The painful realities of growing old

Stephen J. Lyons, Tribune News Service

On the occasion of my mother-in-law’s 100th birthday, I asked for her thoughts as she contemplated a second century. “Keep your mind open and your mouth shut!” she quickly replied. I disagreed with the latter part of that sentence, but out of respect I kept my mouth shut. Four months later she passed away. Her dying took more time than we would have wished, and it was both painful for her and for us to witness. A severe case of gout ignited and exacerbated other maladies, sending her small, fragile body into a tailspin from which she could not recover. “If I had a poison pill I would take it!” she said to her three children, all of whom are more than 70 years old.

She had survived two forms of cancer in her later years: thyroid and a more obscure cancer: Waldenstrom macroglobulinemia, a white blood cell cancer. Her thyroid was removed as was the cancer. For the second cancer she underwent only one chemo treatment and her symptoms disappeared.

When the gout attack took away her ability to stand she required full-time nursing care. We moved her from the assisted living apartment that she occupied for 10 years to a private room in our local nursing home. When the kind orderlies gently placed her in the van to be transported to her new home, she said, “Now, you remember to overdose me when we get there.” She was not joking.

She lasted 12 days, much of the time still in discomfort despite doses of morphine. When she would awake she would look around and sigh with disappointment, “Oh, so I’m still alive.” In those last months, the topic of death was never off limits with my mother-in-law. She was more than ready to for it. Her shoulders had disintegrated to the point she could barely lift her arms. Her knees were shot. Her feet were swollen. Using a walker was a precarious step-by-step challenge. She no longer attempted the trek to the dining room. Enough was enough.

Plans for her service were written and revised several times. She thought long obituaries were pompousscreeds. An expensive casket was a waste of money and a waste of a good tree. She opted for cremation, with the cremains to be placed in a simple, biodegradable urn, and buried next to her husband, who had died 23 years earlier.

She remarked one evening that no one should be sad about the passing of someone her age, someone who had lived a long, fulfilling life on a beautiful farm in Illinois. To her, the children who perish needlessly during mankind’s senseless wars, or who are lost in the unforgiving currents of the Mediterranean trying to achieve a better life in Europe, were much greater tragedies. “Because they never even had a life,” she said.

After six days she refused food. Her body was dying, had shut down and whatever biological impulse triggers hunger had vanished. There was nothing left to sustain. Morphine made her thirsty, but eventually she was too weak to even lift a glass of water. Her daughters took turns applying water to her parched lips with a lollipop-type of sponge. The hospice nurse put her on oxygen, not to extend life, which would have gone against her wishes, but for comfort. When the machine was removed her oxygen level sank to 58%. She died the next morning.

Is this what we want for our elderly loved ones? Currently, much is made about the increase in longevity; how children born today might live to 150 years. The Population Division of the United Nations estimated that in 2015 there were 451,000 centenarians worldwide. By the year 2100 the number is estimated to be 25 million.

We are supposed to be enthralled by this news. But let’s temper the enthusiasm with reality. The body will almost always break down. The mind spins off in many directions, some of them nightmarish. You become trapped, a prisoner of limited mobility, one broken hip away from disaster, often dependent on the care of children, elderly themselves.

We cannot control when we die, but shouldn’t we be able to? My dear mother-in-law contributed money to Compassion & Choices, an organisation in Oregon that advocates for “medical aid in dying” laws. i.e., assisted suicide. Ten states and Washington, D.C., now allow a compassionate avenue to depart this world on one’s own terms. In a 2018 “Gallup Values and Beliefs” poll, 72% of Americans favored physician-assisted euthanasia.

No one should have to watch a loved one linger in excruciating pain when there is no chance for recovery. For what reason? To become another statistic in a longevity study? To await a parting soliloquy that only occurs in movies and novels? A year earlier, when she turned 99, I had asked my mother-in-law if she had any advice as she looked ahead to another year. “Never get this old!” she said with conviction.