Here’s a great way to spend it.

It was Bette Davis who said, "Old age is no place for sissies.” She was right. In spite of all the platitudes we hear about the importance of keeping an aging mind active and the joy of doting on grandchildren, the fact is that old age can be absolutely heartbreaking.

Physical deterioration is the most obvious problem. Some pain can only be controlled by virtual unconsciousness. 

Lack of mobility is perennially frustrating (try maneuvering a wheelchair around and between twin beds in a compact room, and you’ll begin to understand). And the onset of confusion – when you realize that your mind is going, and still feel embarrassed by it – can be very frightening.

But for many, loneliness is the worst part of old age. That can be true for the childless, of course, unless we’re fortunate to have both all our marbles and a sparkling personality. It can be worse, however, for those with children who live nearby but don’t have the time or inclination to call or visit or even to drop the occasional card in the mail.

For way too many people, life consists of decades of routine punctuated by sorrow, fear, and those occasional moments of temporal highs that we call happiness. And if we live long enough, those emotions can kick into high gear –especially if we have little-to-no hope of a heavenly end. 

Can you help?

Compassion comes in multiple forms, and there are many ways to spend it. But if you happen to be one of those with a heart for the elderly, and if you have the requisite patience and interest in others, you can make an enormous difference in the lives of these most obvious occupants of eternity’s waiting room.

If the idea appeals to you, and if you have yet to decide what to do about it, perhaps I can coax you into getting started soon. 

Use your imagination

What can you do to help? The possibilities are virtually unlimited, so maybe a better question concerns what you enjoy doing, and how you might parlay that into something that will benefit some old folks. For instance, perhaps you could: 

• Help your church stay in touch with shut-in members by starting up and running a cards-and-letters ministry.  
• Gather some friends and make lap robes or shawls for the always-cold elderly.
• Set up and conduct a weekly or monthly hymn sing, church service or Bible study at a local long-term-care facility, remembering that today’s elderly may be the last generation in which the majority have been lifelong and ardent church-goers.
• Give a hand to an elderly person who’s finding it increasingly difficult to “age in place” at home. 
• Bring your area of expertise – whether it’s banking or healthcare or crafts or just about anything else -- to share at a nearby senior center.
• Offer to serve as a wheelchair escort on outings sponsored by a nursing home or assisted living facility.   
• Just be a friend, calling and visiting lonely old people to share a cup of morning coffee, reminisce over a favorite photo album, play a game of Scrabble, or read favorite Bible books aloud.

And these are just a few of the ways you could bring great joy to an elderly friend. Whatever activity you choose, it’ll cost you little more than time. Yet it can mean the world to someone who has little left in the way of companionship or resources. 
 
A great place to start 

My personal experience is with nursing homes, primarily with the one where my mother lived and died -- Care-age of Brookfield, a terrific smaller home that’s staffed by people who really care about their residents, and bend over backwards to make them both comfortable and content. If I ever have personal need of such a facility, this is the one where I’d want to spend my last days on this earth.

But there are undoubtedly lots of opportunities to be a blessing to the elderly in your community. If you don’t know what you’d like to do, take some time to explore your options. Ask your friends and colleagues if they know someone who needs help. Call a nearby nursing home or two to ask what sort of hands-on assistance they could use. Or do an internet search using a phrase such as“eldercare volunteer opportunities,”  adding the name of your city or town, and you’ll probably discover scores of organizations that are eagerly awaiting your call.

The Christian's charge

We Christians have been entrusted with sharing the Gospel far and wide (Matthew 28:19-20). I’m certain, in fact, that good deeds performed apart from the Good News are ultimately useless. Those elderly people who know Christ as their personal Savior will want to rejoice in that fact with you. And those who do not know Him need to, just as soon as possible – which means we need to speak up and proclaim the Gospel, speaking the truth in love (Ephesians 4:15).

As evangelist Mark Cahill said in a 2010 newsletter: "I was speaking in the farm country of Iowa recently. And farmers always know one thing: If you do not plant a seed in the ground, it does not matter how much you pray for a good harvest of crops, how much water, sunlight, and fertilizer you use; nothing will be coming out of the ground in three or four months. Why? If no seed is planted, nothing will grow."

