[HN Gopher] It's getting harder to die
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It's getting harder to die
Author : baud147258
Score : 66 points
Date : 2024-06-25 11:28 UTC (3 days ago)
(HTM) web link (www.plough.com)
(TXT) w3m dump (www.plough.com)
| Modified3019 wrote:
| The topic of a "living will" came up in a family discussion after
| my mother's funeral.
|
| None of us have a pathological desire to live at all costs, but
| as it turns out, figuring out when to say "yeah I'm done, see
| yah" and halt treatment is way more complex than it first seems,
| especially when making the decision for someone else. Things can
| happen very fast, and there's a bunch of things that basically
| require a job in the industry to know ahead of time.
|
| If anyone knows of some comprehensive resources for helping
| define reasonable limits, I'd love to hear it.
| rustcleaner wrote:
| There is the POLST form for governing interventions. There is
| durable medical and general powers of attorney. There are
| irrevocable trusts to protect trust assets from long term care.
| complaintdept wrote:
| Talk to an estate attorney and they can give you some advice,
| but ultimately you'll never be able to account for every
| possibility, and you're going to _have_ to trust somebody to
| make the right decisions for you at some point.
| onlypassingthru wrote:
| Anecdotally, a family friend was barely clinging on to life
| for a couple weeks enduring heavy pain meds and abject
| misery. Only when his close friend, and executor of his
| estate, sat beside him and told him everything was going to
| be alright did he finally find peace and let go. He was gone
| within 30 minutes.
| magnetowasright wrote:
| The Order of the Good Death has loads of resources on how to
| have these conversations, what your options for advanced
| directives etc. are, and guides on how to set everything up.
|
| https://www.orderofthegooddeath.com/
|
| They also do a lot of advocacy around green burial, alkaline
| hydrolysis, and whatnot as well.
|
| Caitlin Doughty (who founded the Order of the Good Death) Ask a
| Mortician channel on youtube covers this stuff too, but the
| older videos might be out of date.
| JansjoFromIkea wrote:
| "especially when making the decision for someone else"
|
| This gets additionally terrible when it's for someone else
| whilst handling the wishes of everyone else with significant
| ties to them.
|
| Had a relative die a while back who was going through absolute
| hell the final few days; some family members still have a
| massive grudge towards the hospice for what they feel like were
| moves done to ensure they died quicker. I've absolutely no clue
| why they seemed to think dying in massive pain over a longer
| span of time seemed better but they did.
| ericmcer wrote:
| Kind of a tough read, I just turned 37 and this was the year when
| it really hit home that your body degrades and sometimes it never
| goes back to "normal". I was used to sports injuries being a
| pattern of injury -> recovery -> ramp back up to 100%, but have
| suffered some injuries recently and am coming to terms with
| realizing I will never return to 100%. They will be lingering
| things I deal with for the rest of my life.
|
| It is terrifying transitioning from seeing health as innate to
| viewing it as something you need to carefully nurture or it will
| slip away.
| silverquiet wrote:
| Not everyone gets even that - I've had mobility issues since I
| was seven years old. It's been strange to realize that it
| probably shaped my personality somewhat; I always felt older
| than my peers in some way. The silver lining might be that
| while now they are starting to say how old they feel (I'm
| basically the same age as you), I'll often tell them that I
| don't feel any older.
| ryukafalz wrote:
| > The silver lining might be that while now they are starting
| to say how old they feel (I'm basically the same age as you),
| I'll often tell them that I don't feel any older.
|
| As someone with chronic back pain since my late teens, this
| is... a nice perspective. My friend group isn't old enough
| yet for it to come up very often but I feel like I can
| relate.
| cjk2 wrote:
| Hey you're me 15 years ago. I stopped the sports and switched
| to sustained low damage exercise like cycling, hiking, swimming
| etc. While you can't undo the damage done if you have a very
| high level of fitness, you can reduce the effects of the
| further progression of time. Better be as fit as a 50 year old
| with some damage when you're 70 than as fit as a 70 year old
| with some damage.
|
| End game is not pretty. My ex wife didn't do any fitness stuff
| at all and she's walking with a stick while I'm doing 30km
| hikes at 3000m...
