Why are we so afraid of talking about dying? Most fathers and expectant mothers before and after a baby’s arrival get all sorts of advice. Shouldn’t the end of someone’s life be treated with the same respect and openness, medically and mentally?
As I near 50, my family constellation has become populated with fading family members. My mother and an aunt died of cancer, my father is sinking into dementia as his physical condition declines and three aunts are battling various ailments such as brain cancer, Alzheimer’s and a failing heart.
With all this death circling, and getting a close view of my mother’s, I’ve paid closer attention to how I want the end of my life to be. Instead of fearing it or ignoring the inevitability, I’m joyously embracing discussions of when the Grim Ripper arrives. (Hopefully, she will blame the canned salmon.)
I’m not having a Howard Beale moment and declaring that next Tuesday I will kill myself early enough to make the next day’s edition. I’m talking about how and what I want done or, more specifically, not done when I near death.
I’ve been fortunate that few in my family in my generation, so far, have become terminally ill: A polyp here and there, maybe a dash of hypertension, an uptick in bad cholesterol, but for the most part all clear. But that won’t last. So the death discussion has interested me.
What do we need to die well? The silly political discussion of end of life care, such as the ominous (and inaccurate) “Death Panels,” does little good. (Though that phrase conjures up humorous images of someone like the Soup Nazi yelling, “No chemo for you … Next!”) Instead, we should be discussing what a healthy last chapter of life could look like.
This is not morbid navel gazing. Baby boomers will soon be sliding into their twilight years and end-of-life care has become a crisis. Dr. Ira Byock, author of “Dying Well” and an expert on end-of-life care, has written that medical care for the dying is poorly planned, frequently ignoring the treatment preferences of the patient and family, and pushes for unnecessary medical treatment that prolongs someone’s life and contributes to their pain, isolation and suffering.
Some 20 percent of Americans die in an intensive care unit, part of the more than 50 percent who die in hospitals. Another 25 percent die in nursing homes. A majority of these patients are elderly.
It’s not as if most elderly people want to die in a strange bed hooked to tubes, drugged and completely unaware of their surroundings. In surveys about where people wish to die, 70 percent of respondents said if they had a choice, they want to die at home.
A few years ago, my mother and I went to see an uncle who had a stroke and had no chance of recovery. With aggressive medical intervention, he lived another year tied to a nursing home bed, blind, drugged, unable to communicate and fed through a tube. As we stood in the back of the room, my mother tugged my sleeve for me to hear her whisper, “If you ever leave me like that, after I die, I’ll come back to haunt you.”
Indeed, no one should die like that. So let’s talk about it.