One Caregiver v. One Stuffed Condo. - NYTimes.com

Image via CrunchBase
By PAULA SPAN

I’m enjoying a blog called The Downsize Challenge, whose author posts weekly about her trials and triumphs as she culls through a lifetime’s possessions crammed into her grandfather’s two-bedroom Florida condo.

The Downsize Challenge has raised questions that plague all of us (what do all those keys unlock, anyway?) and fostered a lively competition to see which reader had the oldest expiration date on something in the medicine cabinet (a jar of Vaseline from 1974 took the prize).

It also carries a not-so-subtle message. “I was encouraging other members of my family not to wait 20 years to deal with this stuff, because I don’t want to have to do it again,” said the blog’s author, Julie Lanoie.
More

Profit Status of Hospice May Mold Patient Census from MedPage Today

By Todd Neale, Staff Writer, MedPage Today

For-profit hospice agencies -- which have been increasing in number in recent years -- are more likely to enroll patients with dementia and noncancer diagnoses who require less care than nonprofit hospices, researchers found.
Full Article

End-of-life Consultations

End-of-Life Planning Common in Long-Term Care

By Crystal Phend, Senior Staff Writer, MedPage Today

Advance directives are common among long-term care residents, particularly those discharged from hospice, a CDC report found.

There was an advance directive on record for 28% of home healthcare patients, 65% of those at nursing homes, and 88% of hospice patients, according to an analysis of data from the 2004 National Nursing Home Survey and the 2007 National Home and Hospice Care Survey.

These rates compare very favorably with the 5% to 15% rate among adults overall in the U.S., Adrienne L. Jones, and colleagues at the CDC's National Center for Health Statistics in Hyattsville, Md., noted in the report.

But, they wrote, there's still room for improvement.

The most common forms of advance directives noted in the surveys were living wills and do-not-resuscitate orders.

The likelihood of having any type of advance directive appeared to differ by age and race or ethnicity.

Full Article

Mentor Man Fighting for Elder Rights - news-herald.com

Image by runran via Flickr
By Tracey Read

Tom Fields' father lay dying in a hospital bed in Florida on a morphine drip for cancer.

Fields, a Mentor resident, believes that during his final hours his father was the victim of financial elder abuse by people close to him.

He said his father's wishes about his property were altered as a new will was written.

People took advantage of my father and got him to sign a document," Fields said.

"There was no protection against this. A protocol could have stopped that."

Fields is now an independent advocate fighting to get laws passed to protect families in similar situations.
Full Article

Death Panel Legacy | GeriPal - Geriatrics and Palliative Care Blog

by Alex Smith in the GeriPal blog

Yesterday, legislation that would have reimbursed physicians for advance care planning discussions was stripped from Medicare regulations related to the Affordable Care Act (Health Care Reform Bill).

This was the second time such language was removed. The first time, of course, occurred during debate over the bill in congress. Sarah Palin said she did not want Obama's "death panels" to decide who was worthy of care. John Boehner (now house speaker) said the legislation was part of a slippery slope toward government sponsored euthanasia. Not only was advance care planning legislation stripped from the bill, so were all measures related to palliative and end-of-life care. We didn't blog about this at GeriPal because representative Bleumenauer, author of the original legislation, cautioned against crowing about it, suggesting it should be a "quiet victory."

What the administration couldn't get through congress it has turned to regulation to accomplish. On Christmas 2010, the New York Times broke the story that the Obama administration and Don Berwick, director of the Centers for Medicare and Medicaid, incorporated language into Medicare regulations related to the health care bill that would reimburse physicians for voluntary advance care planning discussions during the newly covered annual visit.

Now, preparing to defend the health care bill against a new republican majority in the house intent on repealing the Affordable Care Act, Obama has reversed course. They claim the language was removed for procedural reasons, but anyone can read between the lines.

A few thoughts about this.

Physicians should be reimbursed for time spent conducting advance care planning discussions with patients. This will incentivize high quality care. Lack of reimbursement for these long discussions is a major barrier to outpatient doctors engaging patients in the advance care planning process.

