In today’s USA Today there’s an article about the growing ranks of family caregivers. One sentence really stood out to me:
“The success of medical advances is changing the problems of health care, and the health care system is struggling to keep up.”
I agree wholeheartedly with the first part of the sentence, but I’d argue it’s patients and caregivers, not the health care system, who are barely treading water.
Grandma’s Coumadin regimen illustrates this problem. She’s complained about her heart “fluttering” since the ’90s. Every time it happens she does her best Fred Sanford imitation, clutching her heart and telling everyone it’s the end. But a few minutes later, she’s fine.
When Grandma was in the hospital last fall for pneumonia, she had a flutter episode. Instead of letting it pass, the doctors put her on a blood thinner called Coumadin (a.k.a. Warfarin), which has to be continually regulated. This entails weekly lab work, frequent doctor visits, and varying strengths of the drug depending on last week’s lab results. I can’t speak for everyone who takes it, but in Grandma’s case it’s a pain in the ass … an unnecessary, expensive pain in the ass.
Grandma is convinced the Coumadin is the only thing keeping her alive, so she bugs me continuously about her pill supply. The last time I sorted her prescriptions I found three separate 5 mg bottles — probably 50 pills in total. I don’t think it’s helping her since she lived with this condition for more than 20 years; I actually think it makes her dementia worse. When she was off Coumadin temporarily for cataract surgery, she seemed more coherent. But medical science says this stuff is keeping her alive, so bring on the pills, side effects be damned.
I haven’t even broached drug interactions, potential conflicts when multiple doctors are involved, finding medically related transportation when you don’t drive or the “do I eat or buy my meds” dilemma. Yes, people are living longer, sometimes better, lives. But whether we admit it or not, there’s a point of diminishing return.
For every yin there’s a yang, and in the case of overly aggressive medical care, its counterpart is growing support for Death with Dignity legislation. This year Vermont became the first state to pass its law through legislation, rather than a public vote. Now, along with Oregon and Washington, Vermont allows
“… mentally competent, terminally-ill adult state residents to voluntarily request and receive a prescription medication to hasten their death.”
Grandma isn’t terminally ill. But as I watch her senses fade one by one and witness her struggle with basics like dialing the phone or knowing the difference between night and day, I silently urge her to stop the meds.
Maybe the next heart flutter will be her last. At least it would be her body’s decision, not some doctor’s. I realize time may change my priorities. But as of today, if I have to decide whether the end of my life is short and sudden or foggy and drawn out, it’ll be an incredibly easy choice.
Image credit: amenic181 / 123RF Stock Photo