Are we wanting immortality?

[MsHeffaPiglet]

It's sad that people in care homes have died.

Does it matter whether they died because of cornavirus, rather than a general infection, from a fall, from a stroke or a heart attack or just old age?

If you are 80, 85, 90 or 95, isn't waking up each day a blessing. Does someone of that age expect or want to live forever?

I understand that you want to spend the last moments with loved ones and that is the cruellest thing with coronavirus and the need to isolate from everyone.

However, I just don't understand the shock, horror at the fact that elderly people in care homes have been affected so much. Is it so surprising?

Re DNRs - it's certainly appalling if a GP sent out letters saying anyone (let alone whole groups) should sign a DNR. One has to assume - if that's what happened - they badly miscommunicated something like 'everyone who has capacity should think about whether they wish to sign a DNR'.

It's bloody awful when someone hasn't done this and then goes downhill beyond having capacity and even if from previous conversations you're 90% sure of what they'd have wanted you aren't 100% sure.

I'm not shutting down the conversation or saying that talking about people suffering is inappropriate

I get where you're coming from and there will, of course, be ways things could have been worded better. But by saying things like "this is disturbing" you are inadvertently shutting down conversation because the reason people don't talk about this subject is precisely because they're so worried about saying the wrong thing. One poor choice of word and you can get accused of advocating for genocide or mass euthanasia as we've already seen on this thread. I may be wrong but I think it's fair that we give people the benefit of the doubt about what they're trying to say. It would take a real sociopath to think that old people should be forced to sign DNRs against their will or to think mass deaths in care homes is nothing to worry about.

Because my mum is in a care home and is 67! Yes she has ms but her mind is perfect!

From my point of view I am not talking about people in care homes with disabilities, or 70 year olds who have just had an accident or stroke they might well recover from. The emotive replies are a bit misleading as no-one has said that... 'anyone over 60 should die...' etc.

The people I, and many PPs are talking about, are the very elderly, very ill, unable to communicate, maybe deaf or blind, unable to move, enjoy, decide, swallow, or know if they are going to the toilet etc. Once people are at that stage it is a blessing to go.

My DM was still living at home but in her last few months my sibling insisted on many invasive procedures (to see if she could 'get better.'). She told us she hated going to hospital yet every week there she was again, camera in her bladder, scans including a CR scan, samples, x-rays, all sorts. She didn't understand it and didn't want it (she used to be a medical professional herself). In the end she stopped talking; maybe there was no point as her autonomy had been taken away from her at that point.
So I can imagine that if she was around Coronavirus, a DNR would have been preferable for her.

” by saying things like "this is disturbing" you are inadvertently shutting down conversation because the reason people don't talk about this subject is precisely because they're so worried about saying the wrong thing. One poor choice of word and you can get accused of advocating for genocide or mass euthanasia”

”I may be wrong but I think it's fair that we give people the benefit of the doubt about what they're trying to say.”

No, nobody’s shutting down the conversation because they disagree with you or because they object to views being expressed. This is an open forum. Questioning, criticism and disagreement are all valid responses to any subject that’s being discussed. Especially one as sensitive as this.

Where does this “benefit of the doubt” as regards saying the “wrong thing” about highly emotive subjects end though?

Nobody can read your (general ‘your’) mind and know exactly what you meant by the “poor choice of words”, if those words don’t truly represent your real views.

”It would take a real sociopath to think that old people should be forced to sign DNRs against their will or to think mass deaths in care homes is nothing to worry about.”

But those views have been expressed on this thread You’re (general ‘you’re’) entitled to say you’re not bothered about the mass deaths of elderly people and that living wills should be compulsory. You’re entitled to imply that cancer/heart disease treatment for people in their 70s is a bad idea because they’ll only end up getting dementia 10 years down the line anyway.

But other people are entitled to say they find these views disturbing.

This is disturbing. The whole care home situation is disturbing, moreso now with outbreaks of illness. Maybe discussions about end of life are something we don't like to have - a bit like not making wills because we don't want to think about who'd care for our children, or carrying organ donor cards. Sometimes we only face disturbing issues when they stare us in the face.

In this discussions it's also important to remember the difference between what the person wants and what the rest of the family want.

@Charley50 That's really sad that your sibling took away your DM's autonomy like that but unfortunately it is a common story. The old person has had enough and wants to 'turn their face to the wall' but the family insist on invasive, distressing, ineffective procedures.

