Healthcare Tradeoffs
I've been helping an elderly friend navigate the healthcare system. It is easy to get present-procedure focused. No one took a long-term view of my buddy's life path.
It's going to be easiest to explain by putting myself in his shoes.
Let's say I'm 80 years old and have a stroke, from which I will recover. At the hospital, they discover I need a pacemaker. The pacemaker is required because I have a condition, which is causing my heart to stop beating for up to 5 seconds at a time, mainly when I sleep.
The heart surgeon says I should fix my heart - he's done the procedure close to 1,000 times. I am likely to see additional years of life.
Why would I hesitate?
I might hesitate because I know my family history.
By the time the pacemaker battery needs replacing (my late-80s) all my grandparents would have been dead, or nearing death.
Here's what my family tree has been serving up...
Organ failure with Alzheimers (pacemaker kept on ticking until kidney failure killed the heart)
COPD with dementia
Cancer
Stroke
"Doc, I have a concern we are helping my body last long enough for me to lose my mind."
No easy answers...
...but here are some questions:
What's my mental, physical, spiritual state now? How am I doing relative to peers and family history? There could be very good years left before dementia hits hard.
Are there conditions/diagnoses where we switch off the pacemaker? Do I want to specify, now, what my power-of-attorney should do? It's easier for a POA to follow my instructions than struggle to balance the considerations of: past self, ever changing conditions and future self.
Does my POA have access to a medical advisor with the skill, and compassion, to navigate these decisions? Look for a middle-aged MD, with a large family tree, where the elders frequently live into their 90s.
Do I have the capacity to continue to bring love into the world? I'd be willing to suffer quite a bit if it was a win for my children.
Lifestyle, diet and modern medicine can greatly reduce our chances of dying early. In each of our family trees, there comes a point where we've done about as good as we can expect.
I've preemptively forgiven my POA for the decisions that will need to be made.
I've had a wonderful life.