| rqtwteye wrote:
| Same here. I had to switch from doing crazy stuff to just
| maintaining health. Hiking really fits the spot. I still get
| a lot of cardio (I have hiking trails with 1000m elevation
| gain within 10 minutes of driving) that way. But things like
| running or martial arts are out of the question. I am glad
| that I was able to adapt to a declining body. Some people my
| age still do high impact stuff and constantly get injured,
| take lots of painkillers and get surgeries.
| riku_iki wrote:
| your situation is probably not completely relevant to age, many
| injuries are not recoverable no matter how old you are. You
| accumulated risks of such injuries which produced result.
|
| If you switch to safer kinds of sport/workout, you still can
| have a chance to be very active for many years until old age.
| kingkongjaffa wrote:
| This really resonates with me. I'm 30 now. I had a rotator cuff
| injury last year and lost some range of motion in my shoulder
| for about 6 months.
|
| This year I got a personal trainer for the first time.
|
| I'm really trying to fight to get in shape and stay in shape.
|
| I spent my 20's working and for the last 5 years I work
| remotely, largely ignoring my health.
|
| Sitting in a home office all day is really bad for you.
| xenospn wrote:
| Go on walks! The sun/allergen exposure and vitamin D will be
| good for you. Literally put walks on your calendar so it's
| easier to remember.
| blue_dragon wrote:
| Use the next several years to build as much muscle as you can
| without damaging your joints. It gets extraordinarily
| difficult to add new muscle as you enter your mid-30s, but
| fortunately you still have time. I work out 3-4 days per week
| for ~90 minutes each.
|
| If you've never done strength training before, you may be
| pleasantly surprised to learn how much extra mass you can
| add, while remaining on a typical diet, with zero chemical
| assistance. Your trainer will be able to help you.
| adaptbrian wrote:
| On the flip side changing diet and it's effects on what folks
| might have seen as something they can never fix/change without
| _____ drug, might be transformational.
|
| With that said, my better half can't bend her arm past a
| certain part on her body, however, b.c of a really small/stupid
| collision/fall coming down a Tahoe MTN ski run. It always
| depends on the problem.
| nsguy wrote:
| I'm a fair bit older than you... What you're saying is true but
| it's also worth mentioning your body has capabilities you're
| probably far from reaching. Most people your age can still
| exceed any physical accomplishment they've had in their
| lifetime if they really want to. E.g. they can play sports
| better than they ever had and they can achieve personal bests
| in any physical ability. If you were a top level professional
| athlete that's probably not true (though even professional
| athletes have longer careers than they used to) or if you've
| been a top 10 GM in chess than that's probably behind you too,
| but otherwise you're young!
|
| I don't know what specific injuries you're suffering from but
| I've suffered from back pain and really improved my situation a
| lot. I'm physically stronger than I've ever been in my life.
| I've worked through some knee injuries. I've even recently
| improved my gum health (in a way someone said wasn't possible).
| It takes more work and more focus but our bodies are amazing
| machines and 37 ain't old.
| fibonachos wrote:
| I'm in my late forties and sprained my back/hip pretty badly
| right at the start of COVID. A year later I was having
| trouble descending stairs and starting to develop knee pain
| on the same side of my body. So I began a fairly rigorous
| resistance training program about two years ago with hopes of
| regaining full mobility. The results have been fantastic. I
| still have a bit of pain from in both the knee and back, but
| it's not disruptive. Most importantly, I have normal mobility
| and the injured areas have stabilized. With any luck it will
| continue to improve so long as I stick with it. That's in
| addition to all the other benefits that come with being in
| better physical shape.
| complaintdept wrote:
| ...and it's getting harder on the families too with nothing to
| really address it. It used to be one day you'd drop dead, or get
| really sick and be dead not long after, and your family after a
| terrible shock could begin readjusting to the new reality without
| their loved one. Now you can have what used to be a death
| sentence and continue living for years or even decades. But the
| systems which support the patient's life are not supporting their
| families, who have to live with the stress and financial burden
| of keeping their loved one alive, and the prolonged grieving
| process which can now take up a huge chunk of their lives and
| still doesn't really prepare them for death anyway.
|
| I'm not saying that we need to get rid of medical advances that
| prolong life, it's just that these things have created new
| problems that we aren't dealing with and that not many people are
| really talking about.
