I want an Off button.

[Hazir]

1. I consider it my right to be able to make that choice, I also find it hard to imagine I would execute that right in a way that would result in the termination of my life. Then again, I am only 47 years old and have no major health issues.

2. Like I said, I don't know your grandmother so I really can't say if she is tired of living or that she's merely tired of living the life she's made to live. When I look out of my window in Istanbul I see women who live a life pretty much as empty as that of people in a nursing home. They sit in front of their home basically doing nothing besides drinking tea and doing their endless gossipping. They still seem to enjoy that very much as in an almost intangible way they are still part of everything that goes on around them. They 'look after' children playing in the street, they are my secretarial service by telling me who has been at my door during my absence and they know who's living where and who doesn't belong.

3. My mother died of lung cancer. When it became clear that the cancer had metastacized she decided that she would not undergo any radiation or chemical treatment to fight the disease. She also made clear that she didn't want to stay in the hospital. We as a family made that possible; we arranged amongst ourselves for care. We arranged for professional assistence and talked through the situation with our family doctor. In the following 7 months she was at home, her health declining. Medical treatment was limited to painkilling and avoiding bedsores. She died from heart failure during a nap in the afternoon. No attempts were made towards CPR, the doctor was called in merely to establish her passing away. We also at no point talked about euthanasia, it was just not part of our psychology to consider it.

[Bitter Jeweler]

Maybe that's the discussion that needs to be had with granny.
Does she want to stop the medication?
I think that is my problem with whats going on.
She will go into assisted living, or nursing home, and that question isn't asked.
It's clear to me she doesn't want to take her meds as it is. She's said it.
My sister tells her she has to.

[Dreadnaught]

Sorry, it looks like I misunderstood what you meant with the "washed my hands" phrase.

Does she have any terminal conditions the medication nis addressing? There are long-term hospice consultations that could be useful to keep her comfortable, and avoid medications that may be addressing her most serious conditions but also have painful side effects.

[Timbuk2]

My girlfriend's mother has a 'Swiss fund' in case of such eventualities.

She doesn't want to be kept going if things become intolerable.

And she is 60 years old and in perfect health, currently travelling Australia in a camper van.

[EyeKhan]

What we really need is a rewind button. I believe its possible but not, alas, in my lifetime. Damn. Maybe in my kid's lifetime though.

[']['ear]

1. I consider it my right to be able to make that choice, I also find it hard to imagine I would execute that right in a way that would result in the termination of my life. Then again, I am only 47 years old and have no major health issues.

Well, I've been there contemplating the void. It's not the void that I would desire, but the end of suffering.

2. Like I said, I don't know your grandmother so I really can't say if she is tired of living or that she's merely tired of living the life she's made to live. When I look out of my window in Istanbul I see women who live a life pretty much as empty as that of people in a nursing home. They sit in front of their home basically doing nothing besides drinking tea and doing their endless gossipping. They still seem to enjoy that very much as in an almost intangible way they are still part of everything that goes on around them. They 'look after' children playing in the street, they are my secretarial service by telling me who has been at my door during my absence and they know who's living where and who doesn't belong.

Great! Can't always be done, but try it if you can.

3. My mother died of lung cancer. When it became clear that the cancer had metastacized she decided that she would not undergo any radiation or chemical treatment to fight the disease. She also made clear that she didn't want to stay in the hospital. We as a family made that possible; we arranged amongst ourselves for care. We arranged for professional assistence and talked through the situation with our family doctor. In the following 7 months she was at home, her health declining. Medical treatment was limited to painkilling and avoiding bedsores. She died from heart failure during a nap in the afternoon. No attempts were made towards CPR, the doctor was called in merely to establish her passing away. We also at no point talked about euthanasia, it was just not part of our psychology to consider it.

IMO that is the way to do it. What if the pain can't be controlled without essentially putting her in a morphine coma? Me, I'd want to push the button once I'd gotten to a certain point. No need to have my family watch an ugly death and incur expenses.

What we really need is a rewind button. I believe its possible but not, alas, in my lifetime. Damn. Maybe in my kid's lifetime though.

Yes, you really are a step away from Alber, aren't you?

[Nessus]

Fucking rats with a wire in their pleasure center, can't stop pushing the button.

