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?

My understanding of pneumonia in general which has been similar to CV in care home elderly and frail patients is that it's not the 'gasping for air/drowning' description that gets banded around.

As the patients are already very frail, the virus has no issues accessing the cells, and so death is much more in the early stages and with less immune fightback (the fevers etc). In the majority of cases, it actually is a peaceful passing away situation as the oxygen blood levels drop and their body just...stops.

Hate myself but source is a family member who heads up an exclusively older care patient team who is very matter of fact.

I appreciate what people are saying about some people in care homes already being very elderly or unwell. But that is not always the case at all. Lots of my clients with learning disabilities live in care homes. These are young people often in robust good health. Just not able to live independently. I do feel that by saying that it is somehow less shocking that people in care homes should die, we do some of my people a great disservice. These guys already have worse health outcomes than other people, which is rightly seen as a national scandal - check out death by indifference and LeDeR

What a grim attitude OP.

To those not bothered by this, what do you think about care homes in general? Should they exist?

I’m bothered about it, but my priority would lay with the 80% of cancer patients not getting the treatment and referrals they need.

I’ve just watched the news at ten and there was a cancer specialist explaining the above, which I find frightening. Basic cancer screening tests are being put on hold. A patient with terminal cancer said unless you’re a covid patient you’ve got no chance- his sad is that? His children were only young. Tragic and will affect the child’s life forever more.

Of course they should exist.

Should we try to make conditions in them as humane, comfortable and compassionate as possible?

Yes absolutely

Should staff be protected from risking their lives by working there?

Like anything, staff shouldn’t be asked to risk their lives. PPE is the main issue of lack of.

If those are important things why isn't it disturbing to see them fall away in a matter of days and weeks, for some time behind closed doors until public and media outrage?

It is disturbing of course it is but they can’t be a priority as there isn’t the staffing. I suppose you could argue that’s where the line has been drawn in some respects. By the time you got the 90 year old in an ambulance up to the hospital it’s unlikely they’d survive the journey so give them their dignity in the last few days.

@Inkpaperstars

People aren't expecting immortality but they would appreciate the time to get their loved ones affairs in order and say a proper goodbye.

I think it's more about the way they are dying. I've been told the care homes don't have oxygen to give, the hospitals are refusing to take patients from them and once they have died it's hard to get a doctor to do a death certificate.

On Newsnight tonight it was reported that there are currently 3000 icu beds free in the uk.
Are care home residents simply not ever taken to hospital with symptoms of Covid-19, even if they might survive with oxygen treatment? Are they just left? Along with the reported reluctance of 111 call handlers to sanction ambulances, if true, it's an absolute scandal, if icus have capacity.

@eeeyoresmiles

The point of my thread is not to advocate for the lifting of the lockdown or to dispute its benefits.

I am for it to protect wider society, of all ages. I don't want the elderly, vulnerable people, high risk shielding groups, NHS or care home staff to be left entirely at the mercy of this disease.

We should do all we can for everybody young and old. However, I know that that certain groups will fare better than others, and others will be impacted much worse. Hence, why I am not shocked, much as some in the media and elsewhere want to make us feel that way.

So... we are all going to have to get a little more closely aquainted with death and disease and we're all going to have to (re)learn to live with a slightly more precarious existence

I agree wholeheartedly with this.

A pp said something like "my relative is in his late 90s but he wants to live to see 100"

I'm sorry, what?

I think we are mostly in agreement that modern advances in medicine are a good thing (I'm not going to touch on the whole dementia aspect and how sometimes this can be crueler).

But this is a fairly new phenomenon. In fact it's an extremely new way of life when you take into account the whole of human history. Are we now saying anything less than 100 is a tragedy?

I just can't get behind that.

A 13 year old dying is a tragedy.

I'm glad you posted this thread because I've often wondered if there is something wrong with me. I just can't get upset about someone I don't know in their 80s or 90s passing away. I try but I can't. All I can think is how they're incredibly lucky to have lived such a long life.

Maybe that is "ageist"... I guess it is because they would have to be a certain age to have lived so long. In the same way it's "sexist" so say a man has a penis, perhaps?

Thanks @Hunnybears

Maybe they need to focus, I hope they are, on having Covid and non covid health care facilities moving forward, with completely separate staff populations. People who are immuno-suppressed/have cancer need to be able to go somewhere for treatment that can be kept as safe as possible. That needs to be an urgent priority. They are in an incredibly vulnerable position, because if transmission rates are not kept very low in the community also they will be facing terrifying risk from covid also. I don't quite see how it links to care homes but it is a top priority.

It's a heartbreaking situation but no-one ever suggests a reasonable solution.

You can be in your 80s and having a great time and be independent but the facts are, every single cell in your body has declined. And you have multiple 'underlying conditions' purely due to your age. You're far more susceptible to any virus or illness and far more likely to die from it. That's fact. It's life.

But elderly people in care homes are there because they need a high level of care. They need that care to survive, otherwise they would be at home.

Hospital admissions with often invasive and physically brutal treatment in an unfamiliar environment is horrible and distressing and extremely unlikely to lead to recovery in any case.

Staff in care homes trying to enforce isolation or social distancing with e.g mobile dementia patients is impossible.

And then you've got the small group of elderly care home residents who don't have dementia but are still frail and in need of care who are currently restricted to their rooms, not allowed visitors or to go out. Who know their likelihood of death in the next few months or year is high anyway even without COVID and are facing the prospect of a miserable existence in confinement and isolation with limited human contact, not even able to see anyone smile at them (if PPE is being used) and would rather die anyway (my Gran and many others).