On the other hand, if I were to chose palliative care priorities for the Obama administration to focus on, this would not be tops on my list. Other issues I would rank higher (thanks to Diane Meier for many of these):

• Funding for palliative care graduate medical education (fellowship spots)
• Funding for palliative care research
• Incorporating palliative care into Accountable Care Organizations

And if I had a choice between legislation/regulation the includes advance care planning, but was likely to get hammered in congressional debate and sink as a result, and legislation/regulation without the language but with all of the other good things the Affordable Care Act accomplishes...I'd take health care reform.

This issue is important. It's just not worth the Obama administration falling on it's sword.

A Reversal on End-of-Life Planning Under Medicare - NYTimes.com

Image via Wikipedia
By ROBERT PEAR

The Obama administration, reversing course, will revise a Medicare regulation to delete references to end-of-life planning as part of the annual physical examinations covered under the new health care law, administration officials said Tuesday.

The move is an abrupt shift, coming just days after the new policy took effect on Jan. 1.

Many doctors and providers of hospice care had praised the regulation, which listed “advance care planning” as one of the services that could be offered in the “annual wellness visit” for Medicare beneficiaries.

Full Article

Surrogate Decision Making in the ICU | GeriPal - Geriatrics and Palliative Care Blog

Imagine your loved one is very sick in the ICU. So sick that the ICU doctor believes that there is only a very small chance of survival, and even if your loved one survived, he/she would have significant, permanent disability. If you were placed in this position, how would you want to make decisions about continued intensive medical treatments to support his/her life? Would you want to make it on your own? Would you want to share the responsibility for this decision with the ICU doctor? Would you just want the ICU doctor to make the decision for you with our without your opinion?

Now imagine we ask the same questions to surrogate decision makers of critically ill, incapacitated adults. How do you think they would answer? We now have some idea of how thanks to a study authored by Sara Johnson and her colleagues at UCSF and University of Pittsburgh.

The study, currently in press but accessible early online, presented two clinical vignettes to 230 surrogate decision-makers for incapacitated, mechanically ventilated patients at high risk of death. One vignette was based on a decision regarding life support similar to the one described above, and the other was about selection of specific antibiotic agents to treat an infection.
Full Article

Gay Man Prevented From Dying Partner Wins Settlement | News | Advocate.com

Image via Wikipedia

An elderly gay man who was prevented from seeing his dying partner in the hospital social workers will receive $600,000 in a settlement, reports the Mercury News. Clay Greene, 78, of Guerneville, Calif filed a lawsuit against Sonoma County’s Public Guardian program earlier this year, claiming he was discriminated against because of his sexual orientation.
Continue Reading

Related articles by Zemanta

• Sonoma Co settles gay discrimination suit (sfgate.com)
• Justice For Greene And Scull As Sonoma County Settles Out Of Court (lezgetreal.com)
• Kept From His Dying Partner, Sonoma's Clay Greene Takes a $600K Settlement (queerty.com)

A Last Conversation With Dr. Robert Butler - The New Old Age Blog - NYTimes.com

Image via CrunchBase

by Josh Tapper - Published July 7th in the New York Times

“I think a lot of older people are sitting on their asses, playing golf, and not making a contribution to society.”

Bounding about his Upper East Side office less than two weeks ago, Dr. Robert Butler seemed determined not to make that mistake. At 83, one of the world’s leading authorities on aging had just published his latest book, “The Longevity Prescription,” piles of which were scattered everywhere.

Dr. Butler died on Sunday at Mount Sinai Medical Center in New York, where in 1982 he had founded the first gerontology department at a United States medical school. My interview with him that day was one of his last.

Dr. Butler dedicated his life to ensuring that ours were longer and healthier. The author of innumerable scientific papers on longevity and aging, he founded and served as the first director of the National Institute on Aging. His first book, “Why Survive? Being Old in America,” won a Pulitzer Prize for nonfiction in 1976.

Thoughts from Dr. Robert Butler

Until just days before his death, he was still putting in 60-hour work weeks as the founder and C.E.O. of the International Longevity Center in New York.

He couldn’t sit still for the course of our interview, jumping up to grab me a soda (he was sipping from a can of Coke) or a New York Times clipping on elder abuse.

