Profiting from the Dying

When my father was in the last year of his life, after a stroke rendered him unable to speak or eat solid food, my siblings and I made the difficult decision of enrolling him in hospice. Based on a friend’s experiences as a hospice volunteer more than two decades ago, I expected hospice workers who would spend time with him, comfort him and make sure he was never in pain.

But what I encountered were overworked and over-stressed staff. Although the hospice we hired had promised nurses coming every day, in reality they would come irregularly and stay a short amount of time, because they had many more patients to treat. We were promised spiritual counselors who never materialized. The social worker who seemed to genuinely care about my dad took me aside one day to tell me she was leaving the company because she was being asked to take on more clients than she could handle, and so was unable to give clients the care and compassion she thought they deserved.

It wasn’t always like this. When hospice was first started (by a British nurse in 1967), it was largely maintained by volunteers, people dedicated to comforting the dying. But a hospice system that was largely composed of caring volunteers changed when Medicare started paying for hospice care, and lot of businesses got stars in their eyes about how much money they could make off dying people. The result has been what you would expect: cost-cutting measures, mainly cutting back staff, to increase profits.

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15 Signs of Aging

You know you’ve reached old age when:

  1. You only buy pants that have elastic waists.
  2. The only performing artist you recognized at the Grammy Awards was Bonnie Raitt. Not only do you not know the latest hot musicians and actors, but your favorites from the old days are dying, getting strokes or showing up at awards ceremonies in wheelchairs or escorted by younger people.
  3. When you get together with friends, the first thing you talk about is your health: how was your knee replacement surgery? What are you doing for your sciatica? How did the cataract surgery go? Has John recovered from his stroke?
  4. Your keep Kleenex in every pocket of every pair of pants or jacket.
  5. You buy shoes a half size too big because your feet are getting bigger as you age and wearing down from overuse.
  6. Everyone speaks too fast. You’re constantly asking your TV-watching partner: What did he say?  Similarly, you forget who’s who in a complicated detective show and keep asking: Wait, who’s that? Was that the man who shot at the police officer or the one who found the body by the lake?
  7. The music in restaurants is too loud. But you hesitate to ask the server to turn it down because you remember your father making himself obnoxious by constantly complaining about the loud music and that he couldn’t even hear himself think. 
  8. You prefer old movies, preferably from the 1970s, over contemporary ones, which have strange plots and don’t make sense.
  9. Even though you hated him when you were young, Richard Nixon looks to be a model of dignity and honesty compared to the current crop of lying and cheating politicians.
  10. You and your friends tell each other how much better life was when you were young, how technology is ruining the world, people drive too fast nowadays, and young people don’t know how to communicate.
  11. You bite your tongue when you find yourself saying, “When I was young,” but you can’t keep yourself from telling your grandchildren that there was once a time before computers, the Internet and cell phones; that we only had four televisions stations; people were nicer then; we did all our research using the encyclopedia; and gas was less than $1 gallon. You want to impress them with how much the world has changed, but they don’t believe you and they don’t care.
  12. You buy shoes that come with Velcro closings because your arthritic fingers can’t quite manage tying shoelaces. 
  13. You’re bored by most TV sitcoms, which seem to feature young people endlessly flirting with each other.
  14. You’re horrified by the clothes young people are wearing now and the piercings and tattoos—so revealing, so tight! —conveniently forgetting you outraged your parents when you were young by wearing bib overalls, mini-skirts, short hair (for women) and long hair (for men).
  15. You start referring to “young people” to differentiate them from “old people,” of which you are now one.  You’ve crossed some threshold, and there’s no going back.

The Perils of Memory

I was recently on a trip with a friend who wanted to show me his favorite places in his home state, some of which he hadn’t visited for 20-30 years. But when we arrived at these treasured places, they didn’t quite match his memory. One place that he remembered as having several trails had none. A car route he remembered as particularly picturesque proved to be nothing special. A river he remembered crossing easily was now impassable.

I’ve had these experiences myself, especially as I get older, and it makes me not trust my memory. I have to wonder if we selectively remember certain things about a place we visit and forget other attributes, so when we revisit it years later we have to combine our faulty memories with the reality in front of us. Putting together these disparate views can be disorienting.

Or maybe our brain combines different places into one, taking the best of each place and creating someplace that, over time, becomes burnished in our memory as the perfect place. It’s that place we want to return to over and over again, the one we mentally escape to when life gets tough and we’re looking for a refuge.

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