Life Planning Fail

In preparing for battle I have always found that plans are useless, but planning is indexindispensable. Dwight D. Eisenhower

Life happens, but that’s no excuse for not knowing where you want to go. That’s a particular issue in healthcare.
People don’t like to think about negative events that are going to happen in the future. They’ll still happen, just the same. For Americans, the difference between life expectancy and “healthy life expectancy” is nine years.  They won’t necessarily come as a block toward the end of life. If fact, you don’t know when they’ll come.
A new study points out that people are often faced with making snap decisions about healthcare without adequate information. (1) That’s due to the failure to anticipate something that’s actually rather likely to happen.
People get hurt and sick. The roughly 320 million Americans generated 130.4 million visits to Emergency Rooms in 2016.(3) What are the odds you’re going to need one?
If you don’t know where you want to go in an emergency, you may get stuck someplace you don’t want to be.
Even if you’ve never had an illness in your life, you will. Nothing on this planet is immortal.
Like it or not, here are some questions for which you need to have answers.
  • Financial
    • How do I cover sudden and potentially large medical bills? What does my insurance not cover that I’m going to have to pay?
    • How do I cover normal bills if I’m out of work for a few months? Or longer?
  • Medical
    • In an emergency, where do I want to go for care? (Related: is my doctor affiliated with where I want to go?)
    • If I’m hurt and need rehab therapy, where do I want to go for care?
    • Does someone have access to my Living Will if I can’t speak for myself? (Having one isn’t a question.)
    • Who will advocate for me with medical personnel if I can’t speak for myself?
  • Living
    • Whose going to care for me if (temporarily or permanently) I can’t care for myself?
Seriously, this matters. We have several local hospitals, two of which are problems.
  • The ER department at one of them has misdiagnosed my wife twice out of two visits. That’s a 100% rate of being wrong. Do we want to test them a third time?
  • The nurses at another consistently ignore a severe allergy that causes anaphylatic shock. Breathing is really nice, but you don’t really appreciate it until you can’t do it. It turns out, the nurses don’t pay attention to wristbands. (One nurse at that facility told us that they assume the allergy bands refer to drugs and not to more mundane and potentially lethal issues like iodine and latex allergies.) Going to that facility is like going to a casino. You might get fixed and you might die. How lucky are you?
As you age, where you go matters more. With seniors, for example, if taken to an ER for a serious fall, there’s a 50% chance of additional problems within six months of the initial injury, including death. Some of that risk is the result of decisions doctors make about medication.(4)
There’s no need to overthink this. Do your homework, ask questions, make decisions, and then get on with the rest of your life. Just get it done.
Aristotle was  right. Anything taken to excess turns bad. That includes both planning and lack of planning.
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Sources:
  1. Emily A. Gadbois, Denise A. Tyler, Vincent Mor. Selecting a Skilled Nursing Facility for Postacute Care: Individual and Family Perspectives. Journal of the American Geriatrics Society, 2017; DOI: 10.1111/jgs.14988
  2. American Geriatrics Society. “Hospitalized older adults may need more help selecting skilled nursing facilities.” ScienceDaily. ScienceDaily, 7 July 2017. <www.sciencedaily.com/releases/2017/07/170707211128.htm>.
  3. Centers for Disease Control and Prevention, “Emergency Department Visits.” https://www.cdc.gov/nchs/fastats/emergency-department.htm

  4. Jiraporn Sri-on, Gregory P. Tirrell, Jonathan F. Bean, Lewis A. Lipsitz, Shan W. Liu. Revisit, Subsequent Hospitalization, Recurrent Fall, and Death Within 6 Months After a Fall Among Elderly Emergency Department Patients. Annals of Emergency Medicine, 2017; DOI: 10.1016/j.annemergmed.2017.05.023
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