The biggest problem I run into with taking care of my 92-year-old mother is that doctors overemphasize the mortality risk and underemphasize the morbidity risk. Whenever doctors tell my mother some procedure has a 10% chance of killing her she puts a thumbs up and says “Sold!” No matter how many times I warned them not to do that, they just can't avoid this blunder. The docs just can’t seem to understand that for many old people mortality risk is an attraction! They’re thinking, “hmm…death by doctor…that sounds good”; the same way deranged criminals prefer “death by cop” over prison time.

Typically any procedure with a high mortality risk has an even higher morbidity risk, but it's like pulling teeth to get a doctor to emphasize the morbidity risk; to say something like this, “ In order to live a few months longer with somewhat less pain, I want you to let me do something to you that could cause your mind to be weaker than your 2-year-old self, make you confined to bed all day waiting to be fed pureed food since you can’t focus enough on chewing to not choke, spend most the day staring at the wall since you can’t make heads or tails of TV anymore, and just waiting for someone to come around every two hours to check your diapers. Oh, by the way, your family will have to shell out thousands of dollars every month for the privilege of not having to be the ones to change you. Oh, and by the way, there is also a slim chance that I might kill you instead, but otherwise you might live longer.” If they present the truth this way, they certainly won’t get as many takers!

I encourage anyone who is a parent’s primary caretaker to refuse to support any procedure with a significant morbidity risk. Though legally you don’t have the power to make your parents say no, and other family members will lean on you to go ahead, stay strong and just say no. Say to the other family members, “If you want Mom to get this surgery, then YOU put in the time to wheel her from hospital clinic to hospital clinic through the pre-op work, YOU make sure the transfer to skilled nursing rehab goes smoothly. YOU take care of the move back home. And most importantly, YOU pay for the cost of extra care if Mom suffers an early loss of capacity along with the promised increased life span because I prefer to just let nature take its course, and I think if Mom was in her right mind she would prefer that as well! But since the damn dummy of a doctor already sold her on the attractive idea that he can kill her then you just go right ahead and make that surgery happen, because I’m oping out!”

SGI Buddhist, Loves Irish and Latin American Literature, History buff, knows a great deal about Medicare

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