00:05tonight on front line Americans 85 and
00:09older are now the fastest growing
00:11segment of the population
00:13I remember being repulsed by wrinkles
00:17and gray hair and now they're just a
00:20part of life medical advances have
00:23enabled us to live longer but not always
00:25better another bypass surgery another
00:28transplant nobody's bothered to think
00:31about what the repercussions are of
00:33trying to keep people alive longer and
00:34longer with such a limited ability to
00:38it's an economic as well as a human
00:40Demand on strap middle-aged and middle
00:43class families they're still caring for
00:46their children when they're also caring
00:48for Mom and Dad but this is really a
00:50story about confronting the inevitable I
00:53keep trying to fix things and even
00:55though my head says I can't your heart
00:59your heart wants to fix everything and
01:01coming face to face with our own hopes
01:04and fears about living old I like life I
01:10but that is not to me
01:37I'm Estelle strongen
01:41I was born on May 30th 1911.
01:44which of my arithmetic still serves me
01:48makes me 94 and a half
01:53all right so who else has it who else
01:56I'm what was once called a stockbroker
02:02today we have the rather elegant title
02:06of financial advisor all right by 500
02:09holx for a2836 and I still even though
02:13I'm 94 I still have Ambitions and one of
02:17them is to do the job well
02:21I know we're chasing it but they missed
02:23it so we're gonna chase it
02:27I was never one of the people
02:30to be horrified as the decades passed
02:34except I have to admit that 90 was a
02:37little intimidating I thought 90 meant
02:42and I'm a little surprised that it
02:4999 years old I'll be 100 in two and a
02:56how's that feel to almost be 100
03:03no never never did I think I'd live so
03:06long I couldn't even think about ever
03:09living so long I I you know a little
03:12frightened I don't know I don't know
03:13anybody who was handed
03:15is there a change is there change yet
03:21we're on the threshold of
03:25the first ever Mass geriatric society
03:28and it is in many respects really a
03:31wonderful time to be old because people
03:33are not only living longer but they're
03:35living healthier into their 70s 80s in
03:38some cases even into their 90s
03:40that's the good news
03:43the bad news is the price that many
03:46people are going to be paying for this
03:48extra decade of healthy longevity is up
03:51to another decade of anything but
03:53healthy longevity in fact more and more
03:56people are living long enough to suffer
03:58from the as yet incurable diseases of
04:18I think the biggest issue facing the
04:20population of patients is loss of
04:24you begin to learn that not everyone has
04:26cancer not everyone has Alzheimer's or
04:28Parkinson's but almost everyone loses
04:36and by function I mean it could be
04:38something as simple as slowly worsening
04:41or really bad arthritis in one knee that
04:43makes it harder to get around
04:47people want to live longer but they want
04:50to live longer in the self that they
04:51have at that moment and so if there was
04:54a way that we could keep you in your 40
04:56year old body until you were 100 and
04:58then you drop dead that would be a major
05:00medical advance but unfortunately as
05:02time goes on these chronic diseases take
05:15gradual loss of one's bodily Powers
05:17really our preparation for some of these
05:21long-term conditions of enfieldment and
05:27I want you to just simply tell the truth
05:31it no one wishes that for oneself or for
05:34one's loved ones the question is it's
05:38here if it's not going to go away how
05:41can we still make something out of it
05:52okay I'm going around here over the next
05:5530 Years the number of people over the
05:58age of 65 will actually double to the
06:01point that they're about 20 percent of
06:02our population about 70 million people
06:04that's Chiller yes ma'am excuse me years
06:08ago people died of pneumonia and flu and
06:12tuberculosis infectious diseases and
06:15we've become much better at treating
06:16these sorts of things and now people are
06:19dying of their chronic diseases
06:21things like high blood pressure
06:23hypertension heart failure stroke
06:26diabetes these are all things that
06:28require management over time
06:31now we're dealing with older folks who
06:34have multiple chronic illnesses
06:36but are still kind of able to maintain
06:38their status quo but any little
06:40something's going to tip them over
06:44you know it's that uh Frailty where
06:48anything happens on top of it you you
06:50expose all of the underlying disease and
06:52disorder that was kind of masked by the
06:54other systems that we're compensating
07:03is our system is set up to treat with
07:06procedures and it's not set up to treat
07:08chronic diseases and to take time to
