To wonder who will look after us in old age?

[malificent7]

I am curently a care assitant temp until my permanent job in healthcare is sorted. It is very rewarding but hard, dirty work for little money.
They are understaffed and many are leaving due to bad pay. As we are an aging population aibu to think this is going to get worse? How can we get carers to stay,?

Disclaimer...there is no way i want dd to look after me...not fair on her...i'd rather go to a home.

@GETTINGLIKEMYMOTHER I agree about the not eating and drinking.

My 90 yr old GM has been in a care home with Parkinsons and associated (Lewy Body) dementia for 10y. She is now 5st and has to take Calpol 6+ for pain relief rather than adult paracetamol because she is so little. She barely eats and drinks, and the doctors have warned us all that this is the beginning of the end. Her body is (finally, horribly) getting to the point where it wants to give up and cannot function/process food and drink normally.

We accept that. We/they let her eat whenever and whatever she likes. Often that's just melty chocolate/crisps like skips or soft cake and sips of fruit juice or lemonade because that's all she can manage or wants.

We've been warned now that it is likely that she will have 'an event' (presumably a heart attack or stroke) that will end her life sooner rather than later. I just hope that it means she will finally go, peacefully in her sleep. She has a DNR, has for years but all I can hope for her now is that she doesn't have anything happen that means it's means it's drawn out or painful.

The difference is that when you are pregnant no one asks you if you want an abortion. No one asks you the question at each ante natal treatment I’d you have considered abortion. After all, caring for a child can be tricky right?*

If there are issues in your pregnancy you are reminded, gently, that you have all option open to you. So your analogy doesn’t work.

But all the ones that are more ‘tricky’, people might be reminded it’s an option.

With death, all dying people will die so they will all be in that position of reviewing what’s available to them. It’s not as if they are dying but most of them will somehow manage to nit die anymore so you don’t need to talk about it…

@MamsellMarie

I'm with those saying they'd get straight to dignitas the moment they needed care. What would decide you needed care. The day you ask DGSon to put the bin out for you? The day you can't find the purse you put down a moment ago. The second time you have a fall despite driving, shopping, mnetting daily.

If this question is to me then as far as I'm concerned I want to be able to make that decision for myself. If I think my life isn't worth living because I can't do it without someone else helping with every basic task and I'm not enjoying life then off I pop. My DHs grandmother who died a few years ago now was calling family members 8,9 times a day and night to fetch this and that whilst they were working ft, bringing up small dc. She was wealthy but would not pay for support. I wouldn't do this to family.

I don’t know who said about abortion, but an awful analogy. If the child to be born was expected to suffer horribly and then die of course a termination would be offered.

I do hope it won’t be too long, @TheDuchessOfDork.

It was at least partly indicative of the excellent care she received in her care home (by no means the most expensive either) that my DM was there for very nearly 8 years, until she did at 97. She had appeared extremely frail for several years, but she went on and on - including recovering from things that often finished others off, e.g. chest infections, a broken hip) - because her general physical health was so robust.

During her time there, I saw so many others arrive, decline, and quietly disappear.

I’m sure even the staff had begun to think she’d go on for ever - I’d certainly started to think she’d see me out!

In the end, she went suddenly downhill and died, all within 36 hours (one of us was with her the whole time) and thank goodness there was never any question of ‘striving’.

It’s always sad to lose a parent but our overwhelming sense - mine and siblings’ - was of relief that it was finally over, for someone who hadn’t even known any of us for some years and whose quality of life was zero.

@Plipityplopity

I don’t know who said about abortion, but an awful analogy. If the child to be born was expected to suffer horribly and then die of course a termination would be offered.

@Plipityplopity

I drew the comparison with abortion, as the legislation allows termination only in very limited circumstances, whereas in practice, it is now allowed for a variety of reasons

My point is that if AD is introduced, it may start off only happening in very limited circumstances, but will almost certainly end up happening in far more cases. And I'm not sure people realise that

@Plipityplopity

And I agree it would be appropriate for termination to be offered if a baby would suffer horribly then die. The legislation covers that

But in practice, pregnancies are terminated in circumstances which were never envisaged in the legislation

I think everyone should be allowed to decide when to end there lives and ideally be able to make legal written plans for events such as having dementia.

If I got to the stage I didn’t know what day it was and someone had to clean me up from soiling myself regularly I’d rather someone gave me what I needed to go to eternal sleep.

A trip to Dignitas for me too. I don't have children and no one in my family is around my age at all so there won't be blood relatives left by that point.

I have no desire to prolong my life if I'm no longer able to enjoy the things that give life purpose and meaning now. In particular any mental decline and dementia is something I don't want to live with. Cooking and cleaning are easy to sort with a paid cleaner and ready meals but personal care is different.

But in practice, pregnancies are terminated in circumstances which were never envisaged in the legislation

Well, yes, they are terminated in circumstances where the pregnant woman envisages acceptable.

As should an end of life decision be, according to the circumstances of the person taking the decision.

In the end, she went suddenly downhill and died, all within 36 hours (one of us was with her the whole time) and thank goodness there was never any question of ‘striving

This was the case with my 93 year old demented mum too. She was found unresponsive one morning, diagnosed with pneumonia and died early that afternoon. We were offered the choice of taking her to hospital for treatment but declined.

When someone has dementia and is doubly incontinent, the mere idea of ‘dignity’ is a sick joke
@GETTINGLIKEMYMOTHER I agree but people with advanced dementia are very very unlikely to meet the criteria for assisted dying. One of the biggest problems with all assisted dying/euthanasia type decisions is that they are supposed to be taken by people in sound mind, who want to die at that particular mind. Advanced dementia usually means not a sound mind, and people may not have insight into wanting to die either- there was a case recently in the Netherlands in which a dementa patient with an advanced directive decided she didn't want to die and had to be restrained/forcibly put to sleep.