Can this be the official, UN-endorsed off button, tyia

[EyeKhan]

Yes, you really are a step away from Alber, aren't you?

Uh, no. And I think that's an unfair comparison. Are you saying some sort of extreme longevity is technologically impossible?

[Hazir]

Tear; that didn't happen, as a matter of fact we never got as far as morphine. But given the 'no unnecessary treatment' position very likely a morphine induced coma would have lead to death. Respirators would have almost undoubtedly come under the heading 'unnecessary' as it would just have pushed back impending natural death. I don't believe in clinging on to life at all cost and with all means available. The other thing I don't believe in is actively bringing death about.

[GGT]

Painful transitions and choices, Bitter.

Is your grammy Greek herself? My sister married into a Greek family, and from what they tell me, the elderly are supposed to be cherished and brought into someone's home as they age. Usually the elder son's, but also extended family's homes. They don't have "nursing homes" in Greece, that would be unheard of in Greek families. I wonder if that's part of her depression, feeling sad and useless?

But yes, I'd like an Off button for myself, if needed. Probably because I was raised as an independent WASPy American, where elderly go to assisted living, or nursing homes, instead of "interfering" with young people's lives. And we're mostly spread around the country, so even keeping grammy at home alone means someone local to check on them, coordinating things. I know a lot of folks with aging parents, living far away, and relocating isn't possible. Uprooting grammy means taking them away from the few remaining cronies and familiarities they have left....sort of an impossible situation for millions.

It will only get worse as the baby boomers continue to live longer

[']['ear]

Uh, no. And I think that's an unfair comparison. Are you saying some sort of extreme longevity is technologically impossible?

Just poking you in the ribs.

But I am saying that your "extreme" longevity doesn't look too likely now. Let's argue that we can "cure" every disease, including cancer, atherosclerosis, misc. neurodegenerations. We can **** with certain model organisms every which way (for example, eliminating their insulin system), but we can't extend their life much more than two fold. Ultimately life just runs the hell down. Let's even say that we can grow almost all organs in vitro (big reason to support all stem cell research, IMO) and replace them Larry Niven style. You still can't replace the brain, and it runs down. Even the extreme geriatrics, who appear to have won the genetic lottery, just stop working. I'm going to put the theoretical max at around 120 years. But the brain is the limiting step, and you can't pump info in and out of it. Trillions of neurons, gazillions of connections, and a large number of the are experience based. That is, the brain is far more than a card catalog. Learning actually alters the physical structure of the brain! How could you possibly record that, and how put it into a cloned brain which grew to maturity without the decades of cumulative structural sculpting? Very improbable. I'll settle for not having died this year, when my number was up.

Tear; that didn't happen, as a matter of fact we never got as far as morphine.

Really? I'm shocked. She must have been extraordinarily lucky (not to be insensitive, but it is very rare for a terminal cancer patient not to need extreme pain management. And morphine is just the old stuff, not enough to treat immediate post-operative pain. The morphine derivatives are several times stronger, and I bet she was on some. I was just using shorthand.)

But given the 'no unnecessary treatment' position very likely a morphine induced coma would have lead to death. Respirators would have almost undoubtedly come under the heading 'unnecessary' as it would just have pushed back impending natural death.

I think you have an appropriately negative view of standard end-of-life care, but that's not what I'm talking about at all. There's a lot of evidence arguing that dying at home with daily nurse visits to check pain involves less suffering and is less expensive. The "death panels" assholes have probably perpetuated untold suffering, and I literally hope that some of the folks that spread that rumor die painful, icky deaths that could have been prevented.

I strongly recommend that you read this (or pretty much anything else by him): http://www.newyorker.com/reporting/2...a_fact_gawande

I don't believe in clinging on to life at all cost and with all means available. The other thing I don't believe in is actively bringing death about.

Great! We'll let you die naturally!

But tell me, had I not gotten a transplant (and many don't), and my weird predisposition of gout had been allowed to run its course, you would have dictated to me that I had to run through the torture of non-stop gout while on dialysis? No exaggeration: at times it got so bad that it felt like nails were driven into the joint. I broke bones 8 times in my sporting days, and only the compound fracture of both bones in my left leg hurt as much as a bad gout attack. I also had my bowels shut down, and I remember thinking that night that I wouldn't want to live another day like that.