07:11figure out what's going on where do you
07:13want me to go I want you to have a seat
07:14right over here oftentimes you can't get
07:16to the heart of the problem on until 15
07:19minutes into your conversation and with
07:21the way Health Care is today you may
07:24only have 15 minutes for your entire
07:34you have terrible what do you read
07:37yes what's happening with the urine I
07:39didn't know I make wet
07:43you can't hold it in no
07:46how long has this been going on for for
07:49like a few months or just a couple weeks
07:56does it happen every day
07:59yeah let me close um
08:23if I can't that's okay it's all right
08:26it'll come up it'll come up don't worry
08:31don't forget to use your cane
08:34the number of geriatricians right now
08:37that are in a training program for
08:38geriatrics and a two-year program
08:40the number that are in their second year
08:42that started this year is about 50. you
08:44know so it's nothing you know it's
08:49so one out of five people are going to
08:51be older adults and there's not really
08:53anyone trained to care for them
09:01with fewer doctors now available to care
09:04for the rising number of elderly many
09:07worry we're on the verge of a national
09:11nobody's bothered to think about what
09:13the repercussions are of trying to keep
09:15people alive longer and longer
09:18another bypass surgery another
09:20transplant without anyone worrying about
09:23how do you get them Physical Therapy
09:25will they ever walk again can they
09:26swallow their food you know it's not a
09:29very thoughtful way I think of providing
09:34medicine has changed I think
09:37in terms of the technology that's become
09:39available and the fact that we can
09:40diagnose people and we can treat them
09:42and we can cure them in some instances
09:44the problem I think is that the pendulum
09:49and so the focus over time became
09:51predominantly diagnosed treat cure good
09:55morning how are you Dr janowitz even
09:58when there's nothing quote unquote
09:59medical to do you still need to be there
10:04as more and more people are becoming too
10:07frail to leave their homes many doctors
10:10are once again making house calls good
10:16David Mueller one of the founders of
10:19Mount sinai's visiting doctors provides
10:21Medical Care to a growing number of the
10:23city's homebound elderly I was going to
10:25write in some notes I can at least say
10:41for the past three years Henry genowicz
10:43has been wheelchair bound
10:45a former physician he is now nearly deaf
10:48and has severe arthritis
10:58how about your knees
11:09each of us whether we're in the baby
11:10boomer generation or not as parents and
11:13we watch our parents get a little bit
11:15older and even if they're relatively
11:16healthy and functional you sort of see
11:18the Slowdown and you anticipate you try
11:20to plan ahead for being able to be
11:23around and care for them and at the same
11:25time you've got a family of your own and
11:26kids and a job and career aspirations
11:30and so it's an unavoidable part of life
11:33and I haven't figured it out for myself
11:35either as far as my parents are
11:36concerned I'd like to believe that you
11:38know I'll be there and be available for
11:40them whatever they need and whenever
11:42they need it but I don't know if that's
11:43really going to be the case
11:46what are their expectations of you do
11:48you know have you had those
11:51um we've had the beginnings of those
11:52conversations probably mostly because of
11:54the work that I do I think their
11:56expectations are very typical and very
11:58traditional none zero you know they
12:02don't have any expectations that they'll
12:04move in with us that don't have any
12:05expectations that we'll have to do
12:07anything extra for them they don't want
12:09to be a burden they'd like to stay
12:18Dr janowitz is a widower and his
12:20daughters live too far away to be
12:22involved in his daily care
12:24so he pays 150 000 a year for the
12:2824-hour help that he now needs to stay
12:35care has gone up because
12:38we have so many Medical
12:41procedures now and interventions that we
12:46often they're you know really complex
12:48things going on that have to be done in
12:51the home hi good morning
12:54so it's become much more complex it's
12:56not just taking blood pressure and
12:58filling up medicine box
13:05how's she doing today
13:13how you doing I'm just doing okay I'm
13:17Lillian the nurse yes
13:19I came to check your blood pressure and
13:21do your dressing on your leg all right
13:26okay I just got to lift your leg a
13:28little Mrs Enoch okay
13:33whatever time the person has left
13:37be the best and most comfortable that it
13:39can be because a lot of these things
13:41have been going on for years and years
13:43and years and they're never going to go
13:45and everybody has the fantasy of dying