I wouldn't like to see any form of euthanasia. I fear that families may put pressure on their relatives to protect their inheritance and not be a burden. It horrifies me how some families can be when there is cash involved
I just don't think we should be keeping people alive with a cocktail of drugs when they have no quality of life. People who I have worked with who are doubly incontinent, permanently in bed, no stimulation. It is heartbreaking to see them. Or end stage dementia. It can drag on and be a horrible death.
It's keeping people alive I object to. But if there is quality of life, however small that pleasure is, I'm all for supporting people

Returning to the posts about our ancestors being used to death:

Many of what we would consider minor diseases and injuries now would be fatal or disabling then
People would have 10 kids, in the hope that a few of them would survive

I'm glad we've moved on from those days of being used to death at an early age

• the past looks much better when you are not living in it.

Much like rhapsodising about the simple life in very poor developing countries

In the middle of a pandemic is definitely the worst time to start considering euthanasia

Too much stress
Too much pressure
Too little time to think calmly

There are very important ethical issues and safeguards that need to be discussed calmly,
when this emergency is fully over

Many people have been thinking about the issues calmly for years.

It's not the time for legislative change (unfortunately).

I think this particular issue, especially about our senior citizens or the elderly is very, very important. If anything is going to hurt the world, it’s a moral decay. And not taking the death of the elderly or the senior citizens as a serious issue is one of the moral decays. And Mike has said it. Any individual, whatever age, any human being, matters. And it pains us to see, actually, in some places, when they want to move into mitigation, because the virus kills seniors or older people only.

That’s dangerous. Whether it kills a young person or an old person or a senior citizen, any country has an obligation to save that person. So that’s why we’re saying no white flag. We don’t give up. We fight. To protect our children, to protect our senior citizens. At the end of the day, it’s a human life. We cannot, I have said this many times by the way, we cannot say we care about millions when we don’t care about an individual person who may be senior or junior. Who may be young or old.

So that’s what WHO is saying. And for all countries, a comprehensive approach, a blended approach, an approach that can help contain this outbreak, is very important, because the death rate from this outbreak is high. We shouldn’t categorise it by young or senior. Of course, to understand the epidemiology it’s fine to do that. But for action I think every life matters. Every individual life matters. If we don’t care about one individual, whether it’s old or young, then we’re not serious. And that’s why we’re saying this is a moral decay, if we try to categorise it that way. A moral decay of the society. Thank you.

Dr Tedros, WHO, 9 March

If eugenics was a social and medical experiment, is artificial prolonging of life an equal social and medical experiment? At a certain point should nature take its course, with palliative care medicine and tlc? Is a comfortable death less difficult than intrusive medical and surgical intervention for short term gain?

@eggandonion

• these are excellent points you've raised.

It feels as though the Overton window regarding medical care for older people (including those in later middle age) and forced euthanasia is beginning to shift

Yes.

And the shift will 'drift' to other groups in the community.

And not taking the death of the elderly or the senior citizens as a serious issue is one of the moral decays... Any individual, whatever age, any human being, matters

Yes no one could argue with that. But people of all ages are dying daily of many things, including preventable causes like starvation. And we don't care about that. Well we care - but not enough to do anything, report on it daily or discuss it on this forum. We just accept that sometimes shit situations happen and people die.

So I guess that's why the WHOs speech rang a bit hollow to me.

There's a special kind of irony in Tedros's warnings of 'moral decay', isn't there?

I find his speech a bit glib. Moral decay not to 'care' about the elderly dying? Old people die. That's what old-age leads to. It's natural. I think there's a kind of moral decay in being so petrified of death and making it taboo, that we try to rid our lives of it. It will happen. It must happen. It's normal.
I want no one to have a painful death, a lonely death - that's tragic. But death itself is not tragic unless it is in a young person who has a life ahead of them. I'm mid fifties and tbh if I died of a heart attack tomorrow it wouldn't be a tragedy for me. DC and DH would be upset but they are adults. I've had an amazing life, travelled, had some great adventures, fallen in love, raised a family, made a home, had a few surprising successes, done all the things one hopes to do in a lifetime. It wouldn;t be a tragedy. And if I die when I'm 70/80 of a virus or anything else, I wouldn't think the society that failed to drag me back to life was in moral decay. I'd think they had better things to focus on that trying to cheat death 24/7.

You could claim it's a moral decay not to listen to what old people want and give them the choice whether they want to see their family and friends and risk dying earlier. Because, as I said earlier, those who are compos mentis in my gran's home are quite clear about what they would prefer.

The shock and horror is that this virus has been allowed to rip through care homes.

Social care has been cut to the bone over the last 10 years. Even before all this, care homes were massively struggling to maintain decent levels of staffing and care.