Josh Tapper is a fellow of News21, a national initiative to promote innovation in journalism, at the Columbia University Graduate School of Journalism. Columbia will launch a Web site, called “Brave Old World: Aging in America,” later this summer.


Read Article

Unlimited Estate Tax Exemption For Farm Estates Is Unnecessary and Likely Harmful — Center on Budget and Policy Priorities

Image via Wikipedia

By Gillian Brunet and Chye-Ching Huang

Proponents of repealing the estate tax have made farmers, along with small business, the face of their cause, driving some policymakers to push for special preferences for farms in estate tax law. One of the most radical of these proposed changes is an unlimited estate tax exemption for farmland, recently introduced by Rep. Mike Thompson (D-CA) in H.R. 5475. This approach is seriously misguided, for three basic reasons.
Continue Reading

Granny shocked by police stun gun in bed sues

An 87-year-old grandmother subdued by police with a stun gun while she was lying in bed hooked up to an oxygen machine is suing her Oklahoma hometown.

Granny shocked by police stun gun in bed sues

GRAY MATTERS: Assisted Death

by Saul Friedman (bio)

 The poet Dylan Thomas said it best for those of us of advanced age: “Do not go gentle into that good night; rage, rage against the dying of the light.” But what if there is no good alternative to quietly turning out your light?

In Connecticut, the home state of insurance giants, a legal and moral battle rages that may have national implications as two physicians have sued the state for an action that could eventually allow patients to choose a peaceful, drug-induced death to avoid the pain and terrors of a terminal illness.
As CNN's Randy Kaye reported,

“While courts have addressed constitutional questions connected with aid in dying, no court has directly considered whether a mentally competent, terminally ill patient’s desire to bring about a peaceful death should be considered a ‘suicide.’”

That’s vital, for a suicide is generally against the law and the family of the person who dies may suffer spiritually and legally, including the loss of insurance and other claims.
 
Thus, Connecticut physicians Dr. Gary Blick and Ron Levine are suing the state, asking that the state’s laws restricting assisted suicides should not include cases in which mentally competent, terminally ill patients take their own lives to avoid pain and suffering.

The suit, which a superior court judge has dismissed on technical grounds, was prompted in part by several cases in which people have been punished for helping friends or relatives to die. Right to die advocacy groups are expected to appeal.

In the most publicized case, in 2004, John Welles, who was dying of cancer and suffering, pleaded with a friend, Hunt Williams, to give him a pistol. Williams did as his friend asked. As Welles walked away in the woods, Williams shouted “God bless” and heard the gunshot. Welles died and Williams was convicted of “assisting a suicide,” a felony in the state.

Blick’s suit was aimed, in part, to clear and free Williams and win permission to end a dying patient’s suffering. Said Blick,

“We’re not talking about hooking up a potassium chloride drip and have our patient’s heart stopped. We’re talking about terminally ill patients who I’ve counseled over the years and that I would like to give them prescriptions and help them die with dignity.”

Blick, the Medical and Research Director of CIRCLE Medical, is a specialist in infectious diseases and HIV-AIDS, which raised for me a question. Not a few years ago, AIDS was considered always fatal. Now it’s not. How many AIDS patients took their lives, rather than wait for the life-saving treatments now available?

Nevertheless, if Blick and Levine are successful in their campaign, Connecticut could join a growing number of states that recognize the right of a terminally ill patient to end his/her life with the help of a physician.

The recent HBO film, You Don’t Know Jack, was a sympathetic portrait of Jack Kevorkian who was jailed for helping a number of people die, most them not his patients. But he brought the issue to a life that is growing. Recent polls indicate that 60 percent of whites (38 percent of blacks) favor allowing physicians to assist the terminally ill to die.

By all accounts, Oregon’s pioneering “Death With Dignity” law has been doing what was intended. The 1998 law (which has been copied in Washington state) has survived legal challenges including protests by members of Congress because of its safeguards. A physician must determine that the patient has less than six months. and a second opinion is required. The patient must make repeated requests, waiting at least 15 days between requests.

