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erin's avatar

No place to put this. From another site:

"How are you enjoying the kick-off to the Summer of Hate?

[insert a rant against Walmart heiress]

Not only that, but we peons will end up paying for all the arrests and all the prosecution of these destructive idiots, as well as their defense....

How very very splendid. I do love being humiliated over and over again. It makes me feel all defeated and submissive. Slap me again oh Great Democrat Benefactor. Thank you!

So, to repeat, not only do we pay for the marshaling of the protests, the signs, the equipment, the shields passed out, the planning and execution of the protests, the paid bad actors, the destruction of buildings and businesses, the police, the Marines, the National Guard, the clean up, we also pay for every court case. Tens of millions of court cases.

I’ll wait till you absorb that. And remember, the U.S. is $34 trillion in debt."

Would love some sign that some folks on the left are still sane in the face of this new insanity.

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erin's avatar

And a quick take from another site. I find Chris Bray worth following.

"People just want some basic level of peace and order, a desire that’s fed back to them through media as a yearning for authoritarianism.

Please stop trashing and burning our cities.

OHHH YOU’RE SAYING YOU WANT TO TURN INTO ADOLF HITLER!?!?"

Yup. That's what it looks like from my window too.

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Victoria's avatar

It's heartening to read the pragmatism and planning you're doing, Vicki. I hope this, like your other articles, encourages more people to tackle the difficult questions and start a continuous, evolving conversation about wishes and scenario plan their needs.

As a caregiver to Dad's last breath at home, to Mum now and friends/family at a distance - I can safely say the devil is in the details. To share a couple of examples:

Gadgets, innovations, aids, fall prevention, etc, at home are great until a fall happens due to whatever. How will you have a bath/shower? Get in or out of the house? Get rehabilitated?

No one wants someone else to shower/bathe/toilet them but if you're talking about dying in pieces the longest decline can be palliative care due to heart failure, cognitive issues.

So, who will do what when under what circumstances, in the most literal of hands-on situations?

The first thing I did to help Mum care for Dad was to attend to all the practical things you've shared - down to an inventory of bills, finances, and writing contact details of the key service people, such as plumbers, electricians, and painters, that they used.

I've helped a few friends/family when they've become ill and it's easy to see that THIS is the tipping point people are unprepared for. I've researched care agency services, read the testimonials and reviews, and contacted local charities and hospice at home services to gather the local insight on their 'go-to' care providers.

Perhaps I'm bias towards the nitty gritty because of the absence of relational care, given the private transactional task-oriented 'productivity' agencies I saw/see. It's due to high, increasing demand, high turnover, high vacancy rates and low pay.

As a single childless person, I'm making my wishes very explicit. I'll probably rent a nice apartment so that the landlord/agency has to organise all the repairs, and it will be in the city with easy access and proximity to services, in addition to culture, concerts, and an airport to travel. The cities here have more private agency services. Plus, large cities have 'centre of excellence' hospitals with better care ratings. I've started a list I'm sharing with my solicitor.

Forgive the lengthy detail, Vicki - you can see I'm already planning, given everything I've experienced and I'm 52. At some point I'll write some articles on this.

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Vicki Robin's avatar

you are way more detail oriented than I am and I’ve just gone to school on what you wrote. i know people who simply put an application in for a downtown senior residency wtih continuing care years before they need it with that practical eye. no housework. lots of possible care options as well as culture options. me, now, I think I’d hate it, but me later… I don’t know. and that’s the thing. we don’t know, even if we do everything right to prepare. A long drawn out illness, dementia, confined to a wheelchair, aargh. the only way i can imagine it is I imagine all my friends have died or moved away.

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Victoria's avatar

I hear you, Vicki - this is how my caregiver brain thinks now. I'm caring for a second parent with cancer, and have supported others. So, from the initial crisis tipping point of each person, onwards, I've been in planning mode. As you've done, being aware of what's around is a good first step versus trying to figure it out in crisis/emergency.

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Kristine Baker's avatar

I’m in the midst of the death situation with my sister and her husband who broke his leg, has cancer, diabetes and needs dialysis. We’re not finding a nursing home that can accommodate all that and the hospital would like to release him. I am motivated by this situation and your article to get a better plan in writing and communicated with my partner about his and my end times. Thank you for your insights.

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Jody Day's avatar

Aging solo without children means thinking about advanced old age and death. We're not going to be able to hope that our kids will manage it for us. I love how you're taking a good inventory of the resources (relationships + physical assets) in your life now at almost 80, and how you might manage those. I can see how rich you are in relationship, having been involved in your local community, and I take great heart and inspiration from that (I'm 60).

In the comments, notice that there are several comments on choosing to end one's own life, either assisted or not, if things get tough. I think this is an easy thing to say (even flip!), but may be a way to deny thinking deeply about the known-unknowns of aging... On the whole, the desire to live is very strong, even in very poor circumstances, and very few old people do take their own lives. However, they could up living very differently to how they might have been able to, had they allowed themselves to face up to the decline and diminishment that late-stage age nearly always involves.

Another 'off the cuff' remark is what I call the 'Golden Girls' fantasy, and it's one I hear from a lot of people without kids when they are a bit younger, and just facing the foothills of old age (50s, early 60s) 'Oh, I'll just move in with a bunch of friends!' they might say, breezily. (But who? When? How? Where? And what happens when one of you gets dementia?)

