“…A time to die…”…but when? And how?

Baby Boomers are the first generation in human history to be able to rely on medical advances to prolong their lives considerably. They have, in effect, added on average more than a decade to the traditional, biblical ‘three score years and ten’ as a result of medical advances enabled by technology – accelerating in particular since the start of the twenty-first century.

However, in the universe we inhabit, light and dark co-exist: one does not come without the other.

The shadow side of this striking gain in longevity is that death can now be put off for a considerable time, often resulting in – on average – eighteen years of deteriorating health with its attendant misery for the individuals involved, their families and friends. The economic realities of this are becoming more and more pressing. Western countries, on average, are dealing with a population as a whole who consume more in health care resources in their final six weeks than in the whole of their preceding lives.

Most of us can now quote several cases from personal experience or from hearsay, of individuals whose lives were painfully prolonged: by those individuals not having made their end of life wishes clear; by families’ general inability to communicate with one another regarding the painful and threatening question of the inevitability of death; and by the medical profession’s increasing focus on the technicalities of technology-expedited care, rather than the humanity, compassion and tough-minded realism required to enable people to have, as well as a good life, a good death when the time comes that life has no quality left and there is only distress and suffering.

On the latter topic, I highly recommend surgeon Atul Gawande’s wonderful book “Being Mortal: Medicine and What Matters in the End”, currently topping the best-seller lists. Here, the author tackles the hardest challenge of his profession: how medicine can not only improve life but needs also to address the hard problem of how to assist the process of its inevitable ending: with greater humanity, care and wisdom than is all-too-often practised at the moment.

In the UK, as the assisted dying debate rages on, with around 75% of the population supposed to be in favour of some form of assisted dying being legalised, increasing numbers of people are choosing to take matters into their own hands. For example, at the end of July 2015, a healthy 75-year-old former nurse took her life at a Swiss suicide clinic after saying she could not bear growing old. Gill Pharaoh – who had specialised in nursing the elderly – said old age was not ‘fun’ and that she preferred euthanasia to becoming ‘an old lady hobbling up the road with a trolley’. Only this evening, I found in my email inbox the following from the UK’s Dignity in Dying campaign:

“Today, Bob Cole had an assisted death at Dignitas in Switzerland and his story has been covered by almost every major media outlet in the country, including a front page in The Sun newspaper.”

I would be most interested to know where my readers are on this crucial issue. My husband and I have completed Advance Directives, stating clearly in writing what our wishes are – and are not– regarding medical care at the end of our lives. To this we have added Power of Attorney documents which give added weight to our Advance Directives. The latter at present have legal force in England but not in Scotland.

I also persuaded our GP to obtain Do Not Resuscitate forms, normally kept in hospitals, which we have included, signed by him. Copies of all these are now with us, our GP and geographically closest next of kin.

All this, of course, may not be enough if either of us is painfully and terminally ill and palliative care, which in theory should be fully available to everyone but regarding which anecdotal evidence –sadly– is building to show where such measures have failed or are inadequate. What would one, other, or both of us do then? I have to admit that, at present, I do not know the answer to that….I’ve also lived long enough to know that, often, you really can not know what you would do in a very tough situation until you are actually there….

A year or so ago, before my husband and I had sorted out what we would do in terms of advance wishes, I had a discussion on the topic of what one does at the end of life with my dear friend Peggy. In her mid eighties, she is still amazingly active, enjoys life, and continues to be a wonderful support to other people as well as a shining example to those of us coming behind her regarding how we should grow older. Peggy, of course refuses to be complimented – “Away with you!!’ is her usual retort.

I recorded our conversation, which is quite short, and have Peggy’s permission to share it. It has the usual mix of Peggy’s and my conversations: a rich mix of grave seriousness, black humour, and sheer irreverence. I hope to post this conversation next week, to continue the dialogue on the topic of how we face and deal with death and dying in the 21st Century.

In the meantime, do let me know what your thoughts are on this, one of the most important issues of our era.

**********

900 words copyright Anne Whitaker 2015
Licensed under Creative Commons – for conditions see Home Page

Do you really want to live to be a hundred?

“Yes, life IS precious but maybe you truly can have too much of a good thing…..”

So said commenter Eileen Williams, in response to my guest and fellow writer Joyce Mason’s article on the topic of longevity to which I am happy to be linking at the end of this article.

Ever since the Big Bang, which is the prevailing scientific theory thus far regarding how life originated in the universe, we have been confronted with the reality that creativity and destruction are woven together. Without that monumentally, unimaginably destructive Big Bang, the creative energies which ultimately produced the richly teeming life we have on planet Earth – and probably many other planets as yet undiscovered – would not have come to be.

Each tiny human, little energy flash in space/time, carries that dual spark of positive/negative, creative/destructive power. We have to learn to balance our creativity with our destructiveness – you could argue on the large scale that the whole of human history has been about that grapple. It is simply not realistic to think that we can have light without shadow at any level in our complex world, either at a personal or a collective level.

Every advance brings that duality. At this point in our history, humans from the post-Second World War Baby Boomer generation onwards are having increasingly to face a dilemma never faced before by human beings. It is this: amazing advances in public health and general medical care have enabled those of us who live in the West and increasingly in the East, routinely to achieve life spans which were rare in previous centuries.

