A Fate Worse Than Death

My mother-in-law, who lives in an assisted living facility, would like to die and prays that God will take her

Photograph by Getty Images

I recently heard scientists discussing how they have slowed down aging in mice. Their long-term goal: delaying the onset of age-related health problems in humans. They envision things I can't, such as a happy old age extending into the triple digits.

Perhaps they haven't experienced loved ones in the final years of life the way I have. Consider my mother-in-law. At 91, she's pretty healthy. But I can't say she's happy.

Back in 2007, when she was 85, life was better. She was still able to drive and she was active in several organizations. She was able to do the thing she loves most: being useful.

Not that her life was a bed of roses. Her husband had passed away and a sizable slice of her time was spent at memorial services for friends. She lived in a retirement community and had begun to fear the day someone would decide she was no longer self-sufficient and send her "over there."

As far as I know, no one ever comes back from "over there"–the residence dedicated to assisted living. When people leave it, they go to the next stop on a one-way downward journey, to the netherworld of full-time nursing. According to my mother-in-law, by that time you'd rather be dead. She knows this because she witnessed her own mother-in-law's ordeal, attending to her through two bedridden years rotting away with cancer.

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The choice of dying is not available, however, since the goal of full-time nursing is to keep you alive. Possibly for years.

Fear of this fate caused my mother-in-law to hesitate before replacing the battery on her pacemaker. She figured the pacemaker could stand between her and a quick death. But it seemed wrong to opt out when she seemed so robust. She had the battery replaced.

I thought about my mother-in-law the other day as I watched the movie "Gravity." If you haven't seen it and don't know how it ends, stop reading. But if you saw it, you know that it ends on a triumphant and uplifting note — despite the death of one of the movie's two characters (and the more charismatic one at that).

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As I left the movie, I wondered why I felt so good despite the prime-of-life death of astronaut Matt Kowalski (played by George Clooney). He was a 10 on the likability scale and the story's real hero.

Yet, his death was not a downer. I suspect the manner of his death is what made it okay. Kowalski died the way he lived, bravely and without sentimentality. His last action was one of generosity; his last words communicated awe.

I tried to imagine how I would feel if the movie had hewed more closely to the end-of-life experiences of real-live Americans. I imagined Kowalski rescued at the last minute and placed on life support. He was fed through a tube to his stomach and supplied with oxygen by a ventilator. Machines monitored his vitals.

I saw his distraught relatives, gathered at the hospital and arguing about his future. A few wanted to pull the plug, arguing Kowalski would not want to live like this. Others couldn't bear to lose him. The hospital, having started "supportive" measures, felt compelled to continue them.

In the meantime, questions arise about long-term care. Neither Medicare nor NASA insurance cover this. His savings would go fast, leaving his family destitute.

Now the movie feels tragic. And instead of feeling energized, I feel angry. I want to throw my popcorn box at the wall.

That's how I feel when I visit my mother-in-law, now that she is living "over there." She moved a few years ago, when she became too frail to take care of herself. She's had to adjust to a tiny world, where all things revolve around care-taking. Nurses and attendants rule her life.

She would like to die. She asked the facility's doctors for help. They told her she would have to starve herself. She tried but couldn't. She has asked us to ease her out of life, but that is beyond us too. So she prays, asking God to take her.

He doesn't seem to be listening. Despite her frailty, her heart beats strongly, and her underlying health is remarkably good. She could go on for another decade.

My heart breaks for her, and I have begun to fear my own final years. Too much life can be worse than a timely death. I think Matt Kowalski would agree. I know my mother-in-law does.


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