You're naive and don't know what you're talking about. And I'm happy for you: may you never feel it.

[EyeKhan]

Your germ cells are the latest generation in an unbroken immortal cell line that goes back to the beginning of life. Immortality in life on the cellular level is very real, however life found an evolutionary advantage to cell specialization with the trade off that most cells die from generation to generation. Unfortunately those are the cells we derive personal identity from....

But knowing the cellular mechanism exists to live indefinitely opens the possibility for adapting it somehow for us. Theoretically we could grow a new adult body around our brain, like in a womb, or grow a body to transplant our brain into, or gradually replenish tissues cell by cell in situ. That might be the solution to brain rejuvenation; do it gradually enough and there would be no sense of lost identity. Or maybe there's some genetic engineering to be done that would give our living cells the means to rejuvenate themselves. Or maybe something completely unexpected.... Who knows? We can do lots of stuff today that was scifi fifty years ago. Given the pace of technological advance, nobody here can predict what will be possible given another fifty years.

[GGT]

Tear; that didn't happen, as a matter of fact we never got as far as morphine. But given the 'no unnecessary treatment' position very likely a morphine induced coma would have lead to death. Respirators would have almost undoubtedly come under the heading 'unnecessary' as it would just have pushed back impending natural death. I don't believe in clinging on to life at all cost and with all means available. The other thing I don't believe in is actively bringing death about.

Sounds like your mother had other conditions that contributed to her death. If she didn't need morphine to control the pain of terminal cancer, there were probably other factors at work. (Intellectually, you know that too, Tear. )

Every life and every death is unique. That's the one thing missing in these conversations. Our tendency is to lump it all into convenient groupings: age, quality of life, future potential, disease process, costs (and their duality), and outcome.

The sad facts are: we have a schizoid ambivalence toward aging and longevity; we have a schizoid ambivalence toward medical science and who pays for its use/advances. And why wouldn't we? Our retirement age is 62 or 65, but many live to be in their 80's and beyond. Some barely limping along thanks to medical break throughs, but others still raring to go without much assistance at all.


edit: Choobs really IS one step from Alber, huh.

[oldmunchkin]

Hell yes I want an OFF button! Failing that, I want to end my life with some measure of dignity, instead of shitting my diapers in a nursing home, not knowing who I am.

I have a DNR on file at the local hospital, my lawyer, my Mom, my Kid, and I all have a copy. I have a "no extreme measures" document on file too. I have my "end of life" wishes all documented and notarized. I also have my memorial service choices documented. I realize that many are squeamish about doing things like this in their 40's, but c'mon people, I did some of this stuff when I was in my 30's, although a few changes have been made along the way, and I am sure a few more changes may be added later. Then too, a lot of older/elderly people have never considered doing this. My parents did these things a long time ago, along with giving durable/medical power of attorney to the person(s) of their choice! Thankfully, as it made it a lot easier on all of us when Dad died.

Considering the way society has changed in the last 50 years, it is not always feasible for a family member to take care of you when you are aging. 50 years ago, extended families tended to live in, pretty much, the same geographical area. Now, we tend to "spread our wings and fly away", sometimes landing hundreds or thousands of miles away from aging parents/grandparents.

Bitter, I understand what you are going through! After my Dad had his heart surgery in 2001, he never really felt good again. He didn't have any other major health issues until later, and even those were really huge. He started telling us things like, "If I had known what kind of shit I would be going through at this age, I would have let those goddamned Nazi Germans kill me! and, "Why the hell didn't you just let me die when I had the heart attack?" (This last one still makes my Mom cry when she thinks about it! ) After his prostate surgery in 2007, he finally felt good, physically, for the first time in six or seven years...BUT he was supposed to be tethered to a fucking oxygen machine or bottle all the damned time. He didn't use it a lot of the time, because it irritated him!

We all knew he had a small (too small for surgical repair, according to his doctor) aneurysm in his stomach. No one was too worried about it, as it had stayed the same size for almost 15 years. About 3AM, on July 6th, 2007, he woke my Mom, told her he thought he would need to go to the VA later that day. She asked if he wanted to go right then, he said no, she needed the sleep because she would have to do all the driving. She went back to sleep, he took off his oxygen and went into the bathroom. (Not unusual since the hose and the door didn't seem to mesh well!) At some point between then and about 5:30AM, he laid down on the floor and died. The official cause of death was the stomach aneurysm. It's almost like he picked his time, and "went into the hereafter" of his own choosing!

