Ok. I have to post this here…

[Crackpot]

….as it has potential for blowback (fucking autocorrect) if someone doesn’t see the humor in this.

My wife works as a hospice nurse. Today she told me of a patient with dementia she was seeing today. She saw a bottle of vodka stashed under his bed and she asked him where he got it. Apparently this guy sneaks out of the nursing home with his walker and a 45 degree lean in his back and walks a half mile trip to the liquor store and buys his vodka along with a bunch of vapes that are “ordered” from other patients at the home (found those too). Apparently he also “shares” with some of the nighttime staff. And if they get questioned about it they’ll just say “he’s got dementia he doesn’t know what he’s talking about”. My wife told him that he shouldn’t be mixing his morphine with alcohol. he said “I’m dying anyway”. He then asked for some extra oxycodone as “It really hurts to make that trip”.

[Burning Petard]

I would like to know more about this person. He demonstrates an indomitable spirit and passion, plus readiness to help others.

snailgate

[Joe Guy]

I'd give him the oxys and tell him to cut back on the vodka.

[Big RR]

I agree with BP; and FWIW, it's likely he is dying anyway, so I'd let him be happy for his last days. I know nursing facilities have some liability, but I wish they didn't; when my (step) grandfather (an alcoholic for years) was dying, my grandmother let him drink what he wanted--when he went into the hospital, he went downhill fast. Why not let them be comfortable? They'll never be walking out the doors.

[BoSoxGal]

The vast majority of people are ridden by their demons unto the end. I suppose there is some dark humor in that.

[Big RR]

BSG--Humor? I don't know--I can't see it. In my view, we have two choices--we can continue to take away the choices of people as they age and become debilitated, or we can work with them and assure they go into "that good night" the way they choose (and, perhaps, the way they lived"). Pumping them full of drugs to extend their life regardless of their feelings, and then denying the the basic "pleasures" they crave is pretty inhuman.

Face it, we will all be facing it soon; how much control should the individual (even a mentally compromised one) have over his or her life? Maybe I've lost my sense of humor about it as I'm approaching that stage of life, but I see no humor at all in it.

[Crackpot]

My dad who has been sober for well over 20 years now has said that when faced with impending death: he wants a drink.

[BoSoxGal]

BSG--Humor? I don't know--I can't see it. In my view, we have two choices--we can continue to take away the choices of people as they age and become debilitated, or we can work with them and assure they go into "that good night" the way they choose (and, perhaps, the way they lived"). Pumping them full of drugs to extend their life regardless of their feelings, and then denying the the basic "pleasures" they crave is pretty inhuman.

Face it, we will all be facing it soon; how much control should the individual (even a mentally compromised one) have over his or her life? Maybe I've lost my sense of humor about it as I'm approaching that stage of life, but I see no humor at all in it.

To be honest I don't see a lot of humor in it, either.

As far as being a hospice worker dealing with the drunken behaviors of alcoholic patients, I entirely understand why most medical professionals won't enable states of uncontrolled intoxication at the end of life. Nobody is pumping hospice patients full of drugs to extend their lives - they get pain relief and little else. If medically controlled pain relief isn't 'enough' and the patient wishes to be obliterated on ethanol, that's not the duty of the medical professionals to facilitate. It is not 'inhumane' for medical professionals to refuse to facilitate those behaviors.

If that's something you want and expect for yourself, you need to make a plan with family members who are willing to deal with the abuse, vomit, shitting the bed etc. that comes of choosing that 'good night' for yourself.

[Big RR]

Good hospice care does approach the end of life and help ease the progress of the patient towards that; but I have also seen nursing homes (and worked in a couple while in college) where people are kept alive due to the wishes of the family (not them) so long as the bills are paid. As for alcoholic--sure some are blotto, but others use controlled amounts to approach their lives and function normally and I'd bet that's just what this guy is doing--i seriously doubt he's going to the liquor store every day and downing bottles of vodka at a time. But the medical establishment has its drugs of choice (and morphine, while it can relieve pain for many, is no picnic as I imagine you have seen--many do suffer considerably from the pain management treatments (and let's not even talk about oxycontin).

Hell, alcohol aside, I recall my dad being in pain around the end of his life getting more or less forced pain medication even though he didn't want it (and when I talked to the doctor he said something like 'If you don't like it, get anther doctor " (we did). Every patent is different and should be recognized as such, but our medical establishment doesn't want to do that preferring the one size fits all assembly line. I think people deserve better and should have some control over their end of life.

[BoSoxGal]

I think people deserve better and should have some control over their end of life.

On this we wholeheartedly agree.

End of life care in this country is a hot mess and very little time goes into researching or teaching on the subject - much like women's health.

We need much more education in medical schools and in public health messaging around end of life care. We need a national conversation about death with dignity. We need federal and state legislation on MAID.

Most Americans seem fixated on denying death until it happens or is undeniably imminent.

[Big RR]

Most Americans seem fixated on denying death until it happens or is undeniably imminent.

And often those who don't and say they are ready to die are labeled as suffering dementia (or suicidal).

One thing I think helps this is that many times availing oneself of an institiution (a hospital or nursing home or residential hospice) often requires you to accept a new doctor you have never met before to coordinate your care (e.e. the "hospitalist"); ypu may still have your own doctor who will be consulted, but the decisions off the new physician carry a lot more weight. I personally know people who had their drugs changed and treatment protocols disrupted by the hospitalist for chronic conditions unrelated (or tangentially related) to their admission (and suffered some problems until their doctor restored the old prescriptions after discharge). It's a problem, because many of us develop a relationship with a doctor and then are at the mercy of a doctor they never met before (unless you want to sign AMA sheets and leave); indeed, it's similar to what happened to my father when he was in hospice care in a nursing home--we had to transfer him after finding a doctor who thought his orders were from on high. Sure, this is economically "better" (and likely makes more money for the institution, but it would be better for the patent who has been seeing the doctor (often for years) to be treated by him or her but that care is sidelined in favor of making money.

[Crackpot]

This story really helped Me out. Over the last month or so I've been dealing with a father who broke his leg and received an accompanying mild dementia diagnosis and dealing with assisted living for a man who has repeadedly mentiond his desire to be independent. That coupled with his youngest cousin (61) having a sudden heart attack coupled with a stroke which resulted in a relatively sow death over a eeek due to the leading treatments for both being directly contraindicated by the other.among a plethora of other things. (for example the third thing on this list was my wife (a medial professional (it you know you know) checking herself into the ER for an irregular and racing heartbeat and being admitted overnight with negative but still undiagnosed results) To say my life has been stressful lately would be an understatement. Hearing that this guy is out there making the most of what he has left was enough to snap me out of the funk I've been in. I've seen in my dad the positive effect that regular personal contact can have in improving ones mental condition and the lengths this guy goes to maintain those bonds (regardless of ethics) helped remind me that we need each other far mor\e than than our desire to separate ourselves from each other.