Updated: August 9, 2023
Having spent all that time, effort, and money to assure your heirs receive as much of your estate as the law will allow, there is another matter to consider, limiting the cost of your care. Although not a top priority toward the end of your life, it may be more important than you think for you and your family.
Unfortunately, it is not uncommon for families to go bankrupt or deeply into debt paying for medical care for their dying relative, much of which may be unnecessary. While Medicare and most other medical insurance cover end of life care, there are still many out of pocket costs, such as deductibles and copays. A 2016 study found that 40% of families could not pay all the medical bills for end of life care in hospitals. Funeral and burial costs only add to the burden.
The cost of end-of-life care will depend on many factors, such as your life expectancy, the use of hospice, location of death, and amount of medical care delivered. Certainly avoiding unnecessary care and stopping medications that are no longer needed will help, but there are other ways to consider.
While wanting to save money on your healthcare while you are terminally ill may seem cold, it turns out that, in many cases during end of life care, less is more. So it is best to think of this as a quality of care issue.
Providing you are not interested in a clinical trial, there may come a point when further expensive care to treat your terminal illness becomes ineffective. In a lot of cases continuing treatment will even do you more harm than good, such as when side-effects and complications from treatment outweigh any slight benefit. Although it is almost never a distinct point, it will become clear to you that more disease treatment is no longer wanted. While this mainly includes additional treatment of your terminal illness, both proven and unproven, it may also include treatments you have been getting for decades that no longer make any sense.
Once this point is reached, 33%-38% of terminal patients will receive some form of unnecessary care. Unnecessary care comes in many forms, including consultations, treatments, and testing, but it is any care that does not fit to your current situation. It can be difficult to define what care is unnecessary for you if your treatment goals are uncertain, especially if there are other barriers to making the decision.
Once you and your family have understood and accepted the situation, you will probably decide that life-prolonging treatment and additional unrealistic attempts to cure your terminal illness are no longer wanted. Once you have made the difficult decision that palliative care is now the best thing for you, your medical care should consist solely of palliative treatments to make you comfortable. This may include treating pain as well as symptoms and major complications of any of your current illnesses. However, even at this point it may be difficult to recognize unnecessary care.
Having said that, there are some situations when care is clearly unnecessary, such as:
Here are some things to consider that might help you decide what may be necessary or not when you have a terminal illness.
Consider the short- and long-term consequences of any of the following.
Unnecessary chronic care if you have a terminal illness will depend on the reason for the treatment and the state of your illness.
Most of this care is medications to prevent conditions you will not live long enough to get.
There may come a point, such as the active phase of dying, at which the discomfort of further dialysis is going to outweigh the benefit of doing it.
Your palliative care specialist will take a close look at your current medications to see if they are no longer needed, could potentially interfere with palliative care, or are now harmful, such as when you have organ failure. They could be preventing a disease or treating one that you have had for a long time. They will assess specific questions about current medications.
In addition, if there is a chance you will have any symptoms or disease and might need additional medication, they will consider if the benefits are likely to take effect before your death.
Under no circumstances should medications be stopped or not started if they would hasten death, since this is considered euthanasia, which is currently illegal in the entire country.
Medications that are only used to prevent future disease or complications
These medications might be stopped or tapered if possible occurrences of these conditions are well beyond your life expectancy. Your doctor must be certain that this will have absolutely no impact on your life expectancy or quality of life.
Never stop a medication unless you have spoken with your healthcare provider and agree that it is the best move for you.
Medications that may have more risk than benefit close to the end-of-life
Medications that have the potential of a return of that disease or severe symptoms within your life expectancy if stopped
This is a much more difficult decision. In fact, most hospice specialists would opt to continue them. If they don’t, they will only do so very close to death when they are certain that this will have absolutely no impact on your life expectancy or quality of life. If there is even the slightest possibility it would impact this, continue the medication.
In many cases, some of your medications may be considered palliative, that is to make you comfortable and improve your quality of life, and will be continued.
Medications that should be taken right up to the end
Many medications will only be stopped during the active phase of dying, which is usually the last few days of life. These medications include:
Unfortunately, if you have a serious disease and terminal illness, especially cancer, you may be easy prey for scammers trying to sell products guaranteed to treat your illness. Unlike most scams, these are more likely to be found on the web, especially in discussion groups, online forums, and in blog posts. You are more likely to be the victim of medical scams if you have memory loss or dementia and serious diseases such as cancer, diabetes, heart disease, arthritis and Alzheimer’s.
Two of the ways you could throw away your money is to spend it on miracle cures or be defrauded by online pharmacies and healthcare product sellers that either send you fake products or never deliver them at all. You may also be lured into thinking you are saving money by disreputable online pharmacies who are sending you lower quality medications or even medications contaminated with harmful substances.
Finally, getting any form of medical care online can be risky. Scammers can get your personal, financial, and medical information and use this identity theft to make purchases in your name.
Don’t be tempted to waste your money on miracle cures. There aren’t any. There are many claims to be wary of.
Getting any form of medical care online can be risky. For example, when buying medications or other medical products there is always the possibility you are dealing with shady sellers. This could result in less potent, fake, or tainted products.
Any time you use a computer to buy something there is a risk of many consequences, but there may be additional ones when buying medical products online.
Buying medication online is very common these days, since it can be more private and convenient, and less expensive, but it is very much buyer beware. You may end up with less effective generic drugs or tainted medications with dangerous fillers, such as drywall and rat poison. Many of these so-called suppliers are actually scams where you may be buying medications that turn out to be fake and possibly harmful and/or that never arrive.
Here are clues to identify possible medication buying scams.
If you have purchased and received medication from a source you are not sure of, there are steps to take to assure you are getting the correct untainted medication and dose.
You can avoid these problems before you buy prescription medications by carefully investigating the source. Check that the supplier is a safe and reputable source.
Scammers who obtain your Social Security, Medicare or health insurance numbers can use that information to pay for their own medical care. Unlike other purchases with stolen information, you are liable for the payments, including any billed copays.
Only use this information at legitimate healthcare facilities and never give it out for any free health checks, such as those that may be offered at shopping malls, fitness clubs, and retirement homes.
Managing a chronic or terminal disease may involve remote monitoring systems and many seniors depend on emergency alert devices. Unfortunately, there are many scams that pretend to inform or offer enrollment in these personal medical alert services, either free or paid for by a family member. The trap comes when these scammers request wired payments or bank accounts, credit card, or Medicare numbers to pay for an upgrade that is needed prior to shipment of the device that never comes.
Never give this type of information to anyone who calls you, no matter who they may claim to be. If your primary care provider did not order or recommend the device, it is almost certainly a scam.
Here are five tips for unsolicited offers (cold calls) about medical alert devices/systems.
Check for specific concerns at the Health Fraud Scams website from the U.S. Food and Drug Administration.
Population-specific resourcesThese are links to financial resources that are only available for a particular group or population of people.
Other financial resourcesThese are sites that offer or describe financial and other resources to any user, but are always worth checking.