13:47you know by just going to sleep and
13:49everything you know not not feeling
13:51anything and everything's great
13:54you just don't wake up
13:55but it doesn't always happen that way
13:58sometimes people live a long time with
14:02serious serious problems
14:18nearly two years ago Ontario payaroso
14:21was sent home from the hospital with a
14:23tracheostomy and a feeding tube
14:25but even with the help of two homemades
14:28paid for by Medicaid his daughter Carmen
14:31still quit her job to care for him
14:41she gives him is really expert care I
14:47she hasn't had medical training but
14:49she's learned everything about his care
14:52to the nth degree so she knows how to
14:55take care of all of the equipment that
14:58he has she knows how to feed him she
15:00knows how to take care of his skin how
15:02to take care of his trachea
15:08I think about it I mean
15:11it's a one-to-one caregiver patient
15:14relationship 24 hours a day seven days a
15:19you can't get that in any institution
15:21that he just never would have been taken
15:50some people feel that their kids are
15:53their race in the hole they'll take care
15:56it's not always the case
15:59I don't have kids for instance
16:04I really seriously have to think about
16:06what's gonna happen to me when I get
16:09and it's not it's it's kind of a scary
16:15we all want to postpone it I know I do I
16:18don't really want to think about it
16:19right now but I'm faced with it every
16:21day because I see it in my work
16:32America is still a country which
16:34believes that the people who should care
16:37for the elderly are their members of
16:39their own family but that is now an
16:43increasingly difficult task for families
16:48people are having fewer children
16:51families are smaller less stable
16:53geographically spread out at the time of
16:56caregiving has gone from months before
16:59death to years and in some cases up to a
17:03decade or more where people simply are
17:07living longer in conditions that are
17:16one study of very very telling study
17:20shows that only those people who have
17:23three or more daughters or daughters in
17:26law have a better than 50 percent chance
17:29of not finishing their life in a nursing
17:32home or an institution
17:35a policeman told us how to go
17:40oh and you're smiling the whole world
17:47when you're laughing
17:51What People Like Us need is is
17:55I wrote to the Maharaja and I printed it
18:00up in the page so they will see it out
18:03you don't have to worry I don't have to
18:05they don't even know it's me I just
18:08didn't give them my name yeah
18:19even though I'm a nurse I never imagined
18:23that I would be in a nursing home as a
18:29came in and fractured him
18:32the been here seven years now
18:41crying over spilled milk years
18:47take things as they come
18:53frightened of what's ahead
19:00I don't want to live forever I
19:12I tell you my daughter
19:23but she's she's doing all right
19:43nearly 60 percent of those who live past
19:4685 will go into a nursing home
19:49and if they stay longer than six months
19:51the vast majority will never leave
19:56one person I visit on a regular basis in
19:59the nursing home calls it you know just
20:01the waiting room and and she views it as
20:03you know this is where we all come to
20:06in you know some perspective she's right
20:10what happens you know
20:13other folks I've seen people you know
20:15who Thrive there you know I've had
20:16patients that were at home and then went
20:19to a nursing home and they're much
20:22the socialization you know the
20:25participating in groups having all these
20:27people around for meals is tremendous
20:29and they live off of it and Thrive from
20:30it so it's not always you know a
20:32downturn for some people
20:37when I leave my home
20:40because I was lonely
20:4696. it was a little hard
20:51so I had a friend here so he said come
20:54over Clara come over it was all right
20:57she was on the seventh floor
21:05you're not alone here
21:08they're not afraid they don't know how
21:11but they people they people and I have
21:14my I get beautiful magazines
21:23I get U.S news world report that for 50
21:27years we have an hour home
21:30so I had the magazines I have the
21:33newspaper and the people they are people
21:41should we increase the taxes
21:48the government program such as a food
21:53Foods stamps food stamps Medicaid
22:05I miss I miss my fault friends
22:12and then I say look you can have
22:33I don't know if growing old is easier
22:37in some ways I think it's more difficult
22:40it gets a lot harder in some ways to to
22:42keep your Independence here
22:45um so you're much more dependent on
22:50giving up Independence is the worst it
22:53is what everybody fears it's what I fear
22:59you have the cane in your left hand
23:01and you move your cane forward and your
23:05and then your left foot
