The prestigious New England Journal of Medicine just reported (September 29, 2011) that 20% of all nursing home patients with Alzheimer’s and other advanced dementia are sent to hospitals for questionable reasons in their final months. Once hospitalized, patients end up with tube feedings, IV’s, and intensive care that prolongs their lives, and at a cost of $4 billion per year.
Why are these people referred? Because Medicare pays three times as much to nursing homes that take these people back after a brief hospitalization. The fault does not lie with the nursing homes; lots of them operate on narrow margins so there is a tremendous incentive to hospitalize dying people. We share responsibility, because as a culture and as families we say life at any cost is worth it.
Advanced dementia is a terminal illness. If you love someone with this disease do not hospitalize him or her at the end. The hospital is the worst place to put dying people. These patients are unable to recognize relatives, confined to bed, and can’t swallow. In the hospital tubes and machines may keep them alive for weeks or months. Is this the care and dignity you want to give to your loved one?
Get together as families; make an advance directive before the nursing home makes the decision, and be sure it’s clearly charted Do Not Hospitalize.
Let your loved ones die where they are surrounded by the familiar; let them go in loving peace, rather than sustain them in mechanical life.
I say this for all my Relations, Mi Takuye Oyacin
If you’re in the Phoenix area this weekend come to see me at a premiere benefit performance of The Healing Doc Meets The Mask Maker. Check it out on my website.