A Strange Thing is Happening on the Way to Old Age

20150127-Botanical garden 185Turning 70 seems to have created a change in my thinking about life and death, and especially life until death. Maybe this is because I seem to be more aware of my mortality. My faith in the Christian message of the birth and death of Jesus has made death just another exciting part of my life’s journey, one I anticipate within the next 10 to 15 years. What scares me is that my body is wearing out in ways that can’t be fixed. I don’t want to face a debilitating, painful illness where I have lost control. I don’t want medicine to extend my life when there is no longer meaning or quality. This really scares me.

I have studied and taught the biological aspects of aging but until now they were about someone else. I am now realizing that my body is aging – wearing out. Isn’t it funny that we can know something intellectually, but then know it at a different level when we experience it. I am beginning to think about what it means that my aging body is going to fail in ways that could result in increasing dependency and, sometime soon, total failure.

This probably sounds morbid to anyone under age 60 and you may not want to read any further – unless you have aging parents and then you should stick with me. If you are somewhere around 70 you should definitely read on because what I am experiencing is universal and inevitable. If you are having a hard time reading this, rest assured I am having a hard time writing about it. I want to be like Scarlet O’Hara and think about it tomorrow. But another part says I need to think (and write) about it now so that I may be able to impact how I choose to use health care and how I live until the end, before I get caught in the health care web and it is too late to decide for myself.

I have been thinking and reading about this for a few months. The first pressure to think about it came from health care providers asking if I had a health care directive. I finally forced myself to create one a couple of years ago when we updated our wills. I thought about it, and we talked about it, and it was much easier than I thought it would be. The reason it was easier was because the decision I made was for right now – this year. I know what kind of medical intervention I want now but I also know I will want to make changes to it as my body wears out in ways that are irreversible. As my body changes, I know my desires for health care and living will also change so I will repeatedly update my health care directive. Maybe we need to update our health care directives when we change the batteries in our smoke detectors.

I received another nudge to think about how I want to die from a post by Brian on his travel blog Everywhere Once titled “To Go Gently Into That Good Night?”  Brian doesn’t leave his life to chance – and I always enjoy reading his very well written essays on making good choices for traveling and life in general. In this essay he is thinking about the choices we can make about how we want to die.

Brian introduced me to the thinking of Ezekiel J. Emanuel who is an oncologist, a bioethicist, and a vice provost of the University of Pennsylvania. Brian talks about Dr. Emanuel’s decision to decline all medical treatment at age 75, electing to die of whatever ailment come first. I later read Emanuel’s article in the October, 2014 issue of The Atlantic and think that his decision is too extreme for me. He is now 57 and has decided that he will decline all medical treatment when he reaches age 75, including flu vaccines and penicillin. In the cost/benefit analysis that takes place when we make good decisions, it doesn’t seem logical to decline a treatment that doesn’t decrease quality of life but can protect and heal us for a while longer. But his arguments extended my thinking beyond my health care directive to thinking about under what conditions I would want to decline medical treatment when I am sitting in my doctor’s office instead of looking up at first responders or in an emergency room.

My thinking was further stimulated when we were with friends last summer talking about what all 70-somethings get around to talking about eventually – health issues. One friend is an ovarian cancer survivor. As she talked about her experience I started thinking about what I would do if I got that dreaded diagnosis of cancer. Her description of her response to chemotherapy sounded very similar to what I experienced before I got my Fibromyalgia symptoms under control.

I realized how difficult chemotherapy would be for me. I would have to stop all the medications that are working so well for me. My starting point would be similar to her response to treatment – and then I would add the discomfort of treatment as another layer. I don’t think I want to do that. I have mentioned this to many friends and family members. A few seem to get it, but most look away. Choosing to die instead of taking on the medical fight doesn’t seem to sit well with people and I understand, especially when love is involved.

I probably can’t prepare a response for when I am told I have cancer or some other potentially fatal condition because my decisions will need to be based on the costs (emotional, physical, and monetary) and potential benefits at that time. But I think I will have a better chance of making the right choices for me and those I love if I have thought through what I value beforehand.

That is why I am writing about aging and death. I want to sort it out in my own mind while sharing with others so we can maybe have a dialogue. I don’t have more posts written and waiting to be posted because this is a process – of reading, thinking, and writing. But there will be more because I know it is a conversation we need to have. Feel free to leave a link if you have written on this topic.

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Categories: aging

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25 Comments »

  1. Having turned 70 last year I can relate to your thoughts and ideas. At present I am healthy and the only medication I take is for hypertension but I realize my body parts are not what they used to be. And I just take life day by day and appreciate the life that I have right now. So far I really haven’t written much about aging and death. You have made me consider it. I look forward to your thoughts on future posts as you take this new reality into your mind.

