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Medical debts of elderly despite Medicare

The chilling dilemma of "the unbefriended elderly," who don't have family or close friends to make medical decisions on their behalf if they can't speak for themselves, generated a bunch of ideas the last time we discussed it. "I would much rather pay a professional, whom I get to know and who knows me, to make the decisions," she wrote. "That way it is an objective decision-maker based on the priorities I have discussed with him/her before my incapacitation." Elizabeth, it turns out other people have been thinking the same way.

So for nursing home residents with advanced dementia, sons and daughters often opt to return the favor - even though the medical consensus is that it's not a favor. Most dementia patients will eventually develop problems with eating and swallowing as the disease progresses, but feeding them through surgically implanted tubes has not been shown to improve their survival, to prevent pneumonia or heal bedsores, or to improve their quality of life. Nevertheless, about a third of nursing home residents with advanced dementia do receive feeding tubes, usually during a hospitalization.