While I miss my Dad every single day, as does my Mom and my Son, it's pretty damned hard to feel what is considered "normal" grief. We had known for years he was very unhappy with his quality of life, and really didn't care if he lived any longer. He had a very good, happy, productive life, filled with love and joy. Those are the things we all remember about Dad. We try to forget those years he hurt so bad and was so sick.

[GGT]

Also, our Off button may be controlled by our proxy people. Dementia is a huge problem today. As Bitter illustrated, even questionable/borderline elderly can get a drivers license renewed, just by going to a certain DOT. Things really shouldn't work this way. When it lays heavy on the family members to take the car keys away, after they got "government permission to drive", it wedges family against officials.

It's been a long time since I've driven in Florida snow bird towns, but we used to have a geezer alert. Big, pristine, light colored cars (think waxed pastel Crown Vics) where you can't see the driver's head from behind = Geezer Alert. We'd give them plenty leeway.

[Hazir]

You're naive and don't know what you're talking about. And I'm happy for you: may you never feel it.

Your condition also affected your brains or something?

[Bitter Jeweler]

So yesterday I learned that my godmother and sister had the "big talk" with granny. I am kept out of the loop.
My sister had a meeting with the social worker who said granny shouldn't live alone.
So they told her she will be going to assisted living. I was told she was kinda quiet in response. She got really mad when they told her she couldn't drive anymore.
She is also diagnosed with dimentia.
She remembers she has a daughter, and her name, but doesn't remember that she has been dead for 5 years. This came up because the nurses asked my sister why her daughter hasn't visited. My sister had to question granny on this, just to see where her memory is. There was crying. Granny seemed to be more upset that she cannot remember this.

Granny complains that nobody comes to visit her. The fact is she has been visited by friends and family nearly every day.

My sister also learned that she is older than we thought, and her birthday has been wrong all these years. Sister found her birth certificate in her house. Granny is 88.

They had a hard time keeping grannies sugar under control. Turns out all the people who aren't visiting her, are bringing candy and goodies to her.

My sister still insists on playing the "challenge her memory" game, which causes arguments. I don't know why my sister can't get it through her thick head to just roll with her memory loss, and not to keep throwing it in her face. The game consists of, basically, "I just told you X", "No you didn't", "yes I did", "no you didn't", "yes I did".

Now we have to go through her stuff and sell her house. We have a year to do so, though.
This is all difficult on a number of levels.

I have to get over my fear of nursing homes. I think I was traumatized by them as a child.
I also have to get over my desire to remember her how she "was", and go and see her, and accept her as she is now. Crumbling.
It's difficult to watch her waste away, body and mind.

[Catgrrl]

It's the hardest thing, to go and see your grandparent like that. My Grandaddy was basically a vegetable for 2 years before his death. He was 74. He didn't take care of his blood sugar like he was supposed to, and got pneumonia on top of that. Add in a lawsuit-exempt Navy hospital and there you go.

I admit after he went home I didn't visit him like I should have. My mother and her stepmother were angry at each other over the situation that led to his hospitalization. Since I was still in college at the time, I didn't make the effort. And I should have. My biggest regret.

Now that I have time, I make sure to see my Granny and Papa once a week (they live close by). Luckily they are still pretty well for the most part. When my Granny had a brief stay in the hospital last month from an unexplained blackout, those feelings came back up again, even though my Grandaddy died almost 10 years ago.

[GGT]

That's gut wrenching, Bitter.

Will you "be in the loop" for choosing granny's new home? Some of them are quite nice, especially ones with dedicated Dementia Wings with high staff to patient ratios. May turn out they're better than the nursing homes of your youth.

Small suggestion --- get a big album, and have those daily visitors sign it, like a guest book. Date, day, name....short comment. Keep a large print calendar close by. That can help with the dis-orientation. If someone wants to put more effort into it, get a polaroid snap shot of each visitor with granny. Make a big collage of all her visitors and put in on the wall where she can see it every day.

A friend of mine is going through this now, too. It's horrible. You have my sympathies.

