Talking About the Inevitable

I am, with nagging, finally getting beneficiary forms filled out for Mama’s various accounts and investments. And along with them are the Advance Directive and POSTL (Physician Orders for Life Sustaining Treatment that goes on her refrigerator or bedroom door for EMTs) forms that we got from the doctor last week. Of course, I had to read the latter documents to her. It wasn’t difficult, really (emotionally, I mean)-she is 96, and we both know she will not die prematurely-but it was odd to talk about it.

She does not want life-sustaining measures taken. Comfort only. Except that, well, her mother. At 99, she needed a blood transfusion, not for the first time, in order to stay alive. My parents were on the other side of the country when the doctor called. My mother told him “no.” And then she got on a plane and headed straight home. She was not in time. Her sister, she tells me now, had been at the hospital, but left. “She kept feeling like she should go back,” Mama says, “but she didn’t listen to the voice in her head.”

The issue is not that her mother died alone. Well, it is and it isn’t. Mama says that isn’t what her hesitation is; she is fine with going when she goes. But she has lived all these years with the guilt that her mother died alone. She doesn’t want my sisters and me to feel bad for decades like she has. So she is hesitant to make that choice for us. I don’t really do guilt very well, but after I checked “no life-sustaining measures,” I wrote in that her daughters are free to over-ride the directive. I think that is understood by the medical and legal professionals, but it satisfied her dis-ease to have it specified.

I read today in the wonderful book I am nearly at the end of, that Washington and Oregon are the only states that legally allow physician-supported dying for people with terminal illness, though I don’t think old age is considered terminal. The author and her mother lived in New York, and her mother was quite clear that she wanted to choose when to leave this life. It was evident that nothing was going to kill her. She had refused antibiotics for pneumonia-”the best friend of the elderly”-three times and survived; and no heroic measures were required that she could refuse. In the end, food and hydration were withheld when her mother, who had lost among many things, the ability to speak, laboriously typed on her reader board “N-O-W.” Her daughter knew what she meant because they had often discussed it.

I don’t know if I can have that discussion with Mama. My reading, however, suggests that most children think their parent can’t handle the conversation. And most parents think their children can’t. And so, it is not talked about.

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