Do the Elderly Always Get to Choose?

Nobody wants to think about getting old but it is something that we will all have to deal with one day.  The number of elderly that have to go into homes are increasing due to more family members having to work and the elderly not having caregivers.  Is there a time when the elderly don’t get to decide what they want?  Here are 2 examples.

John is 88.  He is alert, oriented x4 and completely competent.  He has liver failure due to a history of alcoholism.  His doctor told him that if he drinks again it will kill him.  Sw come to his house and he tells the Sw that his cousin is coming this weekend and he is going to party one more time.  Patient’s wife is crying because she does not want him to go.  She wants Sw to make him not go by admitting him to the hospital. He states that it is his right and this is his last wish.   Sw informs patient and spouse that patient is competent and he can make that decision.  Sw can not stop him.  Sw strongly encourages him not to drink and informs him of the consequences.  He states that he understands.  Patient spends the weekend drinking and comes back on Sunday night in bad health.  On Tuesday patient passes away because he can not recover.

Chris is 88.  He is alert, oriented x4 and competent.  He has broken his hip so he can not walk.  Hospice has an aide that comes in 2 hours a day and his daughter(Amy) is with him the rest of the time.  Amy has to get a job.  She has family that checks in periodically on patient.  Patient gets his medications and always has food and drink by his side.  He has a cell phone and a lifeline to call in case of an emergency.  Hospice finds out that he is left alone periodically during the day.  They state that they can no longer follow him because he does not have 24 hour care and there are no resources available to help him.  Patient understands that if the house catches on fire he would not get out but he wants to remain in his home and refuses to go to a nursing home.  Patient states that he is not afraid and he has neighbors that he can call.  Hospice Sw informs him that 24 hour care is mandatory even if he is competent and understands the risks.  Hospice has to pull out and Adult Protective Services has to be called.

Why does one get to choose the way they spend the rest of thier life and one doesn’t?

Is it fair to pick and choose when somebody is competent because they are elderly?

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