23:08and Dr Bill Koch opened his practice in
23:10Upstate New York over 30 years ago
23:14he's one of the few Family Physicians
23:16left in the area and he sees thousands
23:19of elderly patients every year
23:26she's in her inner chair okay
23:29yeah we still have lots of three
23:31generation households four generation
23:34it's rare that people will give up and
23:38want to put somebody in the nursing home
23:39but the first sign of trouble most
23:41people will go through a long period of
23:43trying to take care of them in their own
23:45home or in the family home or even
23:55I'm happy to come out and see you here
23:57oh sorry yeah having a family really
24:03I think it really gives people a reason
24:11what their life is about often at the
24:13end of life when their career is gone
24:18it's what's important to them
24:30try to sing and sing and think so that
24:35you won't forget it again
24:37do you hear me can't you do it
24:44what you were gonna say you were gonna
24:54to you Chester and rosemary hake married
24:57for 68 years now share a room in a
25:02both in their 90s he has advanced
25:04Parkinson's and she's been diagnosed
25:06with Alzheimer's all right for you
25:10you never do the thing the right thing
25:13right and the wrong thing wrong
25:16why do you do things like that I don't
25:19know because you can't see huh she has
25:24changed in the last two and a half years
25:26I guess she can't hear me out of these
25:30in the conversations
25:44can you imagine not being in the same
25:47room with Mrs hake or would you
26:00Tucson when they brought me in the air
26:05we didn't think any other
26:07my bed was here one bed was over here
26:10we push them together
26:12you know the cold and dancing
26:17so we made out all right
26:24let's try to stand up okay ready on the
26:27count of three one two three three put
26:31your hands on the Walker
26:33right here where we usually hold right
26:40maybe just walk over to the bed
26:44the hakes came into the nursing home
26:45three years ago so that Mr Hague could
26:48recover from a hospitalization
26:50but because of his wife's worsening
26:52dementia they were never able to leave
26:58well then lay down we took that in and
27:01Dr Koch sat down and was very kind but
27:06and explained it they would not be able
27:11he'll be coming there I don't think
27:15anyone wants their parent or a loved one
27:18to have to be in an institution no
27:20matter where it is no matter how nice
27:23no matter how great the staff is it's
27:25still an institution
27:32I always feel like I can make them just
27:34a tad bit more comfortable
27:37I know their desires I know their needs
27:40they don't have to tell me
27:42so I've worried about everything
27:46even the Linens the pillows
27:52the heat in the room
27:59but most of all that I've let them down
28:03by having to make the decisions we've
28:08well that isn't perfect how are you
28:11gonna make that perfect
28:13with my mother it's it's been a slow
28:16process but the last few months seemed
28:18for whatever reason things have
28:21escalated and it's difficult some days
28:25when I'm not sure if she doesn't eat
28:27because perhaps she's
28:29forgotten how to use her utensils or
28:33does she not know how to swallow what
28:36what do you remember
28:40I keep trying to fix things and even
28:43though my head says I can't your heart
28:47your heart wants to fix everything
28:49that's good my Sleeping Beauty
28:53and sings to you will you wake up again
28:57all right I'm Gonna Get Lucky
29:00even with my nursing background and
29:02caring for elderly and terminally ill
29:06nothing has prepared me
29:08for taking on the role of caring for my
29:17okay you want your glasses on
29:22hi Norma you waiting for lunch it's a
29:25little early to wait for lunch
29:28you're just sitting here doing word
29:34oh that's okay I thought there's a band
29:54I'll be a dream you are make him the
29:58cutest that I've ever seen
30:01give him the work that I'm not a broker
30:14don't have nobody to call my own good
30:17morning Kayla aren't you gonna sing with
30:21Mr Sandman bring me a dream
30:27it needs a little louder back here
30:36when you're young you want to live
30:37forever you want to at least live to be
30:42but many people don't want to live
30:44forever when they're old in fact that's
30:56I will tell patients that I think you
30:58know that it's time to stop
31:01Curative treatments whether they go in
31:03hospice or not and just focus on on
31:06function and comfort
31:10often that's what a person needs is
31:12somebody who knows them who has an idea
31:15of who they are of what their goals are
31:19things that have impacted on their
31:21illness to tell them what to do be that
31:23an individual or family and they would
31:24give up a certain amount of years at the
31:26end to to have a good debt
31:39I'm going to turn the television off if