If these procedures are followed, an Oregon physician can prescribe the life-ending drugs, which may be taken with or without a doctor present. In this way about 30 persons a year have gone through the process and died, usually with close family members present. Most of the patients were suffering from advanced cancer or ALS (Lou Gehrig’s Disease).

Leading medical institutions, Harvard Medical School and organizations such as the American Medical Women’s Association, the American Medical Student Association and the American Public Health Association support legislation permitting physicians to assist terminally ill patients to take their lives with drugs.

The American Medical Association stands opposed. And the American Academy of Hospice and Palliative Medicine is neutral, possibly because proper hospice care (in which I am now a participant) can avoid the need to take one’s life and even put off death.

But in the end, hospice provides for pain free and comfortable last days with the help of a hospice nurse to tend to the patient and a hospice social worker to work with the family.

Much of the opposition to assisted death also comes from the severely disabled and persons with serious chronic diseases. They fear, with some justice, that they and people like them will be vulnerable if, for example, their insurance companies balk at the cost of their care. Remember former Colorado governor Richard Lamm telling such people to “get out of the way” because they were costing Medicare too much money?

Other opposition comes from religious institutions and right-to-life organizations who also oppose elective abortions. I disagree, of course, but I believe that just as the state should stay out of a woman’s right to choose, so the state should not need to come between a dying patient and his/her right to choose the manner and time of his/her death.

Oregon’s statute, I admit, is a model of regulation for the safety of the patient’s rights and to guard against abuse - say by relatives who can no longer care for the patient. But the choice of hospice seems to be minimized. That’s why I’m uncomfortable with such organizations like Compassion and Choices, which seems to advocate an end-to-life as if it were a walk in the park.

They may encourage people to seek the alleged comfort of death for no good reason. A woman I know whose medical problems are serious but not life threatening seems to have given up on life because she’s despondent over the death of her husband.

End-of-life advocates seem to provide little encouragement to fight a disease, as I am, and the reasons for their despondency, the better to hang onto life and “rage against the dying of the light.”

As another, more gentle poet, Robert Frost. has written, “The woods are lovely, dark and deep. But I have promises to keep and miles to go before I sleep. Miles to go before I sleep.”

Write saulfriedman@comcast.net

http://www.timegoesby.net/weblog/2010/06/gray-matters-assisted-death.html

Related articles by Zemanta

• First-year complications with assisted suicide (crosscut.com)
• Panel to discuss end-of-life issues (bendbulletin.com)
• Desire for an assisted death should be respected | Ann McPherson (guardian.co.uk)
• Dilemma #3 side A (slideshare.net)
• Barbara Coombs Lee: Hobson's Choice (huffingtonpost.com)
• Lewis M. Cohen: You Still Won't Know Jack (huffingtonpost.com)

Talking About Dying - The New Old Age Blog - NYTimes.com

Image via CrunchBase

By SARA DAVIDSON

“What should you do if your parent is drawing close to dying but doesn’t want to talk about it?” I asked.

I was sitting in Boulder, Colo., with Rabbi Zalman Schachter-Shalomi, 85. Reb Zalman, as he’s called, founded the Jewish Renewal movement and wrote “From Age-ing to Sage-ing,” a classic book on how to age consciously and well.
Continue Reading

TIME GOES BY | GRAY MATTERS: Hospice

by Pulitzer Prize-winning journalist Saul Friedman

My cancer doctor told me in writing, that I had six months to live. But he acknowledged he could not be sure and that the six months could be extended indefinitely.

That made me eligible to take advantage of a little understood, free Medicare program that has been enhanced by the new health insurance reforms, and could be available to anyone with a prolonged, chronic, life-threatening illness. I’m talking about the Medicare/Medicaid hospice program.

Until recently, entering a hospice program was frightening because it meant you understood you were dying and you voluntarily agreed to forgo chemotherapy or any other curative treatment, and were given only palliatives, painkillers and bedside help from professional whose job it was to make you comfortable.

All that has changed. As Dylan Thomas told us, we should “not go gentle into that good night.” So hospice should no longer be feared and avoided like the “dying of the light.” Rather, it should be embraced as a fine, comprehensive, home health care program.

