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Wednesday, January 23, 2013

Death with indignity
Posted by Jill | 6:05 AM
During the end stages of my late mother's illness, I did not want to write publicly about what she was going through. But now that she is gone, it can be instructive.

In late September, Mom had an "episode" which landed her in the hospital. Always in denial about the reality that she had Chronic Obstructive Pulmonary Disease, she continued to smoke and only used her supplementary oxyten when in bed. After she had fallen asleep sitting at her kitchen table, she spent the next two days in bed, unable to even speak properly. The following night she went completely psychotic, screaming terrible things and demanding to be taken to a hospital.

As far as I know, she was given only oxygen at the hospital (where she arrived with a blood oxygen reading of only 83%), and within a few days she was coherent again, though the nightmarish scenario she still viewed as real didn't become acknowledged as a hallucination until a week later.

After two months in an assisted living residence (which she hated), Mom went back home and died 36 hours later, peacefully, in her sleep.

In the last few months of her life, there had been a few times when she had found herself having panic attacks, unable to catch her breath. This is characteristic of COPD patients. My sister had arranged entry into a hospice program for her, but when she proved too "healthy" for inpatient hospice, she began as an outpatient. For all that Mom had suffered from severe depression her whole life, she clung to her incapacitatingly miserable life. What she had described ini September seemed that she had gone to the brink back then and then decided she wasn't ready yet. But by the time she came home, once again incoherent, unlikely to improve significantly, I think the antianxiety meds that hospice provided allowed her to let go and pass quietly.

This was such a blessing, as we had had nightmare scenarios of Mom, always a wuss about discomfort, screaming in terror as her damaged lungs and heart gave out. Hospice was able to provide her with at least some measure of comfort and dignity as she ended her journey.

For those in Louisiana, who may be poor and also dealing with a terminal illness, exiting will not be as painless as it was for my mother. Because 2016 GOP Presidential wannabe and Teabagger Darling Bobby Jindal, has decided that death with dignity is only for those who can afford to pay for it or those fortunate enough to live in communities that have sufficient funding to pay for indigent care:
he has authorized elimination of the state’s hospice program for Medicaid recipients. According to a local New Orleans news station, Louisiana residents over the age of 21 will stop receiving hospice benefits at the end of the month. As of February, low-income Louisianans with terminal illnesses and disabilities will lose access to long-term home and medical care.

The Louisiana Department of Health and Hospitals defends this as a cost-saving measure: Over the next two years, Louisiana will save $8.3 million by ending state-funded hospice care. But that’s a paltry sum compared to the state’s $900 million deficit. And in the same way that raising Medicare eligibility increases costs by moving seniors into more expensive private insurance plans, these cuts will, in the end, place a greater burden on the state, as low-income Louisianans turn to nearby hospitals and ICUs, shifting the burden to localities.

In isolation, it’s a disaster of a plan. When coupled with existing cuts to education and a large tax increase on the bottom 80 percent of Louisiana residents, it’s a catastrophe. Indeed, Jindal seems devoted to engineering a Louisiana that works little for its most vulnerable citizens, and does as much as possible to satisfy the wants of wealthy, entrenched interests.

It's one thing to buy into this notion of "makers and takers." It's one thing to fancy yourself to be a religious man, walking around with an aura of faux-piety, and decide that terminally ill poor people can die in excruciating pain, or gasping for breath, if already-strapped localities can't foot the bill.

Whether Barack Obama follows through on his inauguration speech is yet to be determined. But in his speech, which Republicans quite rightly saw as an attack on their cold-hearted social Darwinist agenda, this is what he was talking about. We do have an obligation to care for those unable to care for themselves. Hospice is part of that for end-of-life care. And no one who would cut people out of hospice deserves to ever invoke any kind of deity again.

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Blogger dianedp said...
I extend to you and your family my deepest sympathy.

Your story sounds eerily familiar.
My mother was not as depressed by as yours. But she was in denial about her COPD.
Her death was peaceful. She was hospitalized several times and faced two major surgeries.
She died in the hospital. Not where she wanted, but there was nothing we could do about that.

I am so sorry for the people of Louisiana. The politicians will not save money at all. There are several studies, some done by insurance companies, which show that people, and their families, have less hospital and ER admissions. Hospital care is much more expensive then the hospicae care they are denying their citizens.
Hateful republicans. Distainful of the poor.

Anonymous Syrbal/Labrys said...
I re-blogged you to Wordpress on this....the incredibly callous nature of the Republicans continues to plumb the depths of human nature....like an automatic mining machine.

Blogger Phil said...
Hospice care givers are a God send.
The alleged saving Jindal hopes to see are going to come at a horrific price for those too sick to do anything about it.

Grayson was right, if you are going to get sick, die quickly.

Bobby obviously has not seen up close and personal what the end of life can do not only to the person who is terminally ill but to entire families who are along for the ride and helpless as newborns to do anything to help ease the suffering.

This is an unnecessary tragedy.

What a heartless fucking scumbag.

Blogger The New York Crank said...
Since nobody's getting out of here alive, there must be millions of Americans who can, on the basis of first hand experience, empathize with what you went through. I am among them.

Withdrawing comfort from the dying is one of the cruelest ways to pinch a penny I can imagine. This, along with cuts to education, and to infrastructure, and to the social safety net, are a form of criminal sabotage. Had enemy agents done a tenth as much damage as people like Louisiana's governor are doing, they would be in Guantanamo, awaiting trial for capital crimes.

Very crankily yours,
The New York Crank