31:46so tell me how things are going
31:54not good not good oh
32:05I don't feel really sick
32:08it's not true I haven't had any no
32:13we've got quite a cough yeah
32:16yeah it's loose yeah but I don't really
32:20bring anything up you know
32:23he takes the oxycodone twice a day
32:26and yesterday I started the morphine uh
32:30the coughing after he was diagnosed with
32:33lung cancer that was just a few months
32:36Dr Katz said I don't want to do anything
32:39invasive and he said Wayne I don't
32:43believe that you would come through a
32:45lot of these tests that have to be
32:47and Wayne accepted that and I did too
32:55none of us want to see him
32:57suffer much more he's been a very sick
33:00man really for the last last year it's
33:05he had that infection and he wanted to
33:07be home so badly and we wanted him home
33:12okay Jude do you have any anything you
33:15wanted to talk with me about before I
33:16check in no you said something about a
33:23uh I don't know you know Let It Go a
33:26year or not you mean I told you you had
33:28a year yeah yeah did we bet on that
33:31I'm not gonna bet with you anymore you
33:33never pay off yeah I know
33:38your time is limited and how long it is
33:40I I don't know no one knows no but if
33:45yeah well I mean it could be weeks or it
33:52you know we don't know well well but
33:58well let me check you here
34:08are you holding up already
34:09yes I get tired but that's I don't know
34:17so there's the morphine
34:31it'll be kind of tough
34:33on Lois probably you know
34:59kind of hard to think about it you know
35:02all I think about it really
35:09two weeks later Wayne Elliott would die
35:12as he wanted at home
35:35you know most people say they want to
35:36die at home but most people die in the
35:37hospital I mean that's not what happens
35:47every day you see someone in the
35:49hospital you have to ask yourself you
35:50know why does this person still have to
35:52be in the hospital there's lots of
35:54with you know confusion disorientation
35:56Falls and affections
35:59one thing that we talked about because
36:00medicines with IVs with tests with all
36:03sorts of things and sometimes you know
36:04you order a test because it's easy
36:06because it's there but
36:07then you kind of opened up Pandora's Box
36:09and now you found something you weren't
36:10looking for and oh boy now what am I
36:12going to do about it well you do another
36:13test and then you do another test and
36:15you say well in order to figure it out I
36:17actually need to go stick a needle in
36:18your bone now and take out some stuff
36:20and then you're okay well and you start
36:22getting into trouble
36:24after you know I had that terrible sir
36:27originally okay good so you do remember
36:31and I shouldn't have had that you don't
36:36people don't have cloth surgery I call
36:39it cloth surgery what's cloth surgery
36:42pulling clothes out of your nose and out
36:46years and just talk and stuff like that
36:52jigsaw and cloth through your body I
36:56don't like that do you do you remember
36:58what the surgery was for
37:00Georgia days was in the early stages of
37:02dementia when doctors removed a
37:05but the hospitalization made her
37:07dementia worse and now Dr Farber is
37:10concerned about her recovery yeah okay
37:16yeah that was a few weeks ago but now it
37:18looks like you know you're having
37:19trouble really still eating and putting
37:25now do you know about the procedure that
37:28we want to do tomorrow
37:3319882 tickled a lot being cut on again I
37:36know I know that's what I wanted to talk
37:40this is is a small incision
37:42and they put a tube in from the outside
37:44and then we can give you all the
37:46medicines all the nutrition the food the
37:48vitamins the minerals the water I don't
37:51would you say the name of it it's called
37:56feeding right there right about there
37:59they don't put a hole in me and put the
38:01tube right there a small hole but yeah a
38:03hole right there oh boy
38:11decision making is a big issue for older
38:14adults and deciding upon a course of
38:16treatment is a big ordeal someone who
38:19gets diagnosed with a cancer when
38:21you know it's a real question of well
38:23wait do we want to do the standard of
38:25care which is surgery and then chemo or
38:29is that really not what's best in this
38:32are they really too sick and dying from
38:34other things and it wouldn't be in their
38:37best interest to even you know go
38:38through a surgery like that yeah hi Mrs
38:41Fuller it's uh Dr Farber calling I just
38:43came from seeing your mom and you know I
38:45talked with her about stuff including
38:47the procedure which is scheduled for
38:48tomorrow okay I know you wanted to know
38:50it's scheduled for tomorrow the feeding
38:52tube would help Georgia days regain her
38:54strength but the cancer had already
