Counseling could have spared families’ heartbreak

Sept. 21 was World Alzheimer’s Day, as well as Respect for the Aged Day in Japan. This is meaningful to me because my grandmother has been slowly deteriorating from Alzheimer’s disease for much of my life. She is currently in the moderate-advanced dementia stage, meaning she is completely dependent on the caregivers at her nursing home.

Plaques and tangles cling to much of her brain like barnacles, and the gradual, irreversible withering of higher brain function has choked out any real sense of awareness, reasoning, personality, memory or recognition.

Except for brief, increasingly rare lapses of fleeting lucidity where she despairs on her current state, she is not in any real sense herself, and hasn’t been for years. When she visited my grandfather’s wake this summer, she didn’t recognize the man in the casket, her husband of more than 60 years.

I usually don’t write about my family in opinion pieces. But this is a case where I feel it relates to a worthy subject, the reform of our nation’s health care. In my column last week, I said one of my biggest complaints with this summer’s national discussion was how much precious attention and energy was squandered “debunking” hysterical claims that had no basis in any actual proposed legislation.

One notable casualty of this summer’s irrational outrage was the removal of government-sanctioned legal counseling for senior citizens from the Senate version of the health care bill. This provision would have used Medicare funds to assist implementing “living wills,” the end-of-life consultations between patient and doctor that would ensure an elderly patient’s wishes regarding terminal treatment.

Such consultations are currently deferred to families’ discretion, but many families have trouble bringing it up, especially with Alzheimer’s, and the provision would have allowed doctors to initiate the conversation with their patients.

Upon reaching Medicare eligibility at age 65, seniors would be notified by their doctor that, if they so chose, their Medicare would cover the cost of these legal consultations as often as every five years. The idea is to legally codify a patient’s wishes before they or their family is under physical or emotional duress, or in my grandmother’s case, virtually incapacitated.

This counseling has never been compulsory and the concept has never been a sinister codeword for euthanasia. Before Republican opposition to everything health care reform hit a fever pitch following President Obama’s election, it had been endorsed by numerous politicians in both parties, including extreme social conservatives like former Republican House Speaker Newt Gingrich and former Alaska Gov. Sarah Palin.

But this summer, Palin wrote an emotionally-charged Facebook note referencing the end-of-life counseling provision in the bill, claiming seniors and the disabled “will have to stand in front of Obama’s ‘death panel’ so bureaucrats can decide … whether they are worthy of health care.”

If “death panel” sounds ghastly to you, it is, and that’s why no serious Democratic health care proposal ever mentioned anything like it. No American politician would win many votes proposing we terminate an innocent person’s life to save money.

Thankfully, according to the Pulitzer prize-winning, fact-checking Web site, this quote received a “Pants on Fire!” rating, a category that the site reserves for infractions worse than merely being “false.”

Alongside the “Pants on Fire!” ruling, Palin’s quote was given the explanation tag “Sci-fi scenario not based in reality,” a damning statement for a woman with a journalism degree.

A gross misinterpretation of the proposed health care bill, her claim was picked up and repeated by opposition conservatives to suggest something out of a Nazi eugenics program, and in the resulting misinformed furor, the provision was dropped in the Senate bill.

I don’t mean to speculate what treatment course my grandmother would have chosen had this bill passed, or that it would have at all deviated from present reality. But she was once a very sharp woman, and I don’t see what’s so sinister about providing seniors with the funding and information to determine their own medical wishes, before that responsibility is passed to their families.

Alzheimer’s disease currently affects more than five million Americans, and may reach 16 million Americans by 2050 as the baby boom generation ages, according to the Alzheimer’s Association, and that doesn’t include the millions more who will have to provide care and make decisions for them. There is currently no cure.

More families than just mine are going to have to make difficult end-of-life decisions before next Sept. 21, and it doesn’t make it any easier when sound, non-partisan ideas like end-of-life counseling are misrepresented and then discarded because of a former governor’s Facebook note.

Hopefully my next piece won’t be such a downer, but amidst all this bogus talk about “government pulling the plug on Grandma” if health care reform passes, I thought I’d share a story about my own grandma, and how we might better consider the wishes of our elders

Zack Thielke can be reached at

2 Replies to “Counseling could have spared families’ heartbreak”

  1. “No American politician would win many votes proposing we terminate an innocent person’s life to save money.”

    No, the politicians would much rather *spend* money to terminate innocent persons’ lives. The current health care plans all propose an end run around the Hyde Amendment in order to facilitate direct taxpayer subsidy for abortion (all pants-on-fire claims by Planned Parenthood and its allies to the contrary). The blatant disrespect this Administration and its Congress have consistently shown for the sanctity of human life are *precisely* the reason false charges like the “death panels” claim are able to gain such astounding traction in public discourse. It is *completely* believable that Democrats would like to gain cost savings by killing old people; they already want to pay to kill the unborn. It wasn’t the right wing that made euthanasia and death panels imaginable to a large portion of Americans this summer; the right wing only took advantage of a mentality the “progressive” movement has built into the national consciousness in the last thirty years.

    This being noted, there were other problems with Section 1233 (the section of HR3200 that dealt with end-of-life counselling). It would not just be an “option;” it would monetarily incentivize doctors to initiate and perhaps insist upon these conversations. That would probably be fine under the current system, but, thanks to other accountability and (theoretically) cost-saving measures elsewhere in the bill, it would, under the new system, further incentivize doctors to pressure older people to opt against treatment in favor of, well, dying. It’s hardly the death panels that fomer Gov. Palin disgracefully (and mendaciously) tried to make of them — but neither is it a “sound, non-partisan idea” that just fell on the wrong side of “misrepresentation” and a single Facebook note.

    Section 1233 is well worth opposing. Although reasonable people could certainly support it — and with them I would respectfully disagree — chalking up all opposition to 1233 as the result of stark raving right-wing lunacy is every bit as disingenuous as Palin’s death panel claim.

  2. There is nothing wrong with a little political discourse, and I respect Mr. Heaney’s perspective, albeit unaware and disconnected. Thielke makes his point from personal circumstances that have offered him an understanding of how important one’s right to decide his or her own future can be. My grandmother also suffered from Alzheimer’s and it essentially ended her life. In the process, however, it killed my grandpa just as quickly as he struggled to take care of his beloved wife. Heaney – get some perspective and then you can respond with more than dull policy analysis.

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