Midday Matinee is our people watching, people doing and people being feature. Join the Woodland Creatures for an afternoon break.
I was thinking about growing old and dying even before the tragedy in Tucson. I am the caretaker for my 92 year old aunt. On the one hand, I would like to grow older with her philosophy of life. On the other hand, my dad who dropped dead of a heart attack at 63 seemed to leave life on his own terms – alive and vibrant one moment and dead on the backyard grass the next.
My aunt has survived breast cancer twice, once in her 40s and once in her 60s. She volunteered for Reach for Recovery for years and still counsels breast cancer patients on the phone. She has congestive heart failure, an artificial heart valve and a pacemaker. She is on oxygen. She goes into her den on the good afternoons and writes little notes to people offering sympathy, congratulations, advice and hope and copies of any clippings if they happened to be in the paper. Her biggest expense after food is probably stamps. She works the phone to keep up with her friends.
A member of our bridge club asked her what the secret to growing old with such style was and she replied, “Make younger friends. Most of the friends who were my age have died. If I hadn’t made younger friends, I wouldn’t have any.”
Mary is a true pragmatist. Her oldest son is happily married to his third wife. Mary is still on very good terms with her first two daughters-in-law. They talk on the phone and exchange gifts and cards. She is quite clear about the fact that her son wasn’t a very good husband but that he married such nice girls, why wouldn’t she stay in touch with them. (For the record I have one former D-I-L and no desire to keep her in my life.)
It is hard to see how slowly she moves and how easily she tires. I think of the frog and the pot of boiling water. I wonder if I will be able to continually adjust to diminished capacity with half of her cheer. I really don’t want to. If I had my druthers I think I’d rather check out the way my dad did.
I have trouble thinking through this dilemma of growing older. We don’t really let nature take its course anymore. We keep intervening. My aunt has stopped most of the interventions but trying to regulate all her medicines requires testing (outpatient) and adjustments. There are of course religious and ethical questions here but mostly I am just trying to understand how I want to approach my own end. Being Terry Schiavo would be up there in my worst nightmares.
Here is what I told my son who has my medical power of attorney. “I want you to remember the pets that we put to sleep because we didn’t want them to suffer and there was no hope of recovery. Please, please treat me with as much compassion as we did our pets.”
The funny part about writing this is, at 64 I don’t feel old. It is the frog within me speaking. Ribbit, ribbit, ribbit….
How about you?
I’ve thought about this, too, addisnana. I’m 60, diabetic, and definitely slowing down. I am even slowly losing my independence because of cataracts which keep me from driving unless the sun is high and bright (everything smears otherwise, and I have next to no depth perception). My youngest daughter devotes a lot of time to transporting me, such as the trip to the dentist on Monday because it was dark and stormy. She figured between the rain, the wet roads and the lack of light, all I would see was a smear. She was right, so she sat for over two hours in the waiting room without even a sigh.
So yes, I think about it. I don’t want to go like my dad. He didn’t take the best care of his diabetes, got severe pneumonia, and wound up on dialysis. This in addition to having only half a heart left after three heart attacks nearly a quarter century ago.
He died from a fall of all things. Diabetes had numbed his feet and lower legs so he couldn’t feel where he was standing, like me he suffered from a lot of dizziness (I rely on my feet and ankles to tell me when I’m tipping). So he fell. For the umpteenth time, probably. And when all was said and done, he was in ICU with enough broken ribs and vertebrae that the doctor said even a young, healthy man was unlikely to survive.
They kept him going for four days before my sister discovered she still had medical power of attorney and called in hospice.
I don’t want to go that way. I fight it by taking extra good care of my diabetes, but I’ve also signed a Do Not Resuscitate Order that goes everywhere with me. It’s chained to my wrist. I can think of nothing worse than being like Terry Schiavo, and I don’t want my kids to make that decision.
My mom lingered for three miserable months in a nursing home. If only they’d called hospice earlier, she would have avoided a lot of suffering. The medical machinery, once in gear, fights every inch for survival until a family member steps up and says No more. In that case it was my uncle, her brother.
I’ve been kinder to my pets, painful as it was. In fact, I wrote a diary a few years back titled: Why couldn’t my mother have what my pets must have?