Untested or known COVID positive patients should not be moved from hospital to care homes as is happening in some areas. And everyone should be made as comfortable as possible at the end of their lives. But outside of that, there aren't many good solutions.

I will never forget Dr. Tedros saying they aren't numbers, they are people and every life matters- once its gone you can't get it back

My gran is in a care home. The manager of that home said all their residents who are compos mentis enough to understand what's going on have expressed the opinion that they would rather be able to see friends and family and take the risk of dying with the virus. You have to remember that facing what could be your last days anyway (life expectancy in a care home is not exactly high even without this) isolated from friends and family is also pretty horrible.

Agree Patte My dad is a healthy 80 year old living independently and has been very active. He is worried that by the time he’s able to socialise again, he may no longer be physically able to do so. He has few years of quality life left and to lose 1 or 2 to lockdown has a huge cost.

I'm aware, by the way, that's there's more to this than just what residents want - there's risks to the staff and possibly putting strain on the NHS. But I do also think what residents want should be taken into consideration where possible (some people won't be in a position to understand the situation which makes it harder to work out what they'd want).

YA definitely NBU!
Just a few years ago, getting to 70 was a bonus.

Your thread matches you name op piggish.

I am totally with the OP here.

I am slightly cynical in that I do think that many people with relatives in ‘care’ homes visit from time to time, make themselves believe the relative is comfortable and happy and depart with a clear conscience, feeling that they have ‘done all they can’.

What is the quality of life really like in a care home? I know that there are some super luxury ones about (where I suspect they may have more treatment options, anyway) but I am talking about the vast majority here. I really hope that the exposes I saw of horrific abuse of the elderly by the (very underpaid) ‘carers’ are a tiny minority but I have a horrible suspicion that there is more of it about than people want to think about.

Do people really think that most people die ‘peacefully’ in their sleep normally? As someone upthread mentioned, opportunistic pneumonia is often the cause of death. End stage cancer (another common cause of death for the very old) also often ends with the lungs filling with fluids and/or liver failure nausea, inability to even drink properly and the virtuously continuing vomiting up of bile. Particularly with cancer, people can be in pain for months before their final death.

As I said on another thread, I really want to die ahead of being in a care home, treated like a child, at the mercy of others’ whims when I eat and drink and even use a lavatory.

Maybe seeing people die, which used to be common place, but we are now shielded from, will allow us a more adult discussion about quality over quantity of life and even allow assisted dying for those of us who may want it when the time comes.

OP you absolute wind-up merchant.

If I ended up in a care home I would pray to die.

However elderly people who are not in care homes but were previously reasonably fit and enjoying life have been struck down by the virus; most of us would grieve for them, especially if it looked as though they'd have had a few more happy, useful years.

I agree OP. Death comes to us all. Covid is a horrible way to die but so are deaths from cancer, COPD, dementia.

There seems to be an obsession with trying to live for as long as possible even if the later years are just existing rather than living.

I've long thought something similar. I'm not talking about LD or those who have some quality of life
I often work in NH and have seen people before they needed admitting. I've had people tell me they wished they could just die. People whose last year of life has been in a bed. They are mostly kept alive by a cocktail of drugs. Whose getting any benefit here? Not the patient or the family. Its very upsetting for the family
The only benefit I can see is to the NH who is raking in about £1000 a week

This thread has made me think a lot. When the over 70s were first told they had to stay indoors I had a chat with my dad who said he was going to ignore it as he's had a "good innings" and he'll have to die somehow. I was quite shocked (he's early 70s) and told him that it won't be for long and that I'd rather, for the sake of the rest of the family, he follow the rules.

Now I wonder if that's a selfish thing to say. My dad hates getting old, he complains about it all the time. He had kids quite late in life which is why I feel as though he'd be gone too soon (I've only just turned 30). But now I think about it the idea of seeing him with dementia or in a home is so much worse than the idea of him dying "too soon". He still pines for his youth and has never retired, he just can't cope with being an "old person" very well.

He's doing the social distancing thing at the moment but if the over 70s are told they need to stay indoors for months/years then maybe we do need to have a proper chat about what he really wants in life.

My Nan died at the start of the year at 89 (her funeral was on her 90th birthday) and when she went into hospital (pre Covid) from her retirement flat with a uti. She wasn’t treated for it, the aggressive treatment needed (2 sets of oral antibiotics hadn’t worked) was deemed too much for her. Dnar were discussed as was levels of treatment but in the end she was simply to frail to fight. The whole process was drawn out over 2 weeks

The point to this is there aren’t new procedures for Coronavirus, dnar not treating etc all existed before it’s just bringing everything to the fore

My other NAn is 95 and has all her treatment options discussed and has had an dnar for years. My DH nan at 95 refused all further treatment. This is just the scale of it

And yes at some point I think we have forgotten the only certainty in life is death. We are fortunate to live in a time when the expectation is that will be when we are old.

Do you actually know anyone that age?

I’m bothered about it, but my priority would lay with the 80% of cancer patients not getting the treatment and referrals they need.

Yes ... and this includes many old but otherwise not infirm people. The 70+ year olds who still could have some good years ahead.

DHs 80yr old aunt died last week. She went downhill rapidly after a scan showed her cancer was regrowing, but whereas the plan would otherwise have been another round of chemotherapy, this wasn't possible under current circumstances. Obviously we couldn't go and see her (she's at the other end of the country) but she seems to have been looked after kindly and compassionately. She wrote a new version of what she wanted for her funeral service, we don't know yet if it was covid-compatible (if not, we'll do it in a memorial service as and when).