By E. Patrick Moores, Esq.
Having recently returned from the Mayo Clinic in Rochester, Minn., and recovering from a lengthy illness, I have spent a couple of weeks reflecting on situations and circumstances I experienced and observed concerning persons who are elderly and dealing with long term illness.
My own personal experience from spending 12 weeks confined to a hospital bed, following complications arising from surgical removal of a malignant tumor in my colon, involved increasing malnourishment and a growing weakness in both body and mind: I found that I was losing the ability to comprehend what the physicians were saying to me.
I was truly blessed by a caring spouse and special medical business associates who intervened on my behalf when my level of well being began to approach a critical low.
The elderly patient faces a huge need of support for physical therapy just to be able to rise out of bed and walk to the bathroom. Not only does confinement to the bed create weakness, there is also the loss of cognitive thinking ability.
My 30 years of experience as an attorney, focused almost daily on medical and insurance matters, was of little use to me in overseeing my own personal care as my condition progressively deteriorated with each passing day. As I was being transferred on a flight to the Mayo Clinic, I was aware that I was very fortunate to have family support for my care needs.
What about, I wondered, the elderly I observed in the hospitals where I had undergone treatment, who seemed to have no such person to oversee their level of care or be an advocate for their needs and care.
Much of the national political debate today focuses on Social Security and Medicare and whether there will be anything left in the system after the impact of the World War II “Baby Boomer” generation, of which I am a member.
Reams of paper have been used to write articles of advice on financial and estate planning in order to provide guidelines for the elderly’s retirement years.
Unfortunately, very little planning is done for the time when the elderly family member is confronted by long-term illness and faces a lengthy period of time confined to a bed.
In our world today, where both spouses are gainfully employed to meet the family’s financial obligations, very few have the time, energy or desire to provide for the daily needs of an ill and infirm elderly parent. Most people seem to think that the government social welfare programs will provide for our needs.
Sadly, government officials have done little to prepare for solving the effects of the looming crisis of the increased costs for medical care and prescription drugs. Our healthcare system and long-term care facilities are quickly heading toward a train wreck of major proportions, with bankruptcy a possibility for both government programs and individuals.
We live in a time of abundance, yet the cost of continuing to maintain our lifestyles, if confronted by a long-term illness, is approaching a crisis level.
Wealth creation, while appealing, is an aspect of daily life in which few are really engaged. Some form of realignment of care resources, expenditures and financial provision is needed to manage the entitlements that eat up our nation’s and states’ financial budgets. Unfortunately, the unpleasantness of the reality we face in future healthcare costs is causing our politicians to bury their heads in the sand and hand these financial issues off to our grandchildren.
The sad state of affairs is that not only do we fail to hold our political representatives accountable, but little is done by individuals to plan for the economic challenges that healthcare will present to one’s own family. All of us will face this situation — some sooner than others. Adding to the problem is the guilt experienced by family members arising from the quality of life issues faced by a sick parent or other family member. The process is exhausting for both the sick and the familial care giver.
The level of care provided by physicians and staff of healthcare institutions, even for minor matters, is becoming a major challenge. One of the hospitals in which I spent weeks as a patient would only change the bed linens upon request by the patient or a family member on behalf of the patient. When my wife attempted to bring me a cup of ice chips for my parched throat, she found the ice chips under lock and key. The “bean counters” that now control the hospitals restrict the availability of clean sheets and the amount of time that the caregiver is able to spend with each patient. Even doctors are confronted with restricted time demands that limit their ability to establish a relationship with patients, or to spend time making sure their patients have a good understanding of the issues of their illnesses.
“Before the crisis” is the time for doctors and lawyers to come to the aid of their patients and clients to help them plan a course of action and acceptance of responsibilities when confronted with the long-term illness of a family member. This not only involves whom is to be selected as the professional medical caregiver, but also involves arranging for separate powers of attorney and living wills to be executed by each family member so that the appropriately-designated person can attend to the personal, business and financial affairs of the ill individual. Plans should include the long-term care decisions agreed to in the event that the family member fails to recover.
Such plans should outline actions, and demand that the primary physician take the time to explain the extent of the illness and course of treatment. Consideration should be given to bringing in consulting physicians and the transference of the patient to a specialized medical facility. The family should agree on the steps to be undertaken before the circumstances arise to an emergency.
Such planning will detail the level of responsibility to be shared by each family member. The level of support from implementing the plan provides a huge source of comfort to the ill family member, and family feelings of worry and guilt are replaced by the expressions of love and care accepted by each family member involved in the planning process. •
E. Patrick Moores is an attorney in Lexington, Ky., and a member of this newspaper’s editorial board. He concentrates his practice in insurance coverage issues, employment and elder law;firstname.lastname@example.org .
Focus on: Compliance Next Post:
Part 2: Nursing standards, their history and significance