Using Grandma: Taking Unfair Advantage of Illness in the Elderly

Last week, I wrote about a patient who passed away peacefully after his family made the decision to disconnect his life support.

This week, I’m sharing the story of less fortunate patient. A 77 year-old woman had a major heart attack about 10 months ago. She was fairly sick before this due to diabetes, and the damage from her heart attack was so severe that she began to have failure of her other organs one by one. At first, she could not get off the ventilator, and then she required dialysis because her kidneys wouldn’t work anymore. She needed several surgeries to insert catheters for dialysis as well as a permanent breathing tube and feeding tube.

I was called to see her because of a pressure sore she got from lying in bed so long. She was so weak and sick that her skin and muscles were literally rotting.

Unfortunately, she required several painful surgeries to remove the dead tissue, and despite the medical team’s best efforts, she was so ill that she had no signs of healing despite months of intense treatment. Throughout all of this, she was awake enough to know what was going on and complain of pain, but not awake enough to convey her wishes to us about how aggressive she wanted her care to be.

The medical team spoke with her family several times about how much she was suffering and how little chance she had of recovering. Despite our conversations, they insisted that everything be done.

Meanwhile, I can count on one hand the number of visits the family paid to her while she was ill. Last week, she passed away, and the family was very angry. I assumed it was because they were upset with the loss, but I later found out it was because they could no longer collect her social security check.

I have seen this situation happen so many times, and it makes me feel helpless to think about poor elderly patients who are living our their final months in pain, suffering through futile treatments so their families can collect money. As a society, we need to open a discussion about how to handle end of life care decisions since patients’ families are not always the best suited to make those decisions.