I am not going to explain to you how I know what it's like to nurse a severely demented person who is incontinent to their death because I don't feel like sharing that, but all I would say is, these people will not just be able to be popped off through assisted dying, they are not the 'candidates' in mind in current legislation, and however shitty and awful and terrible it is to witness someone's decline, they still need to be given what dignity and kindness can be mustered by their carers.

'who want to die at that particular moment'. It's unlikely we would hold people to something they signed 20 years earlier, for example, if they said they didn't want to die now.

I see your point -omg abortion and assisted suicide and whether to care for parents or put in a home - too much for me to think about on a Saturday mor I got!

I think a lot of people change their view on what they would consider a life good enough.

Most people on this thread talk about it from a outsider POV. They have seen/supported people at the end of their life and thought ‘nope. Not good enough. I do not ever want to be in that position’. Which is fair enough.

What you don’t hear a lot if is from people who are actually dying saying that you would rather be dead is different than actually choosing to die/end living. Assuming you are competent enough to take the decision.

From the outside, any death is unbearable (apart from maybe the 98yo who dies peacefully at home). And I would gather that the POV of family or carers are very different from the one who is dying.

I have to say, my own experience with family member dying is that, first and foremost, I’d want much more money put into palliative care. And training hcp to talk about dying and living with a terminal illness. Discussions about what a living will is. Discussions about what makes a life good enough to live (knowing this will change a lot with time!).

@TravelLost I completely agree with you, high quality palliative care all the way. I agree with assisted dying as well, but given how many people either won't be eligible, or won't want to in actuality go down that road, then high quality, prompt, properly staffed responsive palliative and hospice care is absolutely fantastic in giving people a good death. That's what I want anyway when my time comes!

I'm trying to imagine what it would be like for a person with dementia, whose grasp on reality is already limited, to be "looked after" by a robot while sitting on a talking cushion!

Yep.

Just now I have a family member dying if cancer.
The issue isnt the care they are receiving. It’s the fact it’s totally disconnected from reality. They are still treating illness rather than support dying well.
They are keeping the relative in hospital when they should be at home.
They are refusing visits (covid donyouknow) at a time when that relative should have family and their life long partner around.

Now THAT is cruel. And unethical IMO but could’ve solved with better and more palliative care. Offering AD instead is avoiding the issue…, :(:(

@GETTINGLIKEMYMOTHER

Yes, *@User135644*, but there is at least the alternative of not ‘striving to keep alive’ very elderly people with a very poor quality of life.

The default, however, unless relatives voice their concerns (see my pp) seems to be that regardless of quality of life, people must invariably be kept alive as long as it’s at all possible to do so.

I think euthanasia is something to look at more for elderly people with severe cognitive decline/severe physical pain/disability. Especially as health care will only decline and Generation Rent won't be able to afford to look after their elderly relatives.

We complain about overpopulation and too many elderly people we can't afford to look after, yet we do all we can to keep these poor people alive well into their 90s who have severe cognitive decline and chronic pain. It's not always age specific either, plenty of people have a good quality of life and care well into their 90s, while for others it goes a lot younger.

Si well kill people that are too inconvenient .

Scary thought but maybe close to reality. Which is one of the issues with assisted suicide.

a short while before my Mother died, I refused to let the Drs do an investigatory operation to see if she had cancer of the liver. I said, "Are you mad"?
She had been handicapped since I was 20, & could barely walk without help. at the end she was paraplegic, spoon fed, with a permanent catheter (for years) 80% blind, deaf, & didn't know who we were....
She often asked to just "let her go"...
Shocked at the lack of empathy for her & her family

@OnwardsAndSideways1

When someone has dementia and is doubly incontinent, the mere idea of ‘dignity’ is a sick joke *@GETTINGLIKEMYMOTHER* I agree but people with advanced dementia are very very unlikely to meet the criteria for assisted dying. One of the biggest problems with all assisted dying/euthanasia type decisions is that they are supposed to be taken by people in sound mind, who want to die at that particular mind. Advanced dementia usually means not a sound mind, and people may not have insight into wanting to die either- there was a case recently in the Netherlands in which a dementa patient with an advanced directive decided she didn't want to die and had to be restrained/forcibly put to sleep.

I am not going to explain to you how I know what it's like to nurse a severely demented person who is incontinent to their death because I don't feel like sharing that, but all I would say is, these people will not just be able to be popped off through assisted dying, they are not the 'candidates' in mind in current legislation, and however shitty and awful and terrible it is to witness someone's decline, they still need to be given what dignity and kindness can be mustered by their carers.

Yes, but I was not advocating assisted dying for such people. What is needed IMO is a lot less ‘striving to keep alive’ , when allowing Nature to take its course, and give palliative care, would so often be kinder.

Another vote for assisted dying. IMHO it's inhumane that it's not an option for most people.

I could and would offer a home to a parent, or one of DH parents if they are alone and can no longer cope by themselves. We are fortunate to have space to do so if needed.

I would hope to have carers or district nurses making home visits for personal or nursing care, but that we might be able to avoid a care home (if that is what parent wishes, of course!)

I know sometimes it's impossible if their needs are too great, but I would want to consider them moving in with us first.

I don't like the idea of assisted dying being mainstream, but I think palliative care for comfort, rather than treatment to prolong life, should maybe be a more mainstream choice.