38:56spread so she would be moved to hospice
39:04when the choice needs to be made whether
39:06it's the patient making it or the
39:07patient's family kinds of decisions they
39:09have to make sometimes are completely
39:14I had a patient with severe severe
39:16Parkinson's disease and one of the
39:18manifestations of his Parkinson's was
39:19that he could no longer swallow
39:22so I had this long conversation over the
39:24course of weeks with his family
39:27and basically what I try to help them
39:29understand is his body can sustain life
39:32anymore he can't swallow food
39:35so if we choose not to feed him
39:37he'll die from his Parkinson's disease
39:40if we choose to put a feeding tube into
39:42he won't die now we'll have to wait for
39:45a medical catastrophe it'll have to be
39:47an enormous infected bed sore it'll have
39:50to be a stroke it'll have to be a
39:53overwhelming urinary infection
39:54aspiration pneumonia it'll have to be
39:56some that's what I try to term a medical
39:58catastrophe because we've actually
40:00caused it to happen we've let the person
40:02live long enough that the only way for
40:04them to die because we didn't let them
40:06die from their natural illness is some
40:09medical medicalized catastrophe and some
40:12families accept that it's very hard to
40:15do because they're letting someone die
40:17and lots of families can't they cannot
40:20accept that when something happens that
40:24that's okay but until that happens they
40:27need to do everything they can to
40:38who is ready to to Lost somebody for the
40:41family especially the mother I'm not
40:50I know will be one day but
40:59for the past year Dr Farber has been
41:02working with Lucia panesco to keep her
41:04mother Maria out of a hospital and at
41:13now 96 Maria is slowly deteriorating
41:17from chronic heart and vascular disease
41:23that okay yeah just tell her I'm here
41:25it's Dr Farber yeah I
41:30you have a very nice smile
41:38she know she never recovered
41:42a few days ago she was very very very
41:45sad and she looked at me after she have
41:48a lot of pain and the pain calmed down
41:50after the medication
41:52and when I asked her what do you feel
41:55you feel better she say yes and she
41:57looked at me and she say
42:00you try to cure me but you never can do
42:06I give her everything what I have but I
42:09don't know what to do
42:11and that is the hardest part because I
42:13don't like her to suffer
42:18but now when she moves the leg
42:26yeah all right sorry and she's very
42:29you know she has really severe arthritis
42:31and a lot of her joints including the
42:33hips and at this point she's getting
42:35contractures she can't breathe anymore
42:38for the pain okay her mother's getting
42:41sicker overall and we've been spending a
42:43lot of time talking about what to do
42:45when her time comes and and how you know
42:48it's very clear she doesn't want her to
42:49go to the hospital she doesn't want
42:51someone to call 9-1-1 so she filled out
42:53one of these uh do not resuscitate
42:55orders at home to put on the fridge
42:57but it's very hard for her to kind of
42:59picture and accept the fact that that
43:01she is so old and frail and and you know
43:05gonna be around forever
43:16the bright lines that used to guide us
43:24technology didn't get in the way
43:26those lines have become blurred by lots
43:32loving families begin to wander is it
43:35love or is it cruelty to treat this
43:37pneumonia in my father who is suffering
43:40from cancer and has begun to lose his
43:45all of those things that made his life
43:52lots of us now want to spare our
43:55children those kinds of burdens
44:01one hears it said over and over again I
44:04do not want to be a burden to my loved
44:07and people write living wills and make
44:10other kinds of Arrangements precisely
44:12hoping to spare the burden not only of
44:15care but even of decision making about
44:17what should be done with us when we get
44:19to be old and infirm and incapable of
44:21deciding for ourselves
44:24but the fact of the matter is that it's
44:27really impossible to describe all of
44:29those circumstances that one is going to
44:31face and for most of the decisions of
44:34long-term care you can't write those
44:39There Was You Jennifer was
44:43every day I meet a friend an
44:47acquaintance a relative
44:49who is caring for their parents and
44:53these difficult decisions that no child
44:57wants to make isn't that your partner
45:00oh yes I don't know and every day there
45:04even if it's a little decision like well
45:09do they need an antibiotic you know my
45:12parents do have a living will and a
45:17but when push comes to shove are you
45:20going not going to fix that fractured
45:22hip are you not going to fix those
45:23fractured ribs are you going to allow
45:27your father to choke or are you going to
45:29make sure that he doesn't have popcorn
