The Cost of Dying

Honesty around medical costs in the coming months and years is going to be hard to come by. This report from 60 Minutes hit home, particularly given our recent loss (Granny Boone):

Granny specified how she wanted to go. She did not want heroic measures and she died on her terms; her family abiding her wishes. She passed quickly, beautifully and with dignity. Having a living trust, with everything spelled out and appointed powers of attorney saves you and your loved ones from the burden of making quick, wrenching decisions.

I love the tone of this piece. Too many people are not up to having the hard conversations about dying and death. It’s a fact and it’s expensive if you don’t specify how you want to die and what measures you want people to take. It’s expensive even if you do specify, but the question remains, would you want to die in an ICU or at home? Or a more home-like place?

  • Kristan

    (“Passed” not “passes,” I think.)

    “Too many people are not up to having the hard conversations about dying and death.”

    It’s so true, and rather unfortunate. Even at age 24, I’m finding myself frustrated with the way people avoid talking about death (or really, what happens after). My parents are both older, and I don’t want to be morbid, but I also don’t want to be unprepared. Frankly, I think starting at about 25 (when people probably start having anything of their own worth mentioning) everyone should make a will and then update it every 5 yrs after. I certainly plan to. Yeah, it’s no fun to think about, but it’s the responsible thing to do.

    (Note: I don’t necessarily think my way is the ONLY way to be responsible. It was just an example.)

  • Happydog

    I couldn’t agree more about making sure your family is aware of your wishes. Because my Dad is so independent and was sure he would never die–he kept refusing to let me arrange for the power of attorney for him and my mother–and I’m an ONLY CHILD–who did he think would have to make all of these decisions?
    Needless to say the crisis did arrive–and in the last 8 weeks my husband and I have had to deal with both parents in the hospital, my Mom died…so a funeral had to be arranged (thank goodness we knew she wanted to be cremated!) had to move my Dad to a secure facility due to dementia and being deemed incapable of looking after himself by the medical people, I quite my job, my husband and I moved from our beloved British Columbia to Edmonton…Alberta…which is like moving from beach front property in Malibu to the middle of Utah..(not that there’s anything wrong with Utah…I’m just sayin’) we have to clear out my parents house of 45 years (and they were hoarders…like the show on A&E hoarders..), we have to sell the house…all without power of attorney or any really ’legal’ authority except for the fact that as an only child that does allow most of the people I’ve had to deal with a way to cover their ass…no difficult siblings to contest the decisions we’ve made. I do however have to go the more expensive and difficult route of trusteeship if I want to sell the house, have access to Dad’s investments (to pay for his care) or even deal with tax issues.
    So yeah it is definitely the responsible thing to deal with this stuff because for sure someone will have to make these decisions.

  • nobody

    I am sorry for your loss.

    What you say is true, and we would do well to foster a less desperate approach to death.

    But there are powerful reasons for the reticence to discuss the topic. Too many people arrive at death without much of a home to die in, and with too much that they still wish they had done. These things aren’t easily achieved — I daresay Grannie Boonie worked very hard at raising and helping and loving. And I’ll take advantage of anonymity to note that not everyone lives their life that way, and they pay a price at the end.

    If you squander your life, death will be frightening. At that point, medical bills and discomforts are the least of your problems.

  • Ms. Moon

    HOME! No tubes, no wires. Just my sweet family’s arms. And oh yes- morphine.
    I have been to births and I have been to deaths. They are the same if left alone to happen as they should.

  • meowsk

    Even though I am relatively young this is something I think about a lot. Waking up to a million dollar medical debt or in a vegetative state scares me more than death. I have considered obtaining a DNR to stop this from happening but I doubt any attorney would be willing to help a 26 year old obtain something like that. My husband and I also have a pact that if either of us ends up a vegetable we will pull the plug. We should probably have power of attorney set up for these decisions since they are out of the ordinary given our ages but I have no idea how to go about that and am scared of the cost.

    Not to sound morbid but I just feel like this world already has a serious overpopulation problem and I don’t want to contribute to that by staying alive when I was supposed to die. And living with a disability combined with a massive amount of debt just doesn’t fit my quality of life standards.

  • carmilevy

    We lost my dad two months ago yesterday. Although he died suddenly, and at home, death was not something either he or anyone in my family ever felt comfortable discussing.

    Not that there’s ever any way to make it easier – it wasn’t, and 12 years of watching him get sicker did nothing to prepare us for it – but I often wonder if things might have been slightly more, I don’t know, comfortable had we all taken a little more time to explore the topic in advance.

    Human nature, I guess. Either way, may we all know only happies in future. This loss thing is really tough to bear.

  • steve-o

    End of life care has always been an issue with our country’s medical care. In general, most of the expenses you will have as a medical consumer come from the last 6 months of your life.

    It would have been interesting to get a doctor on camera to explain why he/she did all the tests etc, but I do think it would boil down to covering their ass. My father-in-law who is a general practitioner would also agree with that statement.

    He also would put a lot of blame on higher medical costs on nursing homes etc. According to him, they are the worst bunch. Often times they will turf patients to the hospital so they can free up a bed when the patient has only minor issues. Also, the in house doctors routinely ignore the care instructions from the general practitioners who have been meeting with the patients for the longest time and know the patients wishes.

    It is interesting though to see the talk returning to rationed health-care making it’s way back into the foray. When the discussion was first brought up, there seemed to be a lot of promises made that there would be no rationing of health-care. But finally the truth emerges. There is not enough money to NOT have a rationed system.

    While death panels are a tasteless way of describing what ultimately has to happen, the truth is that someone has to make the tough decision of what will be paid for and what will not.

  • Happydog

    Yes, steve-o….someone has to make the tough decision…and wouldn’t you rather have that be your family and not the government?

    • steve-o

      I completely agree. Which is why I’m not in favor of the government option.

      • makfan

        Don’t you think the current system of rationing, which leaves a whole lot of people with no option at all, is worse? I’m talking about people who work lots of hours but don’t receive any health insurance through their jobs. This is disgusting to me and if it means I have to forgo expensive cancer treatment in my 80s, I’m fine with that. Really.

  • Coelecanth

    My 79 year old mother has a DNR. She worked in hospitals her whole adult life and she’s seen now people who’ve been saved by heroic measures usually end up. Not pretty.

    I’m worried though. My brother has all the legal authority should my mother become unable to decide for herself. He’s a fundamentalist Pentecostal, my mother is a new-agey Anglican. According to him she’s going to hell. I really hope her DNR trumps his power of attorney if it comes down to it. I can see him ignoring her wishes in order to get a last crack at converting her.

  • HDC

    Everybody should have living trusts with end of life requests clearly spelled out along with wills. And make sure your family knows you have them and give them copies! My entire family has these.

    My 73 year old grandmother has buried all of her siblings and parents, none of which had wills or living trusts. What an absolute headache it was for her and such an unnecessary burden. We’ve all learned that the hard way.

    A slight aside, my local paper had an absolutely touching story of a family’s burial of their father. This is a great insight into how openly accepting and coping with a loved one’s impending death can be deeply rewarding.

  • rena

    This post struck a chord with me. I work in hospice. Every day that I go to work, I think about how beneficial end-of-life care is…and how difficult this most important stage of life is when people don’t have the help and support they need.

    In our culture, death is not embraced, and thus, it isn’t talked about. Too often, people are in crisis before they begin to think about what they want. I don’t want to repeat what has been said before, but it is SO TRUE that death, when handled correctly, can be a much better experience than people think.