The Job of Dying

"By then, he knew he was dying,
he seemed to approach it as a job to be done
which he knew how to do."

What does a daughter see as she watches her father die? Does she see the death of a hero in terminus?  Or does the superhuman qualities of her father never fade?

In her poetry anthology The Father, Sharon Olds chronicles her observations of her father's death from cancer. An outsider looking in, she portrays her father with worship of how he carries himself during his last days. She tells of his stoicism, his dominance, his strength - qualities that do not leave him even as he approaches his end.

Through her work, masculinity is portrayed never to fade. Indeed, when a man keeps his masculinity even in the face of death, Olds explains that he gains additional respect and reverence by keeping his image even as evening falls.

I'm ugly. Is it my fault?

"Now everything smells.
The piss in the pot beside my bed,
my powdered feet that I can't reach,
my metal chair. The woman who used it last
died and left her smell."

It's hard to understand the view from the hospice bed. Can we say that we've been given less than six months to live? Can we feel the humiliation of being completely dependent on others for care? Can we understand the feeling of being trapped by diagnosis, trapped by strangers, trapped by a body that just... dies?

In an anthology of poems about old women titled Only Morning in Her Shoes, I found Susan Fantl Spivack's poem, "I'm ugly. Is it my fault?" This poem shares the mind of an old woman who is in hospice care. She details an existence where a soul snarls against unchangeable circumstances.

At some point in our lives, we all think about our mortality. We fantasize about heroic deaths, cringe at horror movie endings, imagine what the world might be without us.

I find that this poem focuses attention on something we only imagine and usually shudder to think about. There are reasons why many people are leery of hospices. It brings us too close to our own mortality, the possibility that we too could one day be trapped by the same metal railings, doomed to die in a place were strangers with strange and terminal illnesses are recycled through as the bedsheets change. Hospices are nothing like our greatest fantasies and most horrible horror movies. This poem gives voice to the grit, the truth of an old woman in a place where dreams and nightmares have often perished in reality.

Make Money or Kill Granny?

The heated health-care debate has consumed much of the past months' news for valid reason; it is a complicated mess involving fiscal, economic, and ethical issues. Evan Thomas presents a bold, risky point of view about end-of-life care using his personal experience of his grandmother's passing to expose the complex issues of health care in America. The dilemma that Thomas examines is whether the patients, who are going to die in the near future, should have the right to decide their medical course, or allow doctors to continue conducting more and more treatments on the dying patients, because their (doctors) salary depends on them.

Thomas, for the most part, outlines both sides of why the U.S. health care system keeps so many elderly persons alive. On one side, patients psychologically want to maintain human contact and sometimes it is through doctors. On the other side, Medicare is on a fee-for-service insurance systems where doctors are paid for the number of treatments and test they perform on a patient. This system seems unnecessary; however Medicare wants to "encourage hope" in all their patients. Aren't doctors' main purpose to save lives than "kill" lives? How can U.S. health care improve its quality of service to its patients' emotional need versus their physical needs?

"The real problem is unnecessary and unwanted care." America pays for the unnecessary, which in itself sounds unnecessary and foolish. Who has the final say in keeping a patient's life alive? The family? Patient? Doctor? Health-care? Government?

Slate's Geezer Issue One Year Later: "Diary of a 100-Year-Old Man: Dreams of My Mother, and a Visit From My Grandson"

In the second of three diary entries, the 100-year-old frenchman Leon Despres opens the door to his co-op to graciously invite the reader in. As the reader steps into his "world," he cannot help but feel empathy and a sense of familial affection towards the aged man. Why is that? This grandpa reminisces over the memory of his beloved wife and dreams of his deceased mother as he watches his "congenial caregiver" fuss over his clothes, meals, and bodily functions. These actions allude to the somber reality that he will pass onto to join his beloved soon.

Depres inspires the reader to cherish relationships and look for the simple pleasures in life. Sometimes the inevitable boredom of retirement is the cure to stress and unhappiness.

Slate's Geezer Issue One Year Later: What's the Best Adult Diaper?

An aged man is sitting on a park bench one afternoon. A random projectile inconveniently pegs his arm and startles him. A couple seconds later, his pants gradually darken from the crotch down the pant leg. "So much for super-absorbent!" the aged man might protest while he turns a pale pink from frustration and embarrassment.

Finding the right adult diaper is a challenge: Which brand will fit best? Which will absorb the maximum amount of liquid? Will my clothes look OK with the diaper? How long can I wear a wet diaper?

Justin Peters conducted a research-study on the various adult diaper brands (Affirm, Certainty, Kroger, Depend, etc) to see which ones had the best quality, comfort, absorbency, and style for the elderly burdened with bladder-control problems or incontinence. Peters tested the "super-absorbency" adult diaper through his "three-pronged" testing procedure and rated the diapers on a 5-point scale. During his research he commented that a wet diaper felt like "a damp, loose towel was wrapped around his waist" and a dry diaper was like wearing "portable seat cushions."

With Peters upbeat and humorous comparisons and style he made shopping for adult diapers seem meticulous yet crucial. As much as I dread aging to the point where my bladder cannot function, Peters' findings do nevertheless offer insight to the frustrating, helpless emotions elders experience with incontinence.

A Few from the NY Times

I found two interesting pieces on the Times this morning.  The first, courtesy of the AP, situates the recent Democrat-Republican spats over who deserves the highly valued elderly voting block.  Democrats seem exasperated. They're the ones who invented Medicare and other major entitlement programs, but they are now playing catch-up as seniors increasingly doubt Obama's health-care initiatives. What kind of ground are the Republicans--who have pushed for major cuts in Medicare in the past, even suggesting that it could be phased out--standing on here?  Maybe it's the way they harness a "contractive" and a "bill-of-rights" kind of language that allows them to appear as earnest defenders of senior citizens.

The other, unrelated piece deals with the emergence of geriatric care managers; these individuals can save a family a good deal of time and effort by serving as a kind of mediator both between siblings as they try to take care of aging relatives, and between those siblings and the individual in need of care themselves.  A geriatric care manager is a voice of authority and reason, directing what is an enormously taxing process--both financially and emotionally.  These are precisely the kinds of positions that I think will experience huge growth over the next few decades as the boomers launch into retirement.