Many of us baby boomers rebelled against the bullshit we detected in our racist, sexist society. We rebelled against a war we knew was a brutal lie. We advocated for civil rights. We demanded equal rights for women. Now we’re getting old. What will we demand for the elderly before we are too feeble, too sick to demand anything?
Were our outbursts in the sixties successful? Of course we didn’t produce the utopia or even the socialist system some of us envisioned. But we did make enough noise to inspire some progress in policies and lifestyle, including organic food choices and yoga classes.
We failed in many ways because we were up against a formidable opponent – our inner and outer capitalist. Corporations have succeeded in marketing a toxic lifestyle and we continue to buy it – from the two huge white trucks I see parked across the street in my neighbor’s driveway to the hormone replacement drugs that I took to alleviate hot flashes, drugs that undoubtedly contributed to the development of cancer in my breast.
If there’s fight left in us, we need to take on the healthcare system, not in terms of HOW we pay for it, but in terms of WHAT we pay for. Those of us who have made it to senior citizenship need to continue, or in some cases resurrect, our demand for honest and intelligent assessment of institutions and of our own complacency and collusion with corporate propaganda.
Consider pharmaceuticals. As I said already, I was poisoned by hormone replacement drugs because I gladly bought the assumption that menopause was a bad thing that my body shouldn’t be doing. I know that many women in my generation did let their bodies do what they were designed to do and adjust to the changes. I, unfortunately, had to be scared into stopping the toxic intake of phony hormones; and lo and behold, my body is adjusting. If only I’d had the fortitude to endure some discomfort – hard to do in a society that considers any discomfort a failure.
We need to beware of the tendency to pop pills. I truly believe that the LSD I did in the 60’s and 70’s was safer than many of the prescription drugs people are taking daily now. I’m glad I did psychedelics. I don’t recommend them to others, but I have no doubt that my mind was opened up to insights that remain powerful and that I otherwise might have missed.
The drugs that got people in big trouble then are the same drugs getting people into trouble now – addictive stuff. So, the first thing we need to be wary of is the prescriptions we are given for pain. Doctors and the so-called legal drugs they prescribe are more responsible for addiction than crack and heroin dealers.
Addictive drugs, such as morphine, are crucial for end of life care, when someone has a short time left and should be allowed to take whatever is needed to have more than pain to focus on.
But we need to be aware that pain medication, even non-addictive medicine like Advil or Tylenol, can cause harm, for example to kidneys and liver. Doctors may tell you to take them regularly for conditions such as arthritis, but we need to be informed about the damage they can do.
Right after my lumpectomy, my surgeon insisted that I get a prescription for hydrocodone. I told her I didn’t want it, but she said I needed to at least have it available if I did have horrific, sickening, writhing, hellish pain. Okay. So I got a bottle of it and ended up not using it. Not because I’m stoic, but because I didn’t have a lot of pain.
Unfortunately I do sometimes get seeringly painful, horrific, hellish headaches. A couple of weeks after the surgery I got one. I thought, “Hey – I’ve got those hydrocodone pills.” I took HALF the dosage suggested and the rest of the day I was so sick I couldn’t eat a cracker without vomiting. What if I had taken the whole recommended dosage right after surgery when the general anesthetic was still kicking around?
Doctors, often lobbied by pharmaceutical companies, do NOT always know what’s best for us. We need information. We need to educate ourselves about drugs and make our own decisions. We need to take advantage of the progress that has been made, such as the willingness of insurance companies to pay for acupuncture treatments.
If you’ve done hospice work, if you’ve been to any nursing care facility, you know the enormous amount of drugs people take. No doubt some of them are necessary. But we need to understand that many of the drugs that are given to the elderly and sick are prescribed to treat the side effects of another drug. For example, pain meds often cause serious constipation, and thus stool softeners and laxatives are required. (When I was prescribed hydrocodone, I was also given a prescription for a stool softener; that wasn’t a good sign to me.)
End of care life should include all the palliative methods available, including pain meds. And an effective drug for chronic debilitating conditions is a blessing. But we, the patients, need to be informed enough and respected enough to decide for ourselves what risks we are willing to take.
In many cases the elderly are not able to make clear decisions, because of dementia or some other condition affecting mental acuity. It is so disturbing for me to see old men and women sitting in wheel chairs in nursing homes, opening their mouths like baby birds to be fed pills whose names and purposes they don’t know.
Before we get to that point, those of us who demanded that women and minorities have rights need to insist on informed choices in treatment, not just financial coverage.
