I try to stay upbeat about end of life stuff because (a) I’ve figured out a lot about it, untangling and reweaving what, in my best assessment, we need to know and act on to maximize our chances of dying in peace, and (b) I believe that when my fellow citizens know also, they’ll feel and in fact be empowered to enact it for themselves or loved ones. Much of this is around internals—what’ in our heads and hearts—because that of course is the groundwork for our actions.
Martin Baynes’ article at HealthAffairs, “A Room With A Grim View: The ‘Ambient Despair’ That Marks Life In Assisted Living” is a crucial read. You may end up as deflated as I felt after reading, but read it anyway. It’s too important not to. And then ponder, if you’re young enough, what kind of living arrangement may be in your future.
I’m no lawyer but I’d like to see some kind of smaller shared living on a co-op scale, where the necessarily temporary residents maintain more control than in corporate environments with profit imperatives and managers who answer to—whoever they answer to—and whose interests lay elsewhere, no matter what bromides may be offered about mission, etc.
I’ll out with it: I don’t understand societal fascination for and trumpeting of longer and longer longevity. Science loves it; everyone (it seems) crows for it. Me? If I ever end up living under some corporate entity’s control I hope I enter with a pill or “the cocktail” squirreled away. I believe we each have a right to choose when we die. I distinguish between suicide (ending a viable life) and self-directed peaceful dying when elderly. In the same way I don’t accept the medical definition of “care” (“whatever occurs in a hospital or clinical setting”), I don’t accept medicine’s extremely short-term definition of terminality (a range between “we diagnose you as uncurable and don’t expect you to live longer than six months” and the 4–7 days of bodily active dying).
To be clear, as an end of life change agent who presents to various audiences, I don’t trumpet these personal views. That’s not what I’m there to offer, and in any case there’s no time to get there; what few minutes or several hours allotted go completely to core practicalities about how to advocate effectively and accomplish peaceful dying within broadly acceptable and legal bounds.
Maybe there’s a silver lining to our dwindling economic clouds: if familial generations return to cohabitation, to living together in a single home, maybe we’ll more easily, naturally get what most of us say we want: to die there, in peace.