| cogman10 wrote:
| The problem is it's not black and white what the long term
| outcome will be. A cancer diagnosis that was terminal 20 years
| ago could mean in 20 years you'll die of a heart attack with a
| short period of horrible treatment.
|
| It gets even more dicey when you start talking about things
| like "well, the 20% chance is you'll survive this. The 80%
| chance is you'll die". Almost everyone is going to want to roll
| the 1/5 chance of living rather than taking the "you do nothing
| and you die" path, even if the 1/5 path is horribly terrible.
| FactKnower69 wrote:
| a Christian fundamentalist doing a 180 on Terri Schiavo because
| she rediscovered Luddism is certainly an interesting take
| vundercind wrote:
| Recently watched someone close die over a couple days, after a
| long decline.
|
| The last 24 hours were monstrous to inflict on anyone. Torture.
| Evil.
|
| Hours and hours of faltering breathing, often restarting with
| what was plainly a panicked adrenaline-pumping response. It
| looked like they felt like they were about to drown _every few
| minutes_ , hour, after hour, no relief. No IV fluids (terminal
| anyway, so no trying to keep them alive with techniques like
| that) and unable to drink, so certainly terribly thirsty the
| whole time. Unable to communicate or really engage with
| surroundings, and quite high on pain meds anyway (the closest
| thing to a mercy in all this). It's fucked up that that's a
| fairly normal way for dying people to make their exit. I'm sure
| there are all kinds of problems with trying to provide a way out
| when someone can't make the choice for themselves, without
| opening it up to abuse, but damn, I hope this isn't the best we
| can do because it's _terrible_.
| conroydave wrote:
| Watched my grandfather pass in the same way. Didn't seem right
| to let him pass of basically lack of food and hydration after
| 95 years even though also terminal. I just wanted to see him
| comfortable and he was far from it.
| spurgu wrote:
| I'm sorry for your loss.
|
| _Edit: I feel a bit dumb now, I hadn 't actually read the
| article yet, went straight for the comments. Seems like I'm
| just reiterating what it says._
|
| When I'm in that shape I just wanna go in peace. Preferably at
| home, in my own bed, surrounded by loved ones. No tubes down my
| throat, no shots to keep me alive at any cost, with no end in
| sight.
|
| Here's some good discussion on the topic between two doctors
| that I watched recently: https://youtu.be/O0YIGAUDlzQ?t=242
| lurking_swe wrote:
| The problem with this perspective in my opinion is that many
| times, especially for an elderly person, a small emergency
| can very quickly escalate into a life and death situation,
| and the outcome is not clear until it's too late. you may
| enter the hospital thinking you have a decent outcome, but
| you end up with a bad outcome.
|
| for example, nobody plans to go on a ventilator. But if you
| need one (like severe pneumonia), you're already pretty
| messed up and you're going to have a painful death with or
| without the tubes.
| briffle wrote:
| > and unable to drink, so certainly terribly thirsty the whole
| time.
|
| I know people that work in hospice, and they say this is a big
| misconception (the article hints at it too). they patients
| don't die from lack of water, they don't want water because
| they are dying, and their body can't process it. In fact, as
| you kind of touched on at the start, giving them IV fluids can
| cause them to drown since their body can't process the water.
|
| Death is pretty ugly thing, that comes for us all. I got to
| learn the fun way that in the state of Oregon, it is illegal to
| disable a pacemaker. Even when the person has a DNR, and it is
| really the only thing keeping them alive. The best the doctors
| can do is turn the pacemaker down as low as possible, and hope
| its not enough to keep the person artificially alive. Which
| seems kind of really weird, when its also the first and one of
| the only states that allows medically assisted suicide..
| louwrentius wrote:
| I'm quite convinced that I live in a country where we never let
| people die like this.
|
| Also, I guess prolonging treatment is in the interest of for-
| profit hospitals as found in other countries, thus as long as
| your suffering is profitable, you wil...
| Theodores wrote:
| This is a really good article, not least for the list of ways
| that you will be kept medically alive.
|
| As for the premise of the article, it is definitely getting
| easier to die. We had the plumbers and the rubbish collecting
| workers clear up our communicable chronic diseases, we de-
| industrialised and cleared up the air, we quit smoking, put on
| our seat belts and reigned in the alcohol. So far so good.
