[jbob2000]

I know this is going to be controversial, but at this point:

> My mother’s mild dementia began accelerating rapidly a year ago. I’ve been picking up pieces of her life as she drops them. That has grown from a part-time job to a full-time job. In the past month, as she’s developed unrelated serious medical issues, it’s become a way-more-than-full-time job.

I would have kept my mother out of the healthcare system and let her pass at home or in a hospice. You can't save someone from dementia and old age, don't even try, you are just prolonging their pain. Let her drop the pieces of her life and leave them there. Lymphedema treatment? She's 84 years old with dementia, she isn't going to get up a run a marathon, why would you treat this?

I say this having never have dealt with a dying parent, so this may be ignorant on my part. I am sure it is difficult standing by while a loved one fades. I think it would be better to spend a few stress-free, happy months in a hospice than years running around between the confusing, painful, stressful mess that is the healthcare system.

[crispyambulance]

I understand what you're getting at but it's not that easy: it is not a clear-cut decision when it happens to your family.

Usually, old folks develop an ever growing list of aliments which add up over time, usually one serious medical crisis every few months to a year until their number is called.

Moreover, many of aliments of old folks aren't "terminal". You can't take your octogenarian mother to the hospice, for instance, because she broke a hip, had a stroke, got sepsis from a UTI, or suffered a venous ulcer that put her in a wheelchair (all those happened to my mother in a span of 2 years).

Also, "dementia" (not to be confused with Alzheimer's) is a side-effect of something else rather than a condition in itself. A simple infection is enough for an elderly person to develop dementia to the point where she does not know where she is. Even a pain-killer regimen requires careful management to keep the patient on a knife-edge between lucidity and la-la-land.

[trowawee]

I don't think that's a particularly controversial view. Your last few sentences touch more on the issue - when you're faced with losing someone, it's very easy to say "Pull out all the stops, having [ mom | dad | grandma | grandpa ] here for one more year is worth it." Honestly, the only group of people I've ever been around who have less trouble with that mindset are medical professionals. Most doctors, especially if they're 65+, are DNR/DNI because they've seen what spending significant time in the healthcare system is really like. But I've seen some of those same people fall into the trap of demanding care for their aging parents that they've explicitly rejected for themselves.

[ams6110]

I don't think it's controversial at all. Nobody gets out of life alive. If I make it to 65 or so, I feel I've had my share. It's all downhill after that point anyway, why would I want to prolong the misery?

[AnIdiotOnTheNet]

An easy statement to make when you're nowhere near 65. I've spent a lot of time in my life thinking about death, and as a result I've come to certain philosophical conclusions regarding it. But I know that philosophy is something that exists comfortably in mind of someone without a gun to their head.

[astura]

Hospice and palliative care are not somehow "separate" from the medical system, they are a part of it.