There are plenty of role models, like my 84 year old neighbor who spends much of her day in her stained glass workshop, invites people over to play pool with her, and rides an exercise bike while watching the news. For years she has refused to fill prescriptions for drugs she didn’t think she needed.
I know of another woman in her eighties who had leukemia. A woman who got a degree in chemistry in the 1930’s, one day she informed her family, with her wry humor, that realizing she wasn’t even enjoying Ben and Jerry’s ice cream any more, she was going to stop life support measures. She died peacefully with her daughter by her side.
And the Gray Panthers are still a thriving group, though they don’t get much press. Here’s the website: http://www.graypanthers.org/. Their vision statement: “Create a humane society that puts the needs of people over profits, responsibility over power, and democracy over institutions.”
I will do anything I can to not spend my last months in a nursing home or hospital. And I don’t want the focus of my life to be one of those big pink plastic boxes with compartments for the days of the week that each holds a pile of pills. I hope to die looking at the finches in my yard and listening to John Coltrane’s “A Love Supreme,” having just had a bite of chocolate cream pie.
I need to continue working on my own psyche so as not to be muddled by a fear of death or old age. I need to remember that it is my choice not to take a pill, to get a second opinion, to endure some disappointments and pain. And it is my responsibility to use whatever mind is left to me to understand such choices and to insist that they be respected.
Dianne SchliesAugust 18, 2010 at 12:34 pm
YAY YOU! Gotta get the Coltrane out.
Mary Palmer LegareAugust 28, 2010 at 9:56 pm
This piece makes me think of a simple thing my Mom wanted to do in her last days. She simply wanted to go to Walmart to get specific Christmas presents she had in mind to give my father. I didn’t think twice about loading her into a wheelchair, then into the car, then back into the wheelchair and pushing her around Walmart for as long as she could take it. After all, she had not given me a list she wanted me to pick up for her; she had asked me to take her there.
Well, judging by the reaction of the rest of my family, you would have thought I was taking out a gun and shooting her in the head or jamming bamboo under her fingernails. “It’s a mistake”;”She’s too weak.”; “She’s so fragile.” “It will just exhaust her.” “It will aggravate her pain.” “How can you do this to her?”
Everyone in my family wanted to keep her “comfortable” and “minimize her pain”, but it seemed so clear to me: my mom had a vision of how she wanted this last Christmas to play out for her, and it did not involve lying in bed having her pillows plumped. It involved going to the store herself and finding these specific gifts for my dad which she believed only she was capable of doing properly. I wanted to help her achieve that vision. I felt strongly that her voice and her request were what needed to be honored, not everyone else’s idea of what was good for her. if she was game, so was I.
So off to Walmart we went, under the disapproving glares of my brothers and sister-in-law. It was a sweetly bizarre venture. The gifts she selected were odd. Why on earth did she think my dad needed holiday paper cocktail napkins? The time we spent as I described in minute detail the colors and designs (she was basically sightless by that time) seemed unnecessarily tedious until I suddenly got to the one that she had apparently been waiting for. She jumped on it so decisively that I realized she had been listening intently for just the right one to match the vision in her head. She was extremely picky about it.
my dad, of course, did not care a whit about cocktail napkins and had no plans to ever entertain without her, but clearly the napkins and their details had a tremendous significance to my mom. Perhaps she was getting them precisely because he would never do such a thing for himself. Maybe the napkins were one last way for her to take care of him, to say to him life goes on–you’ll have to do Christmas without me next year, and you’ll be really glad you have these cocktail napkins then…
Who knows? And does it matter? When we got back to her hospice room, she was indeed exhausted and in pain, but that’s what sleep and the morphine drip are for. Clearly she had accomplished what she needed to, and before she drifted off into a satisfied haze of sleep, she managed to direct me in properly wrapping each gift with the appropriate paper and ribbons, and the correct information on the To/From labels.
Four days later, my mother was dead.
But she had achieved what she had set out to do for this last Christmas with dignity, her choices having been respected and honored. I know it was physically and mentally taxing for her, but I also know it was absolutely right to follow her lead. She did not regret the trip one iota, and neither do I.
Your blog had a lot to say about our cultural fear of pain which I think we now define as any minor discomfort, physical, mental, or spiritual. My mother clearly preferred the pain of actual living to the comfort of waiting to die. She wanted clarity, not numbness and confusion; she wanted to be present with us despite the pain. At the end of her life, there was a point at which the pain was so intense that it was as mind-numbing as the drugs. For her, that was where the morphine came in. Better to be delerious with drugs than with seering pain. But she hung onto her clarity as long as she could to be present to her own process of dying, and to make decisions about how she wanted to do that. And in the end she did it well, and on her terms.