Why you are going to end up in a nursing home

Do you know what humans fear the most?

Snakes?

Nuclear war?

A zit cropping up on your nose right before a big date?

No...no....none of those.  What humans fear the most is that they are going to end up in a nursing home. 

I wish that I had a nickel for every person who has told me, "I will NEVER go to a nursing home!  I would kill myself first!"

Yeah.

Medicine has allowed humans to outlive our useful lives.  When we have strokes and heart attacks that disable us and make it so we can't walk, feed, toilet and care for ourselves, we are SUPPOSED to die.  That is what nature intends.  But, we humans have our terrible fear of death to contend with.  So, we go on and on, in and out of hospitals for staggeringly expensive health care; a PEG tube is placed; a tracheostomy tube is placed; surgery, drugs, on and on and on.  Long past the point when our dementia and disability have rendered our lives less than useless. 

We become a burden to our family and society. 

Writing this is not going to get me elected to public office, but this is something we all know but no one has the courage to say. 

But, aren't we saying it, actually, when we exclaim vehemently how WE will never end up in a nursing home?  WE are different, WE are the exception.  All those poor souls rotting away in "extended care" facilities are completely different than US!

Do you imagine there is anyone in a nursing home right now who wanted to go there?  Is there anyone decaying away there who imagined that was the way their life would turn out?

Let's get in our time machine and turn the clock back so we can interview some of the residents at Homily Euphemism Nursing Home: 

Now it's 1944:

Roger, 5 years old:  "When I grow up, I want to be a pilot and fly airplanes ZOOOOM!! and then be trapped lying in a nursing home bed pooping on myself!" 

Clyde, 16 years old:  "Yeah, well, I'm gonna apply at Stanford and, uh, you know, engineering and stuff, get it on with some babe and wind it up being fed mush by some distracted, overworked nurse's aide in a while a television blares banal daytime television nonstop in the background." 

Ethel, 24 years old:  "I want to marry Harley--he's got a job on the railroad!--buy a white house with a picket fence and have six babies named Ruby, Pearl, Sapphire, Jasmine, Hyacinth and Lavender and have them all secretly hope and pray that I die because they are emotionally exhausted from my raving dementia and they feel guilty about placing me in a nursing home."

The NIH says that 49% of our healthcare dollars are spent on 5% of the population.  That population consists mostly of the elderly. 

It seems very selfish to run up a huge medical bill on the way to your grave.  

I have been a nurse for nineteen years, and I have seen a lot.  Here is my advice, for what it's worth:

Do not put anyone over 80 on dialysis 

Do not put anyone over 80 through open heart surgery

Do not put a PEG tube in ANYONE.  Well, okay--if your father anally raped your children and sold the pictures online--then it would be okay to put a PEG tube in him.  That is the ONE AND ONLY exception!

Do not put a tracheostomy tube in ANYONE!!  Even if your father is Pol Pot, tell the doctors, "I know that my father is a sadistic war criminal who buried people alive under his policy of, 'Don't waste a bullet'--but really, I just can't bring myself to put a trach in anyone!"

Practice saying these words, "Let's just keep them comfortable." 

When the doctor says, "Do you want us to take them back to the cath lab?"  say, "Let's just keep them comfortable."

When the doctor says, "Well, we would need to start chemotherapy," say, "Let's just keep them comfortable."

Death is not the worst thing that can happen to you.  Death can be a merciful out.  Medicine is a very sharp double-edged sword. 

We can keep you alive.