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I wanted to like this book. I ended up with mixed feelings.

Leland’s mother had a DNR.

On p 19, he writes: “Her DNR said to withhold care if she had no reasonable chance of regaining a meaningful life. But this was more like bringing in a hose if the drapes in her room caught fire. Afterward she would return to the life she had in her neat apartment. She had friends and grandchildren she loved; she had matinee concerts at the Philharmonic. People with much less enjoy great lives. It seemed ungrateful to reject that life as not worth living. If she wanted to starve to death she could do it without our help. We approved the tube.”

This is cruel and heartless. Leland seems to be judging his mother and her quality of life. And starving to death isn’t as easy as it seems. One sip of water and it’s over.

He’s able to be more dispassionate with his interview subject, John Sorensen: “None of us really wants immortality on other people’s terms; it’s no kindness to wish a scaled-down version of it on the people who want it least.”

Some quotes:

p 22: “The elders all knew something you can’t get on the Internet, which is how to be old, and how the world looks from the perspective of someone who has lived in it for awhile and who will soon be leaving it.”

And he quotes Monika Ardelt, associate professor of University of Florida … “Older people still have a lot to offer us, even if only how to die and age gracefully.”

How valuable is that information? Most of the time people aren’t preparing to die. They want ordinary conversation about ordinary tings.

p 29: His interviewee Fred describes happiness as “a view from old age — taking satisfaction in what was available right now, not hitching it to the future.” Sounds more like prison than happiness to me!

On the other hand, more people need to be aware of this (p 33): “At eighty-five and up, only 11 percent live in a nursing home or similar facility, and almost two-thirds say they don’t have trouble caring for themselves…It’s just that the least healthy get the most attention–no one gets a grant to remedy the happiness of old people.”

Bg problem of cohort effect… selective memory of happiness.

This is simply bizarre (p 42): “Imagine that: to be free of the future, meaning the sum of all things that probably won’t happen, minus the one that will, which is one’s death. Even if just for a minute, the feeling is like that of first flight, weightless and free. Most of us live with this future every day, laboring under its weight. To think like an old person is to journey unencumbered.”

Ardelt’s study — pp 43-44 – doesn’t have a citation. He summarizes, “Those who scored higher for wisdom were more content with their lives [in nursing homes] — as content as people their age living independently.” I’d really like to see that research.

Quotes Ardelt, “Older people are more …afraid of the dying process. Wise people are more accepting of the dying process.” p 44

p 77 – “It is a received wisdom in our time that married people live longer.” He cites research showing that it just applies to oemen; but Bella DePaulo found that this research is generally flawed. Marriage isn’t associated with happiness or other positive outcomes.

p 91: “Loss is one of life’s great instillers of wisdom, including the wisdom that finds compensation for the capacities we think we can’t live without. Only people in California want it to be sunny every day.”

That’s absurd. There often are no compensations. Giving up things that hold meaning — independence, intellectual stimulation, choices — isn’t the same as wanting sun every day. The remark about California is condescending and should have been edited out.

He notes that decline “is more a relationship of negotiation, with some variation and wiggle room, than a fixed path.” p 91
Older people, he says, “now have statins to keep their hearts ticking, cataract surgery to keep the lights on, artificial hips and knees to keep them walking, and swanky scooters to keep them mobile when the new knees go south.”

Sorry, it’s not that simple. Statins have horrific side effects. Cataract surgery doesn’t always turn out well. Artificial hips aren’t always available. And “swanky scooters?” Would anyone choose them voluntarily?

Even over one year he noticed a decline among those he interviewed.

p 114: “If you believe you are in control of your life, steering it in a course of your choosing, then old age is an affront, because it is a destination you didn’t choose. But if you think of life instead as an improvisation in response to the stream of events coming at you — that is, a response to the world as it is– then old age is more another chapter in a long-running story.”

That’s a way to say, “Accept the bad stuff and be humble.” It’s the same advice you’d give to a prisoner of war. Escape is honorable.