In preparation for covid patients, 15,000 NHS beds were freed up by discharging patients as soon as clinically possible. About half of these were discharged into social care. The reason there were so many 'bed blockers' in the first place was because there was not an adequate social care package in place to discharge people to. They are now being discharged anyway, before they have a needs assessment and before there is a care package in place. They are discharged to the first available care home place, regardless of suitability and regardless of their wishes.

www.gov.uk/government/publications/coronavirus-covid-19-hospital-discharge-service-requirements

Government guidance to care homes is still that they should accept covid patients, with symptoms, discharged from hospital.

www.gov.uk/government/publications/coronavirus-covid-19-admission-and-care-of-people-in-care-homes

Like any other communal residential setting, care homes are incredibly difficult environments in which to control infection, especially as residents with dementia are liable to wander and not understand the need for social distancing and scrupulous hand hygiene.

Short staffed to begin with, care homes are now struggling to manage with very high rates of staff off sick and in self-isolation.

We all know about the woefully inadequate PPE situation in care homes.

For residents this all means that not only are they unable to have visitors but they are frequently confined to their rooms, all social activities stopped, being cared for by an incredibly overstretched workforce who don't have time to do anything beyond the basics.

If there is covid in a care home it is highly likely to spread around both residents and staff.

I don't think anyone is arguing for heroic efforts to be made in an attempt to save elderly, frail people who have covid but as it is there are problems even with getting decent palliative care in place.

www.ft.com/content/eedbe1cc-5773-4e07-b9a3-76177f9ad7f1

The 'shielding' policy was brought in when we were still being told 'herd immunity' was the way forward. The idea was that 1.5M people would basically just get in the fucking cupboard for an extended period while the rest of carried on as normal and we let the virus rip through the population. How these people were to be cared for, how they were even to get food, has been a complete afterthought.

At the time, the government were making lots of noises about protecting the most vulnerable. If it wasn't obvious beforehand, it's very obvious now, looking at what is happening with care homes, that they don't give a shit about the lives of the most vulnerable, they just don't want them showing up on the death statistics.

To look at all this and say, 'oh well, old people die anyway, it's probably a blessing' - that's glib. And Tedros is spot on - it smacks of serious moral decay.

Yes there are wider debates to be had about end of life decisions, and care, and rights, and quality over quantity etc. But now is not the time to have them because right now we are all just looking at the numbers and we have become desensitised. Some of the posts on this thread are terrifying.

Both my parents have died. My DM in hospital on a ventilator with an unidentified virus (initial symptoms were high temperature and difficulty to breath....) although that was 10 years ago. My Ddad in a nursing home, more peacefully in his sleep. Both times we were told either on the day or a few days before that death was imminent....but it still felt like a MASSIVE shock both times when I got a call to say they had passed away. I cant explain it, I think it's because even if you know on an intellectual level what the outcome is, your mind is in denial.

@ellanwood

You might think you don't care about dying as you've had an exciting life. A few months ago, I thought the same as you, in my case because I have complex PTSD, and there's been so much pain to cope with, and felt that I was doing my DDs more harm than good. I honestly thought I wouldn't care whether I would survive or not if I caught COVID-19. (I realise that it was my MH issues making me feel like that.)

But that wasn't how I felt when I found myself gasping for breath, feeling like I was drowning. Maybe it was partly because I do have dependent adopted DDs. But I don't believe it was just that. The urge to survive was more primal than that, it's a strong survival instinct that I suspect is true of all human beings; it's just that, as people become more frail, their bodies are no longer strong enough to win the battle.

It's one thing talking about death in theory, but the reality of facing it is entirely different.

To look at all this and say, 'oh well, old people die anyway, it's probably a blessing' - that's glib. And Tedros is spot on - it smacks of serious moral decay.

Tedros should get his own house in order before he presumes to pass judgment on the UK.

I think it's a horrible way for them to die. They may have only lived another 6 months but they could have died with family around them and in their sleep rather than gasping for breath.

We don't even know if these people that have died in care homes were given any assistance like taken to hospital and given ventilation. Did they just suffer and eventually stop breathing? Horrible thought. You need to stop thinking about the fact they would die anyway and start putting some thought into the way they died. Not pleasant. It's not only 80 year olds + in care homes either. There's people in their 60's and 70's too. I'm sure they may have had some years left

Not everyone dies surrounded by loved ones though. I have three close relatives who died suddenly, two alone and one in a cafe on a business trip.

Not everyone dies surrounded by loved ones though.

Not everyone wants to. There's a not uncommon observation that quite a lot of dying people seem to 'wait' until their loved ones have had to leave the room for some reason. There's no one 'right' way ... except obviously as peacefully and painlessly as possible. Of our parents, FIL who was in hospital with the most intervention had the worst time of it.