We need to be about the business of planting the seeds of the Gospel in the hearts of those who have yet to receive Christ. And what better way to do it than while we’re ministering to the physical needs of people who – at least actuarially speaking – are closest to stepping into eternity?

Like many, I thought the command "First, do no harm" came from the original Hippocratic oath taken by at least a few new doctors these days. But apparently the exact original wording is disputed, with "As to diseases, make a habit of two things — to help, or at least to do no harm" a possible candidate. So okay -- close enough.

But it hardly seems to matter anymore, at least in the Benelux nations of Belgium, the Netherlands and Luxembourg -- and you can bet it'll be coming to a hospital near you sooner than you think.

My friend Jeanne from Pennsylvania tipped me off to this most interesting article from The Telegraph, pretty much an American's go-to source for the news that the NY Times has decided to withhold from its dwindling readership.

Number of Dutch killed by euthanasia rises by 13 per cent
 
The number of Dutch people killed by medical euthanasia has more than doubled in the 10 years since legislation was changed to permit it, rising 13 per cent last year to 4,188.

By Bruno Waterfield, 2:27PM BST, 24 Sep 2013

"Voluntary euthanasia or physician assisted suicide, where a doctor is present while a patient kills themselves, usually by drinking a strong barbiturate potion, has been legal in the Netherlands since 2002. 

"Requests have risen steadily since 2003 when 1,626 people applied for medically administered euthanasia, in most cases by a lethal injection, or assisted suicide. 
 
"As previously controversial "mercy killings" have become socially and medically acceptable, the number of cases, the vast majority of medical euthanasia, have more than doubled over the decade to 2012. 

"One explanation for the steep rise of Dutch cases is the introduction last year of mobile euthanasia units allowing patients to be killed by voluntary lethal injection when family doctors refused. 
 
"Around 80 per cent of people who request euthanasia die at home and are killed by doctors on the grounds that they are suffering unbearable pain and are making an informed choice. The opinion of a second doctor is also required. 

"Euthanasia carried out by doctors is only legal in three European countries, the Netherlands, Belgium and Luxembourg. 

"Both Holland and Belgium changed the law to permit it 10 years ago. Using figures for 2012 and based on per capita rates, the Netherlands kills twice as many people by euthanasia as Belgium. 

"Euthanasia is lowest in Luxembourg, where it has been legal since 2009, between 2011 and end 2012, 14 people were killed, a per capita rate a tenth of that in the Netherlands. 

"Most, 78 per cent or 3,251, of the euthanasia requests last year came from people with cancer, new statistics showed on Tuesday. 

"Those suffering from nervous system disorders were in second place, 257, followed by the euthanasia of 156 people suffering from cardiovascular disease. 
 
"Forty two people with dementia and 13 patients suffering severe psychiatric problems were medically killed in cases that are rarer and still generate concern over the competence of individuals to request death. 

"Medical review committees, that oversee euthanasia after the event, ruled that doctors had failed to meet legal requirements in 10 cases, with two incidents involving the difficulty of informed consent by people suffering from severe dementia. 

"It is not known whether or how often a decision to prosecute doctors was taken. 

"In one case, approved by the review committee, euthanasia was carried out on an unnamed woman aged between 80 and 90 who was in an advanced stage of dementia. 

"The elderly woman was suffering from back pain after a fall and was plagued by delusions caused by her dementia. 

"Medication for pain helped, but made her confused and, clinching the case, she had an advance directive requesting euthanasia in the event of her unbearable suffering. During a lucid moment, she was able to tell her doctor, "Yes, I want euthanasia." 

"Highlighting the role of doctors in euthanasia or assisted suicide, Dutch prosecutors demanded a suspended sentence for Albert Heringa, 71, who helped his 99-year mother kill herself in 2008. 

"Prosecutors, while accepting that he acted out of compassion, have pressed for a conviction because Mr Heringa did not look for the legal alternative of seeking medical assistance to kill his mother."

