Are you afraid of dying, and does that factor into your willingness to pay absurd amounts of money to keep yourself/loved ones alive? Why do we value "life" in quantity rather than quality when it comes to old age, even though as Mustachians we generally look at life-time in quality - hence our desire to strive for early retirement? The enormous sums set aside for medical care in old age seem to be at odds with this general outlook.
I've seen enough dying to no longer be afraid of it, but I'm beginning to think that it's inevitable. It might even happen to me one day.
I value quantity because every day of it gives me another opportunity to raise the quality. Perhaps my attitude might change in the face of chronic pain or a terminal disease, but even then I think I'd be curious to see what the next sunrise looks like. I don't think anyone knows until they get to their breaking point, and by then all you can hope is that someone can fetch your stockpile of Percocet and maybe a nice bottle of cabernet sauvignon.
As for the "enormous sums", how would one be frugal with medical spending? It all depends on whose grandmother is being treated. You go first.
Everyone will likely have a personal and emotional reaction to this, but please hear me out. This is the first time in human history where we have been able to artificially prolong life past that individual's ability to fully participate/appreciate/contribute (I couldn't find the right word for this) - both to society and their own life. But at what cost? We are spending hundreds of thousands of dollars on the elderly so that they can putter around, have someone change their diapers, and treat "old age diseases". What happened to accepting old age and death with grace?
My Dad's been living with Alzheimer's since late 2008 but insisted on living independently (as Alzheimer's patients often do at first). He finally moved to a care facility in March 2011 after his literal near-death experience with a perforated ulcer. He spent the early part of 2012 dealing with chemotherapy for multiple myeloma (so far so good) and he's currently deep into mid-stage Alzheimer's symptoms.
Yet for perhaps the first time in his life... he's happy. I don't mean tap-dancing-in-the-halls high-fiving happy, but "content", "relaxed", "mellow", "not worrying about the future", and "at peace" happy. If it took disabling his hippocampus and wiping out 50 years of memory to help him achieve this, who am I to argue? Every day he's thrilled to discover that the care facility takes care of his cooking, cleaning, & laundry. Every day he's thrilled by the surprise of one adult child visiting him and learning that the other is taking care of his finances. He's tremendously relieved that the facility "lets him work there and stay over on the weekends" so that he doesn't have to figure out how to find his home. He loves walking the grounds and hanging out in the sunshine with the squirrels & birds. Dad's life is just like Bob DeMarco's Alzheimer's Reading Room blog. It seems pretty good. We're also beginning to realize that he may have been chronically depressed for most of the last 25 years. So what if this is literally the best part of his life?
I'm curious how others feel about this. The current system is unsustainable, but it seems like few people are willing to "sacrifice" their own futures. Personally, I think I am. I have no desire to be kept alive by machines, wish assisted suicide were socially acceptable, will sign a DNR when I feel it is time, and while I will plan for increased medical expenses in my older years, I do not expect to have the same level of care given to the current crop of senior citizens. I love life but don't fear death like most people seem to, so I genuinely don't understand the "keep me alive at all costs to myself, my family, and society" view of most.
On the practical side, Dad's been signing DNRs for over two decades. My brother and I were willing to go along with his chemotherapy the first time, and Dad came through it like the iron man that he used to be, but he can't handle that again if the myeloma comes out of remission. He wouldn't be able to endure the physical or emotional stress, and the chemo would cause more pain & suffering than the hospice. However last year's chemotherapy was definitely worth having the additional year of his life, even if he can't remember any of it.
The book "When The Time Comes" is an excellent read about families coping with this decision. (
http://the-military-guide.com/2012/02/09/book-review-when-the-time-comes/) It turns out that the current system is more sustainable than the media claims, because more families are stepping up with home/assisted/respite care. Nursing home populations are actually dropping even as the Boomers are "aging in" to this phase of life. More doctors are comfortable with DNRs, and hospice is accepted as the next step instead of an admission of failure.
If (or more likely, "when") Alzheimers affects my cognition, I'll probably be a happy patient. I'd like to think that I'd be able to continue surfing as long as I'm able, and hopefully I'll be able to enjoy some kind of media-- the Internet, reading, movies, or music. I'll buy a long-term care insurance policy in the next 10-15 years, and I'll self-insure whatever exceeds that. However I doubt that I'll be aware of the time when I can't handle my activities, let alone my finances, and I'll probably continue to be a happy guy until I die.
The real stress and difficulty will be borne by my spouse and daughter, but I'm not sure that my euthanasia would be regarded as a socially acceptable means of easing their burden. My spouse and I will probably continue having that conversation until I'm no longer able to remember having it... or until she brings me a nice bottle of cabernet sauvignon.