[Bitter Jeweler]

Thanks for sharing that, Cat.
Add in that this is my really busy time, makes visiting even harder.
I will make it a point to. I'll muster up the courage.

Not bad ideas GGT. I don't think they make polaroids anymore though, LOL. But I like the idea of a guest book. Maybe some kinda scrapbook, visitors can contribute to, to help her, maybe, feel conected?

Oh, they already decided where she can afford to stay. I'm cool with it, I just wish I could have been there when they told her.

I also thought, even though I have that issue of remembering people while they were well, rather than not, I might like to try to take some pictures of her or with her. I expanded that, and thought maybe I could do a portrait session for the other old folkses. Aversion therapy?

[Ominous Gamer]

So yesterday I learned that my godmother and sister had the "big talk" with granny. I am kept out of the loop.
My sister had a meeting with the social worker who said granny shouldn't live alone.
So they told her she will be going to assisted living. I was told she was kinda quiet in response. She got really mad when they told her she couldn't drive anymore.
She is also diagnosed with dimentia.
She remembers she has a daughter, and her name, but doesn't remember that she has been dead for 5 years. This came up because the nurses asked my sister why her daughter hasn't visited. My sister had to question granny on this, just to see where her memory is. There was crying. Granny seemed to be more upset that she cannot remember this.

Granny complains that nobody comes to visit her. The fact is she has been visited by friends and family nearly every day.

My sister also learned that she is older than we thought, and her birthday has been wrong all these years. Sister found her birth certificate in her house. Granny is 88.

They had a hard time keeping grannies sugar under control. Turns out all the people who aren't visiting her, are bringing candy and goodies to her.

My sister still insists on playing the "challenge her memory" game, which causes arguments. I don't know why my sister can't get it through her thick head to just roll with her memory loss, and not to keep throwing it in her face. The game consists of, basically, "I just told you X", "No you didn't", "yes I did", "no you didn't", "yes I did".

Now we have to go through her stuff and sell her house. We have a year to do so, though.
This is all difficult on a number of levels.

I have to get over my fear of nursing homes. I think I was traumatized by them as a child.
I also have to get over my desire to remember her how she "was", and go and see her, and accept her as she is now. Crumbling.
It's difficult to watch her waste away, body and mind.

Brandy's mom is the same with the memory. Everyone is stuck in the year right before Brandy's grandmother died. To Brandy's mom they still live in Georgia, Brent is 7, Ocean is 2, Scarlett and I don't exist. Half the visits she doesn't recognize Ocean . Brandy tried correcting her, but gave up after a few months. Used to joke about it being like the Ground Hog movie with the world being reset every day, but its worse, its like the world being reset everytime she takes a breath.
We tried photos and letters. They just upset her and she ends up thinking someone is trying to trick her.

Everytime Brandy goes to visit, at worst once a week, its the same line of questions, what is this place, where are my parents/brothers, when are we leaving...

[Bitter Jeweler]

Wow, OG.

That's one of the things i have a hard time with. Well, I have been able to roll with it, but when it gets like you say, "the world is reset", that's gonna get tough.
My dad tells stories repeatedly, it's just old age for him right now, but I listen again, and have conversation. My sister is funy, cuz she will tell him "you already told us that." Argument ensues. lol
I've tried to get her to stop doing that with granny. She might catch on eventually, to just let it go. She is not proving anything. Sis told me at dinner granny asked for more butter for her bread, which she already buttered. Argument ensued. I say, just let her butter her bread again. What's the harm? Besides, she loves her butter! I think there are different ways of handling things like that too.

[GGT]

Not bad ideas GGT. I don't think they make polaroids anymore though, LOL.

They made a come-back, kinda. http://www.bing.com/shopping/search?...instant+camera

But I like the idea of a guest book. Maybe some kinda scrapbook, visitors can contribute to, to help her, maybe, feel conected?

It's one of the first things elderly with memory or dementia need, and it makes a HUGE difference for most. Clocks with large numbers, calendars that help them keep track, pictures and visuals that remind them of yesterday or last week (and not just 50 years ago). They can probably tell a long detailed story about something that happened decades ago, but not what they ate for breakfast. They can tell you the first POTUS, but not today's POTUS. Re-orientation is something that has to be done almost hourly, but it can help.