Here's the article, in case you'd like to take a look at some of the links it provides to other interesting stories (including one to an article on how France is moving closer to legalizing euthanasia): http://www.telegraph.co.uk/news/worldnews/europe/netherlands/10330823/Number-of-Dutch-killed-by-euthanasia-rises-by-13-per-cent.html

So this is where we're heading, albeit not as quickly as those oh-so-cool Europeans and their leading-edge, oath-free doctors: If these physicians can't snuff out life before it leaves the womb, and least they can get it on the other end, before some tiresome old man or woman has a chance to cause anyone too much trouble or to cost anyone too much money. Because, doncha know, we're busy people these days, and we need our money for important things like fancier cars and nice holidays.

And to think the people behind such atrocities call themselves "humanists."

Could reimbursements be driving diagnoses in elderly patients? Could the powers that be have anything but the best interests of old people at heart?

I have my suspicions.  
 
But hold on, Foth-Regner, hold on! Our President and our Congress have promised not to cut seniors’ Medicare benefits. Apparently they’re going to accommodate all us Baby Boomers without reducing our services, simply by doing a little belt-tightening. And they’re going to use all the leftovers to insure 30 or 47 million uninsured Americans -- somewhere in that range, anyway. 
 
Surely this is a miracle! Somehow, they have managed to overturn the laws of mathematics. According to U.S. Census projections, in Wisconsin alone, between 2010 and 2050: 

--The population of those of working age, 18 to 64, will increase by 28%.

--The population of seniors 65 and older will increase by 120%. 

No word on what percentage of those in the working-age category will actually BE  working, and therefore paying taxes. But let's not be petty.

So what have we got? Double the seniors, a stagnant workforce, and continued inflation  (the Feds have been printing money as fast as they can – we will be fortunate indeed if we don’t have hyperinflation in a few years). And yet somehow Congress is going to cut $250-500 billion (depending on who’s counting) from Medicare spending over the next decade – AND insure up to 47 million more Americans with the savings! 

And how will they reap these huge savings? By “trimming projected increases in …  payments for medical services.” Really. What medical services? And what happens in a free market when prices fall? Demand goes up … supply goes down. Which means shortages … and longer waits for these “trimmed” medical services. The only solution will be for government to take it all over and provide us with the kind of cheerful, friendly, transparent and competent service we get at the DMV or public schools. 
 
People need to stop listening to what politicians say and start looking at the economics behind their promises. Eventually, the wheels will come off. And now that China et al are becoming increasingly squeamish about lending more money to us, it looks like that day is fast approaching. When we can’t borrow the money from other countries anymore, then what? 

All I can say is that it's probably not a great idea to entrust your health and well-being to any level of government. The numbers just don't add up.

I'm glad my citizenship is in heaven. Hope yours is, too.

It’s a fundamental law of economics: If demand for any given product or service exceeds its supply, the supply will have to be rationed in some way – by price, or age, or health, or lifestyle, or a combination of such factors.

If you’ve been paying attention, you already have a good idea of how this is impacting today’s elderly, and what it will do to them years down the road –  perhaps when we Baby Boomers begin seeking out more intensive healthcare.  

Consider just one example: Suddenly, “aspiration pneumonia” seems to have become epidemic among the elderly, particularly those in long-term care. Many have apparently forgotten how to swallow liquids, instead inhaling their beverages. 
 
That, our bureaucrats suggest, is why so many of these old people get pneumonia; it has nothing to do with the fact that they live in facilities where even the most diligent sanitation efforts can’t wipe out every last germ. It has nothing to do with the fact that, being exhausted, they spend perhaps a little too much time lying down, letting stuff accumulate in their lungs. No no no, my friends – it’s because they can’t swallow anymore! 
 
So these elderly people end up in the hospital with pneumonia. And the doctors heal them and send them home just as quickly as possible with orders that only thickened liquids shall ever again touch their lips. No plain water or coffee, no juice or milk, ever again.
 
But are these really doctors’orders? Looks like it on the surface, but when our local hospital pulled this on my mother back in 2000, the nurses admitted that it was because Medicare was pressuring them to order it for her. 
  
“But was her pneumonia really caused by aspiration?” I asked incredulously.
 
“Doesn’t matter,” they said. “If she gets pneumonia again and she’s still drinking  unthickened liquids, Medicare might not cover her hospitalization.” 
 
They had no choice, they said. At the behest of the bureaucrats, my mother would be on thickened liquids for the rest of her days. 
 
