Accept Mortality

Yes,it is the ultimatum to every one without exception,
whether one likes or not. We have our own reflections on old age,
retirement living and preparing for departure.Even people
who consider it inauspicious to talk about final journey,
indeed think a lot about the same.They do it more
frequently than what others do,without their own knowledge.
As you say, it's practical and pragmatic to think about these
issues and indeed plan for them without being unduly
sentimental. We owe it to our children to make the adjustment
to our going away easy for them.
I am reminded of Atul Gawande's ‘Being Mortal'?
For sure it's morbid but immensely interesting and thoughtful.
Old age Home is a great topic for some credible sociological research.
Research findings are not all benign. Some studies show that living
with other old people is actually depressing and accelerates
emotional deterioration. New research shows that people's
sense of well being is maximum when they live in
heterogeneous communities.
None of this is conclusive but it certainly is material for reflection.

The Katha Upanishad has perhaps, the best philosophical
explanation of Death in the form of a dialogue between
Yama and Nachiketas.


There are medicos who fearlessly talk about the travails
of their profession. They examine its critical limitations
and inherent failures based on personal experience
and that of their colleagues as life nears its end.
They meet with 'death' so often and are capable
of viewing the reality barring emotions and sentiments.
It is worth while to have hard conversations and
locate people who show us how to make certain
not to sacrifice what people genuinely care about.

Nursing homes, devoted above all to safety, battle with
residents over the food they are allowed to eat and the
choices they are allowed to make. Doctors tend to rely
on false hopes and treatments that result in shortening
lives instead of improving them.
We learn of an incident. It begins with a tingle in a surgeon's
fingers and a pain in his neck. A couple of years later,
he learned he had a tumor inside his spinal cord.
That was when the difficult choices began. Should he
have it removed right away in a risky operation, as his
doctor recommended? Or should he take time to consider
this question : At what point would the expanding tumor
cause debility bad enough to justify the risk of greater
debility or even death in trying to fight it? This is the
dilemma of a surgeon who is a patient himself.
How we can one better live with age-related frailty,
serious illness
and approaching death?
It is a clarion call for a change
in the philosophy of health care. A doctor's job is more
than ensuring health and survival, It is“to enable well-being.
For many, such talk raises the specter of a society
readying itself to sacrifice its sick and aged. Medicine
has been slow to confront the very changes that it has
been responsible for — or to apply the knowledge we have
about how to make old age better.”
Doctors also age.We have seen our family doctor since
1965.He has saved my husband and children from various
ailments and crises. We liked the approach he had, the way he
made us prepared for eventualities when my aunt passed away at 52.
As we became old, he also did.
I could see an altogether different person in him.
The bodily ageing takes us by surprise.
It was a dignified voice to older people ,like me
in the process of losing their counterparts.
I was made to see the world from my husband's perspective,
not just those of his doctor, worried family members which
included me too.But our family doctor who prepared
me to face the reality met with his end six months
prior to my husband.
Assisted Living cannot be defined at all. It differs
from patient to patient, place to place and time to time.
There are so many models of care that promote frail
people’s ability to live a meaningful life, by imbuing
them with cause or promoting their ability --to keep
shaping the story of their life in the world.
Arriving at an acceptance of one’s mortality and a
clear understanding of the limits and the possibilities
of medicine is a process, not an epiphany.
The ideal modern doctor should be neither paternalistic
nor informative but rather interpretive, helping patients
determine their priorities and achieve them.
Here is a touching example.
The piano teacher is on her final weeks. She was suffering
from terminal, untreatable leukemia. The doctor persuaded
her to leave his hospital and try, with his support, hospice
home care rather than passively await the future or
seek “death with dignity.” With a combination of
pain management and thoughtful physical assistance
she regained energy and found the zeal, in the six
weeks that followed, to give private lessons again.
She also enjoyed a recital organized by her pupils,
past and present, wherein they could all express
their gratitude to her. Three days later she slipped into
coma and passed away peacefully.
“Last days need not be lost days.”

jayasala 42