The law wouldn’t allow us to treat a pet the way we treat our elderly and ill. If there is no hope, we recognize the cruelty of endless treatments. My mother, who begged to be allowed to die, spent an extra three months in agony. Why?
I’d like to go out like your dad, too. I don’t want to linger, drawing out death and grief.
Thanks for a very thoughtful look at a truly important issue.
P.S. Your Aunt Mary sounds absolutely wonderful 🙂
I realize the hubris of contemplating something that may be totally out of my control but I want to have a say in what kind of medical interventions are made on me and for how long. I too carry my health care directive with me everywhere.
I think now part of keeping the elderly alive is technology related, part of it is to make money and part of it is just because it can be done. We haven’t been very thoughtful at asking whether we should keep people alive. There isn’t one answer for every person but I would at least like to answer the question as it pertains to me. ❓
Good point, addisnana. I’d like to make the decision myself. I’m not suggesting, even remotely, that those who want to take every single step to lengthen their lives should be denied anything. But those of us who feel differently should find a supportive medical community.
All too often, the patient never gets asked, even when they can be asked. Then things are left in the hands of family members wracked by grief, guilt and fear.
Thank you for this compelling and poignant “people watching” story, addisnana. I know you were concerned about whether it fit with Midday Matinee. It does. So much of our end of life policy and practices are motivated not by care for the person who is ill, but by the feelings of and our feelings for those who will still be here.
When my grandmother finally turned downhill after her stroke, my mom had the medical power of attorney and the responsibility for deciding whether to continue life support. She made the right choice, as the alternative would only prolong the dying process. But her brothers were furious with her and said some ugly things, perhaps in grief, perhaps because they hadn’t taken the opportunity to come and say goodbye even though mom had told them it was very close. Almost none of us wants to be, or be thought of, as having “gotten rid of a problem,” even when it’s the only compassionate choice in terms for the person who’s ill. But there are just enough people who would “get rid of a problem” that our policies and practices are geared almost entirely toward preventing that … even if we too often prevent compassion along with it.
And yes, part of it is that end of life practices are the cash cow for health care providers. During the health care debate, I read that most of us incur 75% of our lifetime health care costs in the last three months of our lives. It’s often little more than a transfer of our life savings from our families to the health care industry.
I was thinking about this and some of the “staying alive” is for others in your life. My memere fell and broke her hip and then had a stroke after the surgery. She lost her independence and ended up in a nursing home. She had always said “I neva eva want to be in a nursing home” (she said “neva eva” because she had a very cute Massachusetts accent). But she lived in one for a couple years and because she did my daughter got to meet her and we have a 4-generational picture.
Her “hanging in there” even though she had been vehemently against living in a nursing home gave me something that I had always wanted: a chance for a daughter of mine to meet her and to have our picture taken together. It is on the wall in my office.
Thank you for this Midday Matinee, addisnana, and for the memories it brings to me.
By the way, I have directives and the only thing I worry about is that the 2nd person in line for decision making is my brother who is a Catholic. He said he would respect my wishes but I think the Catholic Church is adamant about keeping dead people alive until they get a sign from their god. Lightning bolt hitting the ventilator? Not sure.
One of my sons converted to Catholicism. I respect his choice and love my daughter-in-law immensely. I gave my medical power of attorney to my other son. I am not sure how my newly Catholic son would weight my wishes against the dictates of his church. I’m not counting on a power failure as part of the plan.
Good idea. 😉
I probably should find someone else as this has bothered me for a while.
Interesting question about Catholics, Jan. Our local diocese refused to become involved in the Schiavo case, saying that it was “a family decision.” (The entire family live in our diocese.)
Pius XII promulgated an encyclical back in the 1950s saying that extraordinary measures were not required to maintain life.
John Paul II opted to have all medical intervention stopped two days before he died.
Yet Benedict comes along and announces that no Catholic hospitals are allowed to follow such end-of-life directives. There was quite an uproar from the entire Catholic medical community here. I will note for the record that my sister, who is an administrator for a Catholic Hospital system, called hospice for my dad and had all life-sustaining efforts halted.
But if you have any doubts, find someone else. 🙂