45:32and and things of that nature are you
45:36ready I never had anticipated being
45:40in this position nor having my parents
45:44in the situation they're in good job
45:49get up come on tuck your bottom under
45:51there you go straight up our daily
45:54struggle is to continue to try to assist
45:58them in having a purpose in life because
46:00there's no question that in many aspects
46:04they've lost the quality of life
46:06don't put it out too far right foot
46:09push through those hands good walker
46:16yeah and we had everything all set here
46:21we had drawn oils we set up across Sons
46:39oh get that left foot right up there
46:41there you go I'm trying to learn to walk
46:52she and I both can't if we were scared
46:54because she can't run one night I can't
46:56run the other hand we can't run
46:58two wheelchairs or one person
47:04I don't know what to look forward to
47:07I don't really look forward to anything
47:11old ages for the birds
47:20dude do you think you could find an
47:23two seven four six three
47:28a lot of what I am and I think a lot of
47:30people is what we do and if you can't do
47:41drive a car to make music to think
47:47I don't have anything to do with it
47:53probably at least once a week and
47:55sometimes every day people say you know
47:56if I ever get like that take me out
47:59because I don't want to live that way
48:08in their practice are confronted with
48:10situations where patients are are really
48:16when this happens I want to be very
48:21I don't want you to prolong my life or I
48:23want you to make something available for
48:26me that will you know help me to be more
48:28comfortable and end it when I want to or
48:30even sometimes you know will you help me
48:32to do it when the time comes
48:39because of these experiences I've had
48:40these discussions with my wife too about
48:43end and she and I are at Polar Opposites
48:46in terms of what our expectations are I
48:48mean I would clearly want to be given
48:51if I were terminally ill or I had a
48:53progressive illness a degenerative
48:56Progressive illness that was kind of
48:58gradually take away all of my function I
49:00would want to be able to opt out
49:03I want that control and I don't know
49:06whether I'd ever use it but I definitely
49:08and to her that's it's just
49:11inconceivable that someone could think
49:13like that life is life my son who has
49:16power of attorney in case anything
49:25that would authorize
49:28termination in case of
49:32hopeless looking condition
49:36I'm not signing that
49:41there are a lot of cases
49:48this patient has three months to live
49:51and they've lived 30 years
49:54I don't think that medicine knows
49:58everything perfectly
50:01and that while there's life There's Hope
50:04and it's part of my general optimism I
50:11if it were that hopeless my heart would
50:14intervene and say the end and I'm
50:18willing to let it go with that
50:21why do you think so many people are
50:24prepared to sign though because they
50:27don't want to see their children suffer
50:29and I said to them I don't care
50:38how long would you like to live Mr
50:40singer how long would you like to live
50:45they have a question
50:47I never thought of it
50:53I I like life I like crying
51:07I like it but it's that it's not to me
51:17it's I think simply not true that we can
51:20know in advance how we ourselves will
51:24feel about many of these things once we
51:26find ourselves not 45 and fit but 75 and
51:31viewing life with a different lens
51:37I'm trying to accept the coming
51:40limitations with a certain amount of
51:42Grace I have this perverse occupational
51:45interest to see whether
51:48having thought about it all this time I
51:51can age better rather than worse and
51:55be a kind of decent example to my
51:57children and to my grandchildren
52:00it's not simply in my control
52:05it's a time of life that interests me a
52:09hi Mrs Golf all right how you doing for
52:13the first time in history those 85 and
52:16older are the fastest growing segment of
52:18the population hi Luella and within 25
52:23years there will be over 70 million
52:26elderly Living in America I'll be back
52:33we haven't even begun to contemplate
52:35what this means socially in terms of the
52:38meaning of having all these years
52:40stacked up at the end of life
52:42it's a lot easier for the country to
52:46think about the economic aspects
52:48we've not yet begun to face up to what
52:51this means in human terms
53:19next time on Frontline
53:22I got the World on a String Americans
53:26with credit cards 185 million interest
53:30and fees paid to the credit card
53:31companies 101 billion
53:34big Banks holding all the cards
53:40some things money and power can buy for
53:43everything else you want to know about
53:44credit cards there's Frontline
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