A few years back, there went by a news story about an event in Holland. Apparently, the Dutch have decided to… is there a good way to say this?… to kill their elderly. The human being in question — a lady with Alzheimer’s — apparently had her wits about her when the doctor tried to administer the lethal injection and fought back with alacrity. Then, the doctor asked the family members to hold her down. Then, he put her down like a sick dog. I was shocked. I remember being glad that this sort of thing does not go on in America.

I took care of my aged father for several years. He was relatively well, though his mind was sometimes better and sometimes worse. Living with him was very trying, because — and this was a lifelong pattern with him — he was a personality disordered man. I will not describe the scenes that sometimes went on between us. I will just mention that I had a dear friend nearby who regularly rescued me and let me stay there while my father raged and carried on. The last year of his life he suffered a fall, but recovered well, and his ct scans showed a healthy 91-year-old.

One evening, my father was unusually talkative. We discussed his future, and whether he would be willing to give assisted living a try. I was surprised and glad, because he rarely talked to me, and because we carried on a good discussion without his use of hearing aids. A hopeful sign, I thought! We went to bed agreeing to speak more on the morrow.

I woke at 5 am with him banging on my door, yelling, incoherent. I opened — a mistake — and when he lunged against me, trying to keep the door open, he broke my arm. I called the cops who quieted him down. Then I went to ER. When I came home and prepared my father’s breakfast and pills, he began to stalk me, telling me he wanted me out this instant. After giving him the pills, I locked myself in the bedroom. All was quiet for a few hours, then the yelling and banging on my door began. The door shook in its frame.

I called the cops again. They spent about three hours here, trying to calm him down, getting abused in turn. My father even struggled with them physically — I don’t know where he found the energy. I confessed to them I was worried that he was going to try to poison me, and they advised me to keep all my own food in the bedroom, which seemed an insane piece of advice. Is this how I should live? Eventually, they realized that he was past any signposts of sanity, called the medics, slapped the Baker Act on him (“dangerous to self and others”) and took him to the hospital, where my father tried to kick and hit personnel. They gave him some anti-psychotics that made him worse. Eventually, with great difficulty, they found him a bed in a psychiatric institution.

And this is where the system began to play me. I was, of course, a babe in the woods, and as the situation unfolded, I spent my days on the phone, trying to figure out what to do from one day to the next. And I toured many institutions that take in the aged. My father’s insurance would have paid 100% of the costs of him being in the mental hospital. But after zonking him hard with several different anti-psychotics, they claimed he was just fine now (after a week!) and I should make other arrangements. I had him transferred to assisted living — a very nice place as such places go. They did not tell me he had developed bed sores. (My father refused to move while he was there, making them believe that he could not — so I can’t really say it was all their poor care that brought those sores about.)

Was he well? Of course not. He shrieked all the way down from the hospital to the assisted living home. When there, my father — who you remember “could not move at all” in the hospital, started running around the assisted living place, barging into people’s rooms, and that even without his usual walker. He created such an upheaval that I was required to pay for round the clock aides to keep an eye on him. Eventually, we were able to ease off, and the home made arrangements with neighboring “memory care” unit (that’s where the Alzheimer’s people are) to take him during the day. He was also further dosed with anti-psychotics which nobody seemed to be able to adjust so that the crazies would stop but he could function.

Well, in the end, that arrangement fell apart, and he went back to the local hospital. There he lay zonked out of his mind, his sores getting worse, while they were trying to figure out what to do with him. There was some sort of an appeal to the state that took several weeks to resolve. Meanwhile, I was looking for a memory care place for him — and was lucky to find out near me, a small one that was run by a church, and people had individual attention. When the state declined the appeal, the church facility took him in. I was so glad then, full of hope that they would be able to get him off the drugs and back to being alive. It looked that way at first.

Then I ran into insurance problems. If my father had straight Medicare, the facility’s doctors and rehab people could look after him. But he had one of those HMO plans that demand the patient goes to certain doctors only. My BC/BS advisor went on vacation, the replacement was not able to get me either a competent doctor or a rehab person, and my father’s muscles went rapidly into permanent atrophy. When he came there, he was coherent, and was able to get up and have lunch at the common table. Within days, he was shrieking his head off, back on the nasty drugs, alone in his room. I came twice a day to check on him. He could still talk to me. I asked him if he was hungry or thirsty. He said no. Then he said: “I am afraid.” My father… whom I’ve never known to be afraid of anyone. That was the last thing he said.

The next day, as I was coming in, the director called me and told me I should talk to the hospice. This too was a shock. That day my father had refused all food (he actually crushed the spoon they were using to feed him some yogurt) and his message was clear. I was up till midnight making the arrangements, late Friday night.

The hospice got him a special soft bed, and took excellent care of his bed sores. They also got an attendant to be with him 24 hours a day. They made sure he was getting some water to wet his mouth, and eventually began to rub liquid morphine around his gums (though in my opinion, it took them excruciatingly long to get around to it).

My father died 6 days after the hospice took over. In three months, he went from a healthy albeit intermittently demented person to a corpse.

I came out of this ordeal with a case of PTSD, a frozen shoulder, and a lot of questions. I am writing this post to warn others. There were three problems with his care. 1) The anti-psychotics ruined his health. 2) The advice I was given was of the sort designed to “draw down” his assets (such a nice official phrase, eh?). He could have stayed in the psych unit until they stabilized him, at no cost to us. Instead, they lied to me. The assisted living home was motivated to go along with the lie, because they stood to profit by his monthly rent. And in the end, even the church place should have advised me that it looked like my father needed hospice, not moving to yet another institution. More money for them. (They did tell me, but after he had been moved, while assuring me it looked like they were wrong.) And 3), when I begged people to calm my father with opiates (which would have given him constipation but would not have turned him into a zombie) rather than zombifying anti-psychotics, they refused. Only the hospice can administer the opiates, they said. I had nowhere to turn.

So this is the way we kill the troublesome aged in America. The quiet ones — and I saw many during my sojourn through the institutions — lie in their chairs in front of the TV day in, day out, year in, year out. The hospice, btw, was free and excellent. Apparently, it is important in the United States to pour unlimited money into the dying. Why?

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