I admit that this solution does nip those pesky repeat hospitalizations in the bud. These patients mostly don't live long enough to return to the hospital. Taste it, and you’ll understand why:  thickened liquids taste like they’re slimy with spit. Someone else’s spit. If that’s all a person can drink, it doesn’t take long to become dehydrated and to die.

Although the professionals I’ve consulted assure me that I’m surely wrong about this, I don't think I've ever personally known anyone to live more than a few months on an exclusive diet of thickened liquids. 
 
What an efficient way to prevent those repeat hospitalizations!
 
Of course, it’s not government-sponsored euthanasia. But it’s close. It is government-ordered withholding of not only a basic human need – water – but also a needed medical service, which is to say those theoretical repeat hospitalizations for the same cause.  
 
As a Respiratory Reviews article said some years ago, "One possible explanation for the apparent increase in aspiration pneumonia is that hospitals are increasingly likely to specify aspiration pneumonia to obtain the maximum allowable reimbursement from Medicare." 
 
The author continued, “Of greater concern is the possibility that [these diagnoses] might be revealing a smoldering epidemic of aspiration pneumonia among elderly patients." 
 
I’m sure he must have been kidding. He didn’t see the possibility of letting reimbursement drive diagnosis as absolutely chilling? As miles worse than the possibility that there’s a natural epidemic among old people? 
 
I know what my view of this "care pathway" is. How about you? 
 
NEXT UP:
A silent epidemic: Basic math tells a horrifying story.

Forget everything you've learned about death.

Forget what Jesus said about the  horrible day when "brother will betray brother to death, and a father his child; and children will rise up against parents and cause them to be put to death" (Mark 13:12-13a). That was then, this is now.

Forget, too, what the apostle Paul said about death being "the wages of sin" (Romans 6:23) and "the last enemy that will be destroyed" (1 Corinthians 15:26) and that it will be
"swallowed up in victory" (1 Corinthians 15:54). What did he know?

And don't even give a thought to what might come next. What difference does it make?  All roads lead to the heaven of your dreams, whatever that may be.

What matters today is having a "good death," my incredibly smart friend Julie told me sorrowfully

So I looked it up. I googled "good death" and, by George, she was right. I got 665,000 hits -- enough to show that it's a subject of serious discussion among academics and healthcare thought leaders, but not enough to indicate that it's a phrase people toss about as just another modern cliche.

So what is a "good death"?

An About.com article advises us that a group called the Debate of the Age Health and Care Study Group has defined it thusly: 
 
·  To know when death is coming, and to understand what can be expected [editor's  note: before one breathes one's last, no doubt -- not "what can be expected" after breathing one's last] 

·  To be able to retain control of what happens. 

·  To be afforded dignity and privacy.
 
·  To have control over pain relief and other symptom control.
 
· To have choice and control over where death occurs (at home or elsewhere).
 
· To have access to information and expertise of whatever kind is necessary.

· To have access to any spiritual or emotional support required. 

· To have access to hospice care in any location, not only in hospital. 
 
· To have control over who is present and who shares the end. 
 
· To be able to issue advance directives which ensure wishes are respected. 
 
· To have time to say goodbye, and control over other aspects of timing.
 
· To be able to leave when it is time to go, and not to have life prolonged pointlessly. 

"These ... principles are good ones," the article added, "to incorporate [in] health care services, professional codes and care plans or missions for end of life care organizations and institutions."

Note that if a dying person needs any sort of spiritual or emotional support, well then, by all means provide it! Be like Mother Theresa and help that Buddhist be the best Buddhist he can be!

And for Pete's sake, do not harass the dying with any talk of trusting in some Imaginary Friend. In fact, don't even let anyone with such an intolerant belief system near people striving to achieve a "good death." He or she might have some lunatic idea about "pulling them out of the fire" (Jude 23).

So that's it: In our enlightened culture, death is no longer a penalty, or the enemy, or something to be swallowed up in victory. No siree! As long as a "good death" can be assured, everything will be ok.

Welcome to our brave new world, where a "good death" could well be the prelude to a very bad eternity.

"Faith is one of those things that gets tougher to acquire the older you get." This quote from a blog that shall remain nameless seems to reflect conventional wisdom, doesn't it?