A little background: In 1995, Medicare was under assault from the Republican Congress led by Newt Gingrich. Specifically, Medicare’s funds were cut to pay for private Medicare HMOs. And Medicare was criticized for the amount of money it was spending on the care of beneficiaries in the last year of their lives. Indeed, it accounted for a third of Medicare spending.

Medicare responded with its pioneer hospice program to care for the dying. Hundreds of hospices were founded around the country, most of them funded by Medicare which included nurses, social workers and devoted volunteers who became the providers of palliative care for the dying.

Private insurers followed with coverage of hospice services, but private insurance carried heavy premiums; Medicare covered 100 percent of hospice costs.

I watched how it worked for a close relative who was dying of lung cancer and his family. Hospice supplied the hospital bed set up in the home. Hospice supplied the drugs he needed for pain as well as the care to keep him clean and comfortable. And hospice helped with bereavement counseling for his wife and son.

Then, as now, he was admitted to hospice because his doctor attested that he had less than six months to live. He died three months after his diagnosis. But remember the columnist Art Buchwald who cheated death and remained in hospice care for much longer than six months?

Because such predictions are more and more uncertain as treatment options have become available, the courts forced a change in Medicare regulations. A person could not be discharged from hospice because he lived longer than six months; the six months could be renewed indefinitely.

Since 2007, Congress and Medicare have realized that with medical advances such as the CT-Scan, PET-Scan, open heart and by-pass surgery, radiation and chemotherapy, Medicare could not insist that hospice patients cannot take advantage of these possibilities while fighting his or her disease. Medicare and private insurers adopted an “open access” policy, admitting into hospice – for curative and/or palliative treatment, as long as a doctor said they had no more than six months to live.

Thus hospice has become a comprehensive health care program for the seriously ill, who may or may not be close to death. Indeed, as I have learned, it is not at all rare that a beneficiary can get well enough to graduate from hospice. My hospice expects me to be one of those beneficiaries.

In the meantime, hospice assigns to a beneficiary a nurse who comes by your home regularly to check your vital signs, see how you’re doing and help with chronic or even acute medical problems. Even more important, the assigned nurse or another nurse is on call 24/7. That means that if there is an emergency, such as a urinary problems, or the side effects of the chemotherapy, you need not go to the emergency room.

I’ve learned that the hospice nurse on call is equipped and trained to deal with such problems. No longer do I need to call 911 on a weekend and go to an emergency room. Besides being traumatic and tiring, it would cost Medicare hundreds, even thousands of dollars.

Similarly, while a hospice beneficiary may keep routine appointments with doctors, hospice nurses are equipped to deal with colds, the flu and other ailments that would ordinarily send you to a physician at Medicare’ expense. And hospice will help a patient’s oncologist by drawing blood often to keep track of possible problems such as a drop in the red or white cell counts or potassium and iron levels.

Thus hospice becomes your caregiver in fighting the disease as well as preparing for the worst. Medicare hospice, for example, supplies beneficiaries with kits that include morphine and other powerful painkillers; I’ve put my kit away and have almost forgotten about it. The best option is to avoid hospitalization for your illness for Medicare requires that hospital patients forgo curative treatment.

In addition, Medicare hospice assigns to beneficiaries a licensed, professional social worker to help family caregivers with advice, counseling and resources to help patients and families cope with the stresses of life-threatening and debilitating illness. Hospice may supply a hospital-style bed with linens or oxygen, or an IV to prevent dehydration.

The recently passed health reforms expanded curative and palliative hospice care for children in Medicaid or the Children’s Health Insurance Program (CHIP). It allows children enrolled in either program to receive hospice services without forgoing curative treatment. The Centers for Medicare and Medicaid Services (CMS) are expected to require states to comply with the changes, which are to take effect in 2013.

Finally, as of next January 1, the reforms will require that a nurse practitioner or doctor must have a face-to-face encounter with the patient at the end of the six month period to recertify his/her eligibility.

You can read or download and print [pdf] Medicare’s 16-page booklet on its hospice services, including where to find a hospice near you.