I notice that you do not include plans for any possible cognitive decline, should that happen. Do you have someone legally set up to be your Power of Attorney for Health and Finances (or whatever the legal terminology might be for this in the US). Someone you trust who would be legally able to liquidate and manage your assets on your behalf if it came to that? And make medical and legal decisions about your care if you are not able to? When we don't have kids, knowing who that person might be can be hard to work out. And it changes over time too. Relationships change, people move, people die, we might lose the trust we had in them...

None of this is easy. Only looking away, crossing our fingers and hoping for the best is. For now.

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Vicki Robin's avatar

i do have a person to manage decisions if i can't. as you say, all circumstances and pillars can change. are changing now in the US. Living with uncertainty. Even if you have family you believe is there for you.

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Marc Wilson's avatar

After reading this, I wonder about my plan for long term care, make it shorter (stop eating) or die faster with some help. I pray that I will have good enough brain to make the decision when it comes.

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Bruce Hostetter's avatar

Vicki, I love that you have given all of us a primer to do our own longterm roadmap to prepare for the uncertainties (and probabilities) of aging. I have a plan to do what you have shared here but will probably be dead before beginning it. We now have no excuse but to figure out the details of our own. Thank you

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Amy Roberts's avatar

In Canada, we have MAID - medical assistance in dying. If I’m diagnosed with a terminal illness I’d rather do that than prolong my suffering. Heck, life itself is a terminal illness. What are your thoughts on this, Vicki?

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Vicki Robin's avatar

my sense, but don’t hold me to it, is that there is no reason to tough out a long drawn out process, but timing is crucial, and if you lose your mind first I don’t think you have the option of assisted suicide. I used to think there was karmic value in allowing nature to take its course, but not sure anymore. there is also VSED, voluntary stopping of eating and drinking. i know people who’ve taken every route out. if I had my druthers, i’d like what i said, living fully with the energy I have and then a few weeks at most of the body shutting down. with people I love at hand. It’s good to have this conversation again and again so we are used to having the conversation and ultimately capable of letting go into the light. Practice. Practice. Every death gives us a chance to practice.

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Leo's avatar

I've thought perhaps I would just walk into the river... Drowning shouldn't be too unpleasant, and it should be fairly fast.

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Michael Gerald-Yamasaki's avatar

I wonder how nutritious shrooms are🧐😎

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erin's avatar

It is said that freezing to death is not unpleasant either.

I know of folks who chose helium.

Myself, I vote for a vial of opiates.

Falling asleep amidst sweet nature... then let the bears have me. :-)

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erin's avatar

I am not Vicki, but perhaps you'll permit me to barge in. Involving the doctors in killing people is an abomination. Full stop.

It's not hard to commit suicide. People do it all the time. I was once told that I am dying, many years ago, and made it my business to learn how a person can dispatch herself. There are different ways to go about it. I found the book Final Exit helpful.

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Amy Roberts's avatar

An abomination…why? Veterinarians do it for our beloved pets.

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erin's avatar

Aha. So you figure, just put auntie down like a sick dog? Yikes.

And please note, we don't put Fido down cuz he is depressed. In Canada, they do it to humans. "Abomination" is too mild a term.

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Amy Roberts's avatar

You can believe whatever you like. But you’ll have to show proof for a claim like that.

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erin's avatar

Please, do a few minutes of research yourself?

They are not hiding it.

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Amy Roberts's avatar

So…you have none?

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Bruce Hostetter's avatar

@erin--Many have found comfort in MAID here in the States and of those, many have not chosen to implement it, gaining value from the comfort derived, just in case. I know physicians who have written orders--voluntarily--and they were under no obligation to do so "involving doctors..."). They support individuals with terminal diseases to face suffering on their own terms. Part of medical practice is about relieving suffering. I am glad that you had choices and found the one that worked for you. I am very sorry that you had to deal with that much pain and a decision of that magnitude.

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erin's avatar

Primum non nocere!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

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Bruce Hostetter's avatar

"First, do no harm" is not as simplistic or absolute for medical ethicist as it may sound, which is why sometimes the best option is to choose a path: "heal without cure", as in the case palliative care. One modern interpretation is, "do what is best for the patient". When MAID is considered, does a patient turn to someone like yourself to dictate the terms of harm? Or do we trust the patient and doctor through their therapeutic relationship to make that decision?

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erin's avatar

If someone wants to commit suicide, they do not need to consult me. What kind of a bizaree notion is that? It's up to them.

Doctors do not necessarily do what is "best for the patient." Corruption is rampant in the medical profession. And yet doctors still enjoy a lot of prestige and power and this should not be used to push vulnerable people towards death. Primum non nocere sends the message that the healing profession ought to be in the healing business, not in the killing business. Hippocratics understood this over two thousand years ago, and you don't?

I object to doctors lending themselves to be killers. To involve doctors is inviting all sort of abuse in. I've heard of canadian patients being pressured to agree to being killed, as they lie in the hospital. People are saying that even unhappy or poor folks going through a hard time are being "offered" death. And do you really want to live in a world where healthy unhappy people are being killed so that their organs can be sold? Yeah, maybe not yet. But there is big money thataways. As the Harvard story showed, there is good money in peddling corpses too. It's all so repugnant. Medicine has lost its compass.

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