Is 85 too old to climb Mount Everest?

From a WashPo article – Should Nepal impose an upper age limit on climbing Mt Everest?

A study of climbers 1990-2005, showed that overall climbers made it to the top 31% of the time with a 1.2% chance of dying. Those 60 and up? 13% chance of reaching the summit and 25% chance of dying. Recently an 85-year-old man died, apparently of altitude sickness, while waiting to climb. Much better than living with the aftermath of a heart attack or stroke.

My response: If you’re over 60 you get to choose your risks. Dying at 85, surrounded by fellow climbers, in the fresh air of a beautiful mountain … why is this worse than living a few more years to die in a nursing home, surrounded by indifferent caregivers, eating bad food, forced to accept invasive medical procedure you probably don’t need, and possibly tied to a bed or a wheel chair, subject to verbal or physical abuse?

Patrick Henry said, “Give me liberty or give me death.”

What’s wrong with, “Give me freedom to stay out of a nursing home or give me death.”

“No Spouse, No Kids…Prepare to Age Alone”

Finally a mainstream publication recognizes that many in the aging population don’t have “the family” to care for them. It’s worth reading here.

It’s positioned in an upbeat way, suggesting that you can take control of your life in these circumstances.

Like most journalists, the author chooses the condescending term “elder orphans,” implying that those aging alone are helpless victims. The terms also invokes a touch of insulting humor, with the contrast of “elder” and “orphan.” An orphan is someone who has lost both parents.

Applied to any adult, the term seems irrelevant. It’s the absence of children and spouses that leaves the aging person with no source of help, yet exposed to considerable abuse, including abuse from mainstream medical professionals.

Additionally, the story ignores reality. It very difficult to find a proxy who’s willing to step up and who’s reliable, especially if you’re a “pull the plug” kind of person.

And it’s not that easy to stay connected. Age discrimination is social as well as economic. The elderly are considered irrelevant in our society.

But at least we are acknowledging that there IS a problem. That’s a good first step. Now we need to hear from more people who fear this situation.

“Living to Age 75” Is NOT Selfish

It’s long overdue. We’re hearing about people who want to die on their own terms. Ezekiel Emmanuel’s article, Why I Hope To Die At 75, should be required reading for everyone.

I get totally frustrated when I read (or hear) people say, “Suicide is selfish.” The survivors are the ones who are selfish. They’re asking their “loved one” to hang around long enough to be stuck in a nursing home, where it’s not considered abuse to tie someone to a chair in diapers in front of a television set. Even if they visit every day for an hour, which is extremely rare, they’re asking the relative to put up with 23 hours of misery so they can have a single hour, not to mention the “feel good” emotions of saying, “My mom…” or, “My dad…”

We also forget that more and more of us are single and living alone. We’re used to solitude. We’re not used to sharing. Just adding a caretaker to our lives removes all possibility of a decent quality of life.

Emmanuel’s article gets it right. The people who chug along into their 90s are outliers. Getting pneumonia is a blessing. The idea is to die before you become disabled. Ironically, if we knew we could pull the plug anytime on demand, many of us would choose to live longer.

I’m going to print out his article to share if I have to see a doctor again. They probably won’t listen but it might shorten the conversation.

Right to die: values, not psychology

The decision to die is a matter of values, not mental illness.

When conversations get difficult, or patients don’t do as they’re told, all too often the medical doctors turn to “psych consults.” A friend who’s married to a psychiatrist told me the hospital now tells “mental health professionals” to find patients incompetent when their decisions go against the hospital’s bottom line.

Psychiatrists can assess physiological components of mental illness; psychologists and some psychiatrists can help people change their thinking and behavior to become happier and enjoy smoother lives.

But what if your only option is living in “assisted care” with minimum-wage uncaring attendants, where you can be tied to a wheel chair in diapers and placed in front of a television for hours at a time, with tasteless food and frequent needle pricks for tests that don’t affect your longevity or well-being?

That’s the common nursing home experience and it doesn’t take a psychologist to see that a wish to die is completely rational.

A professional who diagnoses depression in this circumstance should be tied to a chair in front of a television set tuned to soap operas, wearing diapers, for at least 4 hours. Don’t tell him when you’ll be back. If he complains, say patronizingly, “Oh, are we feeling upset today?” and tell him he can’t have dessert after lunch. Throw in a few needle sticks and see how he feels at the end of the day.

“I died today…” Photoset of a dog’s last day

This photoset went so viral it broke the server. Click here and prepare to be moved. 

It is a beautiful story of a beloved dog’s last day on earth. Dukey was dying of cancer. He’d lost a leg but the tumor kept growing. Since he wasn’t comfortable, Dukey’s family arranged for the vet to come and give him some relief.

They wanted his last day to be something really special. So Dukey got to eat all the hamburgers he wanted. He went to the splash park with his groomer who was also his best buddy. He spent time with the family, telling jokes and reflecting on how much love he’d had. (Yes, the photographer’s comments are a little anthropomorphic, but who cares?)

Dukey finally goes to sleep on a blanket at his favorite park, surrounded by love.

Thousands of people sent comments, and a few echoed my own sentiments. Why can’t humans get to go this way, too?

If Dukey were a human  in a hospital, hospice or rest home, he’d be with strangers. Families are scattered. Doctors will do everything they can to keep you alive. We hear horror stories of sticking needles into people when they’re close to dying. Some cruel doctors even encourage their 90+ patients to get colonoscopies.

Perhaps the cruelest indignity is the way many medical people will insist on feeding people the same horrible food they’ve been getting. I’ve heard first-hand stories of caregivers trying to give their loved ones ice cream, only to be told, “But it’ll spoil their appetite!” Or, “It’s not good for them.”

That’s why I think everyone over 70 should be offered a cyanide pill, no strings attached. You don’t have to take it. You can ask for all the medical care you want, even if it runs up a big bill and delivers nothing but pain, suffering and a big stroke to the doctor’s ego.

But I bet things would be better if we had that choice. We could turn away from nursing homes that resemble prisons, saying, “I’d rather die.” If enough people did that, there would be more incentive to treat people humanely.

I suspect a lot of sick people are ready to say good-by. It’s selfish for their families to deny them the chance to slip away like Dukey the dog. I think they’d rather die on their own terms, eating their favorite foods, doing the things they want … maybe listening to a favorite piece of music.

I’m not in favor of capital punishment. But we recognize the need to give condemned men and women a decent death. A lot of places offer a last meal and a spiritual guide, something people in nursing homes and hospitals can’t get.

I am haunted by the images of Dukey. They are sad in  a good way. They show what I’d want for me.

 

Incapacitated or Making A Value-Based Decision?

In this article, Addressing Capacity, Dr. Mark Lachs notes that 40-50% of people over 85% have some form of cognitive impairment.

In one example, a woman refuses to admit caretakers to her home. “What if there’s a fire?” she’s asked.

If she says, “I’m willing to take the risk,” she may just not be aware of what’s going on.

If she says, “I’ve lived a long life and I am willing to take that chance to maintain my privacy and independence. I can wear  a life alert pendant.”

Dr. Lachs notes that people have the right to make that choice. I wish more doctors did.