"If you aren't saved by age 18, chances are you never will be," is another way of putting it.

It makes me wonder what the underlying message is. Maybe something along the lines of "Don't bother witnessing to adults, 'cause they're not likely to listen"?

And that in turn makes me wonder who's the author of this little piece of advice. The god of this world, perhaps?

If I had to guess, I'd say that 40% of the people I know were born again when they were well into adulthood, often because of the sort of life-changing trauma that is peculiar to the over-30 crowd.

Just yesterday, I heard about a nursing-home resident who was saved at age 102. Thanks be to God that someone ignored conventional wisdom and shared the gospel with her, apparently not concerned that she was too old to become a believer!

Just heard the woman behind National Grandparents Day on the radio and she mentioned these tips on her web site. Excellent suggestions across the board!

DO

Learn something about your prospective friend before visiting:  interests, background, limitations and needs.

Touch and hug. Physical touch can go a long way toward letting  the resident know you care.
 
Respect confidence. Keep private conversations private

Be a good listener. Your friend may often have no one else who spends time to talk.

Keep promises. Be careful what you promise. Never say anything unless you mean it.

Be conscientious about meeting your scheduled visits.

Encourage friendship among the residents.

Be gentle, kind and sincere.

Respect privacy. Knock before entering a room.

Remember that residents are adults and should be treated as such. Accept and respect each resident as a unique individual, regardless of mental or physical condition.

Remember that you are a vital part of the community; so is the resident.


DON'T

Be a clock-watcher while visiting. Quality, not quantity of time is important.

Feel obliged to solve the personal problems of the resident. Just being there to listen and empathize is important.

Let the resident dwell on negative feelings. Allow them to express themselves, then move on to a positive activity.

Bring food items for the resident before clearing it with the activity director or nurse.

Attempt to give nursing care or perform duties of paid staff such as lifting or transferring.


Thanks to the folks at National Grandparents Day!   

As a follow-up to yesterday's Golden Years post about the coming collapse of the nursing home industry in the US (see below), here's an appalling article about what's going on in Belgium. In a nutshell, physicians there are harvesting organs from people who've decided to have doctors murder them because they are suffering, or because they're disabled and their medical care is "too expensive." 

In short, these patients are worth more dead than alive. 

Think it won't happen here?  Think again: Isn't this a perfect Big Brother solution for all these old people who are threatening to hang on year after year when there's no one to take care of them?

Where will you be living circa 2040 or 2050? 
 
Okay, so if you’re a born-again believer, you’re probably gleefully envisioning heaven or are at least adding “if the Lord tarries” to the question. And if you’re not, and you’re over 40, you may be counting on moving in with your children or enjoying a living arrangement like the Golden Girls’ of 1980s TV fame.  
 
But just say none of these alternatives pans out, and you find yourself unable to live on your own. Will a decent nursing home be an option for you? 
 
The truth is that only God knows for sure. If our economy crashes and the Huns
overrun our country, all bets are off. But let’s keep playing make believe and pretend that America’s still the Beautiful and we still have some viable financial resources to work with. What’s likely to be available?

It turns out to be a disturbing question.

On the one hand, the demand for nursing-home care is expected to more than double by 2050, according to a recent study by JAMA and the Kaiser Foundation. 
 
On the other hand, the supply looks like it’s destined to dwindle. A long-term-care insurance expert in Green Bay, Wisconsin, points out that a third of U.S. nursing homes are already, at best, showing no profit. The rest are losing money, thanks to dwindling Medicaid and Medicare reimbursement rates. 
 
And don’t count on the government. Reports in states from Louisiana to New York confirm that county-owned nursing homes are already losing money, with many struggling to survive and some already closing their doors. 

What’s going to happen when we're ready for these services?
 
“It’s literally schools versus nursing homes,” according to Washington Post columnist Robert J. Samuelson. “We need a better balance between workers’ legitimate desire for a comfortable retirement and society’s larger interests. Instead, our system favors the past over the future. Things could be done to mitigate the bias None would be easy or popular. But it’s first necessary to acknowledge the bias and discuss it openly. This we are far from doing.”

If you don’t find this commentary chilling, you might want to read it again and consider exactly what this columnist has in mind. Think this is another case of our wanting to be "just like Europe"?