Write to saulfriedman@comcast.net

TIME GOES BY | GRAY MATTERS: Hospice

Related articles by Zemanta

• Hospice -- Dying with Dignity (seniors-health-medicare.suite101.com)
• Hospice may no longer mean halting treatment (msnbc.msn.com)
• Letter: End-of-Life Decisions (nytimes.com)
• Hospice Palliative Care: Discovering Your Voice (newswire.ca)
• Unique Hospice and Palliative Care Unit Provides Patient Care and Physician Training (eon.businesswire.com)

Death of 'Caveman' ends an era in Idaho | Local News | Idaho Statesman

BY TIM WOODWARD - twoodward@idahostatesman.com

Known as the "Salmon River Caveman," Richard Zimmerman lived an essentially 19th century lifestyle, a digital-age anachronism who never owned a telephone or a television and lived almost entirely off the land.

"He was in his home at the caves at the end, and it was his wish to die there," said Connie Fitte, who lived across the river. "He was the epitome of the free spirit."

Richard Zimmerman had been in declining health when he died Wednesday.

Few knew him by his given name. To friends and visitors to his jumble of cave-like homes scrabbled from a rocky shoulder of the Salmon River, he was Dugout Dick.

He was the last of Idaho's river-canyon loners that date back to Territorial days. They are a unique group that until the 1980s included canyon contemporaries with names like Beaver Dick, Cougar Dave and Wheelbarrow Annie, "Buckskin Bill" (real name Sylvan Hart) and "Free Press Frances" Wisner. Fiercely independent loners, they lived eccentric lives on their own terms and made the state more interesting just by being here.

Read more: http://www.idahostatesman.com/2010/04/23/1164899/death-of-caveman-ends-an-era-in.html#ixzz0m16K3wpQ

Related articles by Zemanta

• Idaho: Man known as Dugout Dick dies in his Salmon River cave home (thenewstribune.com)

Legislation Will Allow New Yorkers to Make Health Care Decisions for Family Members Who Lack Capacity to Decide

Image by erjkprunczyk via Flickr

Governor David A. Paterson today signed the Family Health Care Decisions Act (FHCDA) into law. The FHCDA allows family members to make health care decisions, including decisions about the withholding or withdrawal of life-sustaining treatment, on behalf of patients who lose their ability to make such decisions and have not prepared advance directives regarding their wishes.

“I could not be more pleased to sign this bill into law today as it will help ensure patients receive medical care more quickly and will help avoid unnecessary suffering,” Governor Paterson said. “After nearly two decades of negotiations, New Yorkers now have the right to make health care decisions on behalf of family members who cannot direct their own care.”
Continue Reading

Related articles by Zemanta

• Paterson Signs Law on Making Health Care Decisions (nytimes.com)
• New York State Senate Passes Family Health Care Decision Act (lezgetreal.com)
• A Big Day for Health Care in New York (timesunion.com)

Report reveals struggles of LGBT older adults; solutions can and must be found in our community

Image by bastique via Flickr

by Hannah Clay Wareham

(Bay Windows)The March 2010 report entitled "Improving the Lives of LGBT Older Adults," authored by the LGBT Movement Advancement Project (MAP) and Services & Advocacy for Gay, Lesbian, Bisexual, and Transgender Elders (SAGE), offers a comprehensive examination of the challenges facing LGBT elders today, and an outline of changes that need to be made to improve their quality of life. The most effective change, not surprisingly, starts at home in local LGBT communities.

The AARP’s chief operating officer Tom Nelson writes in the report’s introduction, "LGBT individuals and the LGBT community at-large have a major role to play in determining the degree to which policy and advocacy issues that affect LGBT older adults are given appropriate consideration." Nelson cautions, however, that several of the issues raised in the report -- such as healthcare and Social Security -- need to be addressed on a nationwide scale. The AARP’s (formerly known as the American Association of Retired Persons) participation in the report indicates this cooperation. "While many of the AARP are members of the LGBT community, the issues raised in this report extend beyond our membership and our organization," Nelson wrote. "It is not only a question of LGBT fairness -- the issues raised involve the fair treatment all Americans, and how our society will promote a secure retirement."