Oh, they already decided where she can afford to stay. I'm cool with it, I just wish I could have been there when they told her.

Try not to fret or feel guilty when you're absent from those things. Granny probably doesn't remember, anyway. But moving forward....it may help her recognize you, when you DO come to visit, if the photo collage thing has some semblance or organization. That's just a personal anecdote I've noticed. Elderly who have loads of framed photos or things randomly hanging around, can't make the progression from "That's me when I was five. That's me when I was 30. That's me yesterday." Same applies to family.

<Oh come see my family photos! That's my, Bitter, when he was five. I remember that. Good times! What do you mean he's almost 40 years old now and has a beard? MY Bitter would never have a beard! I remember My Bitter when he was five years old (so MY Bitter is still five years old). Where's my Bitter and why doesn't he come to visit?> Yet you're standing right there, with your beard.

I also thought, even though I have that issue of remembering people while they were well, rather than not, I might like to try to take some pictures of her or with her. I expanded that, and thought maybe I could do a portrait session for the other old folkses. Aversion therapy?

More like immersion therapy. Psychology aside, you're such a great (and I mean GREAT) photographer. You see things others don't see, in shadow and light. You can turn expansive architecture more beautiful when you notice the details, and capture it with your lens. Bridges, roads, doorways, flowers; seeing the detail.

After all, you create small and lovely jewelry that reflects the larger whole person. Take a close look at your granny's hands. There's a whole world in those hands that tell a long story, quite hard to capture. Who was it that did a whole study of hands.....Michelangelo?

[Bitter Jeweler]

I like that idea. The pictures of us from young to old.

I don't feel guilty that I wasn't involved, I feel excluded, when I was the one who was pushing this ball earlier, and nobody was listening.

On the photography, I doubt she will let me take pictures of her. But i will try. In my photo circles, so many are into "fashion" photograpy with "pretty" girls, that I just don't get. That's the other reason for taking pics of old people. There are stories there. Emotions...

[GGT]

Brandy's mom is the same with the memory. Everyone is stuck in the year right before Brandy's grandmother died. To Brandy's mom they still live in Georgia, Brent is 7, Ocean is 2, Scarlett and I don't exist. Half the visits she doesn't recognize Ocean . Brandy tried correcting her, but gave up after a few months. Used to joke about it being like the Ground Hog movie with the world being reset every day, buts its worse, its like the world being reset everytime she takes a breath.
We tried photos and letters. They just upset her and she ends up thinking someone is trying to trick her.

Everytime Brandy goes to visit, at worst once a week, its the same line of questions, what is this place, where are my parents/brothers, when are we leaving...

It has to be organized, though. Can't just throw a bunch of photos around and expect her to make a linear connection. Too much stimulation is just as bad as not enough. That's why organized photo albums are good. It's also never productive to "correct" them. If there's any sense remaining that they're "forgetful", getting old, or sick....their ego will kick in. They still have some pride and will argue to keep it. For as long as they can. It's a fairly basic need, so don't deny them that.

[GGT]

Bitter, maybe this new generation Polaroid could be good for granny? She may even remember Polaroids and get a kick out of click, eject, view? Instead of you using a digital camera, editing, printing, coming back the next day (may as well be next year to her) and saying SEE?

[GGT]

I don't feel guilty that I wasn't involved, I feel excluded, when I was the one who was pushing this ball earlier, and nobody was listening.

[GGT]

Also, just so it's clear, I do know end-stage dementia, OBS or Alzheimer's victims can't necessarily be "retrained". If photo albums were the panacea, every patient would have one, designed specifically for their needs.

But it's something care-givers can't really "make" or "do", so it's left to the family. It's also one way family has valuable input and action, in a situation where they feel helpless.

[Catgrrl]

Grr, yes I know what you mean bout correcting or cutting off people that tell the same stories.

My Granny will do that occasionally (to be fair it is a huge family so we all forget who we tell what story to sometimes) but I would NEVER correct her. I just smile and listen.

Even my mother will do it time to time. She usually catches herself before she finishes. But if she doesn't my sister will get huffy with her about it. I want to tell my sister to shut the fuck up sometimes. Because even if she has told it, oftentimes it's a funny story so I like to hear it again anyway.

[Bitter Jeweler]

I want to tell my sister to shut the fuck up sometimes.

ME TOO!