Karolyn Gomes – RN

I spoke with Karolyn from the Berkeley Pine’s long term care center today. Karolyn has been working in the healthcare industry for about 10 years so she has experienced many instances where having a plan in place would have resolved some serious problems.

At her facility, the nurses encourage patients to  fill out an advance directive form but most people post pone this until it’s too late. She was kind enough to share three stories which really highlights the importance of a medical directive.

 

story 1:

Several months ago, there was a residence in her care who did not have a medical directive. Her kids who became the de facto decision makers of her care wanted to keep her alive for as long as possible. It turns out that the kids were living in her home and cashing her social security checks. Social security pays about $2000 a month and medicare cover $3250 a month for the patient, so the children were motivated financially to keep her alive. The care facility wanted to stop treatment but they were obligated to do whatever necessary to keep the patient alive even if it meant ordering unnecessary procedures or sending her back and forth to the hospital (something that is very expensive). The nurses ended up filing a report to an ethics commission on the grounds of financial abuse. It was very unfortunate that “she [the patient]  no longer had a choice because her family was making the decision.

story 2:

There was a patient not too longer ago who had entered the facility with a massive stoke. He was comatose, on medication, and ate through a feeding tube. His condition was so bad that what came out the feeding tube was almost the same as what came in. His body had deteriorated to a point that it could no longer take in nutrients. His family could not let go so they insisted that the facility do whatever is necessary to keep him alive. His daughter prayed for a miracle that the nurse do not think is possible. None of his sons wanted to be the one to pull the plug on their father.

story 3:

Story number 3 comes directly from Karolyn’s family. A couple of years ago, her mother-in-law was admitted into a long term care facility. The mother’s son (who is her husband) and the patient’s husband wanted the best care for her. In their case, they avoided the conversation of medical directives because it is such a terrible topic to talk about. Even though Karolyn wanted to intervene on behalf of her mother in law, she couldn’t because the family did not want to cause turmoil so they avoided the topic and the care facility was forced to give unnecessary treatments.

Other takeaways:

The California advance directive information is freely available on the web.

When people go to purchase a funeral plan, make sure that it is put in a trust so that it is not considered an asset by Medicare. They deduct your burial plots from your Medicare benefits if you do not put it in a trust.

The web design was very good. The colors were not distracting to seniors. However, we should have a feature to enlarge the website so that people with poorer eye site can easily adjust the size for readability purposes.

-Doanh

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