The definition of a "secure retirement" may differ from the mainstream for LGBT elders, however. This population, practically invisible until recently, can face struggles and challenges unique to their community. From the effects of social stigma and prejudice to reliance on "families of choice" rather than biological families, problems that have not been accounted for can spring up at any place along the path to a happy retirement.

According to "Improving the Lives of LGBT Older Adults," there are several things that can be done on the levels of community, state, and nation to improve the lives of LGBT elders. Federal marriage equality would ensure that spouses are eligible for their partner’s Social Security benefits, and enable same-sex couples to make medical decisions for one another. Changes in federal and state law could exempt same-sex couples from having to pay inheritance tax on their spouse’s estates (a that tax straight, married couples aren’t required to pay.) Non-discrimination laws could ensure that "family members of choice" are recognized as formal caregivers, and prohibit nursing homes and residential programs from discriminating against LGBT elders.

One of the highest hurdles, however, is the social isolation that many LGBT older adults feel. The SAGE/MAP report revealed that many LGBT elders feel unwelcome in healthcare and community settings, which can result in higher depression, poverty, re-hospitalization, delayed care-seeking, poor nutrition, or premature mortality.

The most reprehensible of situations that causes LGBT elders to feel uncomfortable and unwelcome is also, thankfully, the easiest to fix. The discomfort LGBT senior citizens feel in today’s modern lesbian, gay, bisexual, and transgender communities only hinders their access to a socially positive community that should welcome the bearers of its history with open arms. Many lesbian, gay, bisexual, and transgender older adults are going back into the closet after spending a lifetime (literally) fighting for equality, because they no longer feel they belong in our community. Not only do many seniors feel they don’t have a home in mainstream aging communities, but with us they are "homeless" as well.
Continue Reading

Related articles by Zemanta

• Aging issues tougher for gays (cnn.com)
• Seminar tackles abuse in same-sex couples (cbc.ca)
• Task Force Asks Congress to Amend Fair Housing Act to Protect LGBT (lezgetreal.com)
• A Worthwhile Cause (perezhilton.com)

Voluntary End-of-Life Measures Banned at Catholic Hospitals - The New Old Age Blog - NYTimes.com

Image via Wikipedia

By PAULA SPAN

In the 600 Catholic hospitals and hundreds of Catholic nursing homes around the country, such issues may grow more contentious in the wake of a new directive adopted by the United States Conference of Catholic Bishops.

As Harris Meyer recently reported in Kaiser Health News, the directive establishes “an obligation to provide patients with food and water, including medically assisted nutrition and hydration” for those who can’t eat or drink, and it specifically includes patients in “chronic and presumably irreversible conditions.”

Patients whose advance directives prohibit feeding tubes if they have terminal illnesses or have entered a persistent vegetative state (as mine does) would either have to accept such treatment or transfer to another facility.
Read More

A Mother’s Decision to Die - The New Old Age Blog - NYTimes.com

by Paula Span

I was talking to a woman in Rhode Island the other day whose father is in a nursing home with advanced dementia. Her weary mother had voiced a fairly common sentiment: “When I reach that point, just leave a bottle of pills by the bed.”

Readers of this blog often express the same just-shoot-me idea whenever we discuss topics like increasing frailty, cruel progressive diseases and nursing homes. Sometimes the comments reflect jocular bravado: “My choice, of course, will be to OD on delicious biskits ‘n’ gravy,” Doyle wrote here a few weeks ago.

Sometimes, though, people sound quite serious. “Nature tells us when it is time to go,” Frank in Houston commented. “Sometimes it is up to us to listen to nature and take action.” I found myself wondering if Frank had already made arrangements, or at least started his research.

Expressing such opinions has been much easier and more common than acting on them. The religious and political opposition remains strong. A recent Montana Supreme Court decision brings the number of states where physician-assisted suicide is legal — the advocates at Compassion & Choices prefer to call it “aid in dying” — to just three. (Oregon and Washington are the others.) But even where it’s legal, when competent people suffering from terminal illnesses decide they want to end their lives, such decisions aren’t simple, and shouldn’t be. And their effects are rarely limited to the dying themselves.
Continue Reading