unconsciousness.

The thirsty part is just from lack of giving water.  Withholding water is specifically called for in the legally approved "care"protocols.  I fast and know that after day three hunger goes away so to die of hunger is not really painful, but it can take a month.  But to die of thirst is quite horrible and only takes a few days.  Withholding water is a critical part of euthanasia, and in practice it takes about a day and a half to finish off someone who is very ill.  In the UK it kills about 130.000 people a year.

You do realize that if I had not asked that 2nd and 3rd question, the Aricept would have continued.   And no doubt it does, all over the country, right now, for people who have no Alzheimers.

And of course, while all this is going on, we taxpayers pay for state workers who show up and "inspect" the records and patients to assure nothing untoward is going on.  Inspectors inspect what the state calls "health care" and finds nothing amiss in that regard.

For the years afterwards, my mother and I would have long conversation on many topics, she filling me in on strategies for dealing with and economic crisis and depression, meaning of life and suffering, and tales of long ago. I found her counsel terribly useful.  She also developed some insights that were astonishingly clever. My mother changed more in those last few years than in her previous entire lifetime.  It was fascinating to watch.  I won't criticize my mom, but I'll just share a quick clip from a man whose work she previously found delightful.


When she was on the receiving end, she had reason to rethink some of her tastes. Her generation loved the plays that supported this man's views.

If anyone is going into such care, and again no one has the right to require or volunteer for such "care," just make sure lots of family is around with lots of attention to signal this parent is not here to be killed.

No doubt plenty of people will find this offensive.  But I find euthanasia offensive, and the truth ought never be offensive and euthanasia ought always be.  To say there are some circumstances when it is necessary to place a person in such intensive care is a false dilemma.  First hard cases make bad law. Second, there is nothing wrong with an elder, or anyone, dying at home, as part of life.

But there is a business opportunity, the point of this blog, coming up.  But first, let's note we are all (except me, because I am exempt) now in the system for which my mom volunteered. The republicans will never repeal this law, any more than Obama would ever end the wars. Let's look at the first line in the Obamacare act, which the Bishops generally support. The first sentence is a lie.


This Act puts individuals, families and small business owners in control of their health care.

You have no control when anything is mandated. We are born with control over our health care, which is diet and exercise.  But the act is using health care to mean medicine, and on two levels this is a lie:  one is you cannot pick what medicine you want from whom you want, nor have USA citizens been able to do so for about a century, since the state has taken over the definition of medicine.  Second, what the state now calls medicine is no such thing. Aricept is good medicine to the state.  The state gradually eroded peoples control over healthcare, and the act ended it.  I find the farther from state control, the better the medicine, and happily I can still go overseas if I want good medicine.

So what is the business business opportunity?  Most wealth in the United States is concentrated in the hands of women, because they outlive their husbands.  As women age, and they live in larger houses, someone should set up a website to match elderly women with young families.  The young families move into the home of the elderly women, and for free rent integrate the elderly women into the family life.  Mom lives better longer, the kids get intergenerational benefits, and the young family is motivated to keep mom as hale as long as possible to keep the benefit of the arrangement in place.  It is also a sort of benign redistribution of wealth as the equity in mom's house is in effect to some degree transferred to the young couple who is saving money while living free with mom.

The Catholic bishops are worried about their "rights" and missing the point that what they support is not medicine.  But as the Vatican keeps telling US Catholics, "You are on your own."  And helpfully they list small business on par with hospitals and schools in doing good in society.  So solve this crisis with a small business matching mom and young families.

I was the last person to talk to my mom, and the last person to see her alive.  She was scheduled to be moved the next day to the brand new retirement home highrise with a view of the bay, something she was promised when she signed up, a fabulous state of the art facility.  I was flying to Hawaii the next day.  We chatted about her big move and how in the morning we'd both be in paradise.

When I landed at Kona I got a call from my sister mom had died.  Funny, that last conversation.

Feel free to forward this by email to three of your friends.


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