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  2. I appreciate how you wrote this particular post. My thought, that if I thought longer and was less afraid, might be, “Yup, that Will to LIIIIIIIIIIIIIIIIIIIve thing is very very engrained into us!” and “Why IS that?” and at what point do I know that I am accepting life vs. being depressed and giving up. I wonder if the giving up is from inside or comes from veering from expected norms and views. There is a song that goes: so you waaaaaaaant to liiiiiiiiiiiive foreverrrrr!!! i dunno who sings it, the words just popped into my head.

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    • Thanks for a great & honest response. You have given me some more to think about as I write about this aspect of preparing for the end of my life.

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    • I hope to give you some ideas to help – from what I’ve read and what I have been thinking. I know you have been thinking about it because it has appeared in your poetry.

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  3. I just turned 73 and my friends and I talk a lot about aging and the dying process. Our interchanges are always informative. I see them somewhat the same as the commeraderie I sought as a young mom sharing our pulling-our-hair-out moments. Now I have a need to know how others are thinking and dealing with the challenges of these later years. Keep up the conversation. After seeing two siblings die in their seventies of cancer after the ravages of chemo and radiation, I don’t think I’d choose that route either. But I know until I face that kind of moment, I won’t know how I’ll respond. But chemo on top of fibro? I’m with you. I can’t imagine.

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    • Thanks, Lois, for understanding. I can’t imagine how I would get through any phase of my life without friends (both related and not). It always is a little scary to post this type of essay, and I am so happy and encouraged when I get support. Thanks.

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  4. Since starting my 60th year, almost a year ago now, I’ve been very aware of my mortality, but without the faith you have. I’ve made sure my husband understands why I wish cremation when the time comes. The thought of cancer scares everyone. It’s best to talk about these things with your loved ones so everyone knows your wishes, and it also opens up a conversation so you can find out what they want in regards to their own demise or sudden injury or how they stand on organ donation. Too many people ignore that death is part of living. Good post.

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    • Interesting, Christine. We started talking about funerals, cremation, visitations, memorials, burials, etc. during our 60’s. A long time ago I wrote what I would like included in a memorial service. This is something I need to redo. You are so right that we need to talk through all the decisions we need to make.

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  5. I’m in my 60’s and my husband and I have had numerous conversations about this topic. The bottom line for us is ‘quality’ of life. About three years ago, a friend in his 70’s was taken to the hospital with heart failure. The doctors wanted to perform a variety of tests, procedures, and surgeries. He asked if after the tests, procedures and surgeries would he walk out of the hospital and return to his life. The reluctant answer was ‘no.’ To that he said, move me to hospice and let the process begin. He passed about two weeks later on his terms. During those two weeks, he said goodbye to family and friends and finalized all business matters he wanted to take care of. I think of his bravery and hope I can do the same when it is my time. I think life ending decisions are specific to each person, and we should respect that. ❤️

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    • Wonderful story, Judy. It does take a lot of courage to say no to medical procedures. I think you had a wonderful guide. Thanks for commenting.

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  6. My husband and I turned 70 this past year. We’re both healthy at present and take no prescription medications. However, we have had this conversation about end-of-life and are in the process of writing individual letters to our sons who will make decisions for us if we can’t do it for ourselves or for each other. We have our wills and end of life documents in order. I don’t think it’s morbid to talk with those you love and let them know what your wishes are.

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  7. Wonderful post Pat – I turn 64 tomorrow and I have made the decision get away from the work rat race by the end of the year. I will probably continue working part-time (partly out of necessity) – but have come to realize that time is all we have – and there are a lot of things that I still want to enjoy.

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    • It is a balance, isn’t it Nora. Many people find work very meaningful so it is hard to find the balance you speak of. It took me a while to find meaning in retirement but we also wanted the freedom to travel and spend winters in the south. I wish you well – I’m sure you will find lots to post about.

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  8. Pat, I always appreciate these open posts from you. Because I read healthcare news all day, I’ve given this a fair amount of thought. I think that at some point along the way with modern medicine, we’ve lost the ability to allow death to happen gracefully. I’m not saying that I look forward to it, or won’t fight it, but there’s a point at which one must consider that living is not the opposite of “not dying.” And you are right – that kind of care is expensive, and could leave a legacy behind for our loved ones in addition to the grief of our passing.
    I’m sorry that you’re having more troubles with your body. Sending your blogging hugs and a nice cuppa tea. They won’t fix anything, but they are hopefully still nice 🙂

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    • It just could be that a lot a people are thinking this way and if we all speak out, more people will be more thoughtful about life and death and medicine. Thanks for the thoughtful comment and the hugs. Blog-hugs & -cuppa always make the day brighter.

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