|
| But, if you look at the physiques of people, the levels of car
| dependency and the predominance of the Standard American Diet, it
| seems that people are going the way of Joe Biden in old age, to
| have what you might call a loss of cognitive abilities, yet able
| to be preserved near indefinitely. The President isn't unalive,
| but he isn't really there. Millions are in the same boat,
| functionally alive but only from the eye-sockets down, and
| probably with bits of their colon or bladder removed due to
| cancer that they have bravely fought with a diet of highly
| processed food and a sedentary lifestyle.
|
| When it comes to how to live a healthy life, there is so much
| misinformation that we are all an experiment of n = 1. There is
| no realm of information that is anywhere near as confusing as
| diet. Really you are forced to join one tribe or another if
| longevity is your game. Either you are going to go all in on
| 'everything in moderation' or go fully ketogenic meat only
| carnivore, or the other way, full on vegan.
|
| The Google confirmation bias is strong with the whole topic, and
| I am sure that I could look up 'can I get omega three fatty acid
| things from eating goat hair' and somewhere there will be an
| article or 'scientific paper' promoting the eating of goat hair,
| with a study from some goat herders living in Outer Mongolia,
| thousands of miles away from any fish, with excellent omega three
| things going on. There will also be an 'adsense' advert for where
| you can get goat hair online and Reddit threads on whether you
| need yak shavings instead.
| 01HNNWZ0MV43FF wrote:
| I mean Biden also comes off slow cause of his stutter. He just
| has to survive inauguration.
| blue_dragon wrote:
| To me, Biden comes off as slow because he frequently trails
| off mid-sentence without finishing his thoughts. I suppose
| all of us have that to look forward to in a few decades - I'm
| not excited for it.
| paulpauper wrote:
| I am not a fan of Biden , but for an octogenarian to go on a
| stage and debate extemporaneously like that , as poor as his
| performance was, puts him in an elite category. The average 80
| year old does not exist (average life expectancy is 78) or much
| worse shape overall. We're not talking doing crossword puzzles,
| but stepping up on a stage before a national audience as
| President and debating. I think part of the perception of his
| bad performance can be explained by overinflated expectations.
| paxys wrote:
| Regular reminder to read _Being Mortal: Medicine and What Matters
| in the End_ by Atul Gawande. It offers a detailed and sometimes
| shocking look into the end of life /palliative care system in the
| country and show just how broken the incentives are industry-
| wide.
| pb060 wrote:
| I faced a similar problem as my wife had a chorionangioma, a
| placenta tumor. Or it was my son, it's even hard to tell who had
| it as placenta is external to both. In the hospital where we
| were, they were doing their best to keep the baby alive despite
| all the issues with the rupture of the amniotic sac and body
| damages that he already had, which I understand. What I didn't
| understand, and still don't, is how they were getting ready to
| try and keep him alive once he would be born, most probably at
| the 6th month and with probable brain and other physical damages.
| I respect doctors who can't choose between their patients life
| and death, and most of all parents who love their to be born kids
| so much that they are ready to face a life or hardship. I just
| think that medicine should not just focus on keeping patients
| alive, but also consider the quality of their life before taking
| a decision together with the relatives.
| mcshicks wrote:
| Had a pretty close childhood friend choose assisted suicide (in
| California) a few years ago after a year long battle with blood
| cancer. It's not easy to do, I think his biggest fear was losing
| his ability to consent as his mental condition declined rapidly.
| The link below outlines the process. He was getting home hospice
| care staying at an Aunt's house hear the hospital he was treated
| at. I don't think it is the right choice for everybody, but I
| certainly think in my friends case it was.
|
| https://www.uclahealth.org/patient-resources/support-informa...
| mbesto wrote:
| We don't let people die with grace in the US. Not only is
| pathetic and not very noble, but its a massive drain on the cost
| of healthcare.
| globalnode wrote:
| if you opt to stay home to die but youre in terrible pain, who's
| going to administer the pain meds? whos going to be there 24/7 to
| clean up or get you whatever you need? what this article is
| talking about is either very very very expensive home care or a
| family that basically become full time carers. with our society
| no longer advocating communal living and a sort of "every man for
| themselves" attitude throughout life, how is all of this actually
| supposed to work in reality? -- nice sentiment but unrealistic
| except for a very lucky few it seems. this is what hospitals are
| for now.
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