The Last Resolutions – Avoiding Dying Badly


image courtesy of Trey Ratcliff –

My husband’s aunt recently passed away, and a dear friend’s father is in a medically induced coma and may be nearing the end of his life.

I mention these things, because end of life and all of its ramifications is quickly becoming a huge feature in the lives of my friends and family. It has always been a huge emotional event, but in today’s medical arena, something else has become equally devastating. The cost of end of life care is now eating families and their assets up in large, expensive bites.

CBS News said in 2009 that Medicare spent 50 BILLION dollars on the last two months of people’s lives.  Approximately 18% of Americans spent their last days in an ICU which runs around $10,000.00 per day.  75% of us were dying in hospitals, where a large percentage of us will experience what they call “dying badly.” Dying badly is described as “Dying suffering…dying hooked up and surrounded by machines.”

See LINK for the full article.

My friend, whose father is in an ICU right now is faced with a horrible decision. His family is uninsured, and it is costing his mother $6,000.00 per day to keep his father there. They are looking for a less expensive option, but the area does not offer hospice care and at some point the money will simply run out, leaving his mother which much less to support her in her remaining years.

So, you ask, what do I do? No one wants to be the one who tells the doctors to stop, do they? And yet, that is what we must do, individually and as a family. The Mayo Clinic weighs in with this informative piece.

Our attorney had a personal perspective on the whole end of life issue after going through a horrendous ordeal with her own mother. In response to this experience, she recommended something new to all of her clients when they drew up their wills (if you haven’t done this…do it!). In addition to the normal “Directive to Physicians,” “Advance Directives,” etc., she adds a Supplemental Directive which lays out four typical end of life scenarios along with the doctor’s estimate of survival or condition. For each of the four scenarios, it asks you to check of what, if anything you would want done. Ease of pain? Additional testing? Extreme measures, such as a ventilator or dialysis? It was very detailed and really made us think about how we would choose to spend our end of life days.

I will not pretend that it was easy. The tough, but necessary stuff never is.

When we got right down to it, both my husband and I wanted our children to feel as comfortable as it is possible to feel when letting us go. You can only do that if you tell them specifically and in writing what you want. Our wishes boiled down to being allowed to pass without pain and without chewing up our resources or our children’s in those last days.

We talked with them about it, and took them through the supplemental form so they understood our reasoning and I suspect they will want the same for themselves when they draw up their own wills. This is a different phase of parenting which you may not have even thought about.

This is not fun to discuss, but if you do it now, you will never regret it and both you and your families can rest in peace.

Update: January, 2013. 

For great insights on how some Doctors feel about end of life care, check out How Doctors Die.

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