My grandparents almost all lived into their eighties. This was unusual for their generation. Now, people routinely live into their nineties. This is fine for many people who live to a healthy old age, then die suddenly. We all aspire to this. But this great advance carries a very dark shadow. An increasing reality, and one which is set to consume a huge proportion of the economic resources of affluent countries, is that quality medical care now available for people in later life is prolonging many lives well beyond their ability to contribute to society, family life or their own happiness.

http://epistemic-forms.com/Visual-Thinking.htm

What do we do about this? It is an issue which we simply have to grapple with and resolve somehow. Shortly after finishing this article I will be heading for my local hospital to visit a dear old friend in her nineties, frail and ill, depressed and having lost entirely the spark which her freedom to get about had given her, allied to her own indomitable spirit, well into old age. She just wants to go. But medical care of high quality is helping to keep her alive.

Over the last few years I have heard some awful stories about the prolonging of lives which had, by any common sense measure, reached their natural end. A vivid but by no means uncommon example of this can be seen in the story of a friend’s grandmother in her late eighties who had a severe heart attack and would not have survived. But resuscitation techniques dragged her from the brink to endure a miserable, ill eighteen months before she eventually died.

I am horrified to think that I or my husband, in old age, could be hauled from the edge of dying to an existence in some miserable twilight until death eventually could not be staved off any more. We have living wills. But would the paramedics called to an emergency if one of us had a severe stroke, know that we do not want any intervention which would drag us back to a life of severe incapacity?

I think that in our materialist society the essence of what is a complex and multi-faceted issue is this: we are culturally afraid of death and do not know at this point how to face or manage it with compassion, wisdom, respect and common sense. We were better at coping with death hundreds of years ago than we are now. Religious faith is on the wane, secularism on the rise, and the tyranny of too much choice and too many options is increasingly holding us all to ransom.

Well, what are we going to do about it?

Dealing with end-of-life issues is very much a topical issue here in Scotland at present, with this month seeing a further presentation of an End of Life Bill to our Parliament by that gritty, courageous individualist and Independent Member of the Scottish Parliament, Margo MacDonald, who suffers from Parkinson’s disease. She wants the right for herself and others to end their own lives with dignity and with the assistance of the medical profession.

There is considerable opposition to the Bill right across the board, as can be seen from just one recent article:

http://www.christian.org.uk/news/end-of-life-bill-could-bring-death-tourism-to-scotland/

But Margo, as she is affectionately known here in Scotland, has done us all a favour by triggering a nation-wide debate and discussion on the issue of what we do about end of life issues. Economically, socially, and personally, we have to find a better way of managing the issue of how we face death in general and individual’s deaths in particular. It is too costly at every level to keep sticking our collective heads in the sand. We are fortunate indeed in the UK to have a thriving Hospice movement which offers wonderful palliative care to people who have reached the last stages of their lives. But there is not enough of that type of care.

We cannot live forever. We all have to die sometime. So what are we going to do about this huge problem?

While you think about it, check out that fine writer and fellow Baby-Boomer Joyce Mason’s thoughtful piece

Do You Really Want to Live to be a Hundred?

****************

1000 words copyright Anne Whitaker 2010
Licensed under Creative Commons – for conditions see Home Page

No, you probably don’t have Altzheimer’s….!

This post should probably be appearing on my new site

MoreBitsFallOff.com

However, being an uncharacteristic hive of industry today, I have posted something new there already – check it out! What was I saying? Oh yes, NOW I remember…..which brings me to the friend in whose honour I am republishing a book review which appeared here on ‘Writing from the Twelfth House’ last year. I spoke to her this morning. She was (once again!) so worried about incipient Altzheimer’s that she wanted to re-borrow the book I had lent her last year which she had found incredibly reassuring. It is called “Where did I leave my Glasses?” and is absolutely wonderful. No-one over the age of fifty should ever leave home without it.

Here is my review:

“Where Did I Leave My Glasses?”

The What, When and Why of Normal Memory Loss

by Martha Weinman Lear

A few weeks ago my husband dashed off to an evening meeting. Shortly afterwards, he rang me, sounding stressed. “Can you please find my glasses for me? A friend is passing by shortly – she can pick them up and bring them along to the meeting.” My irritation with him dissolved into fits of laughter when I eventually found the glasses. Where were they? Yes, sitting right on top of the book he was then reading, called “Where Did I Leave My Glasses?” by Martha Weinman Lear.

One of the realisations which don’t dawn until the fifties – I speak for myself here, maybe you are ninety-six and still in denial! – is that it’s all downhill physically from now on. I think writer Richard Holloway is right when he talks in one of his books (surprise, surprise, can’t remember which one….) about the importance of starting to cultivate fortitude once you reach your fifties. Time is going to win, and you, small speck of ephemeral matter, are going to lose – no matter what you do to try and stave off the aging process.

An indestructible sense of humour is a huge asset in facing this truth. So is information which cheers you up rather than depressing you. Everyone over the age of fifty should therefore read this book. It succeeds in being simultaneously very informative and very entertaining on the topic of normal memory loss, a subject which generates intermittent worry for, I would estimate, at least 99 per cent of us who are baby-boomers and older.

Martha Weinman Lear, former articles editor and staff writer with the New York Times Magazine, is well qualified to research and present information and opinion on the topic of memory loss, having written extensively before on social and medicine-related topics.

I infer from the book that she is a person past the first flush of youth. Here she is, inviting us to

“Consider our own memory situations, yours and mine.

Here is mine:

Adjectives elude me. Verbs escape me. Nouns, especially proper nouns, totally defeat me. I may meet you at a party, have a long, lovely conversation with you, be charmed by you, want to know you forever, and a day later not remember your name….”

The book is laugh-aloud entertainment, rooted in real conversations with real people all of whom including herself have funny disclosures to make centering round the five top responses to the question she put to all the lay and expert interviewees in the book, ie ‘What can you most reliably depend upon yourself to forget?’

These five were:

Where did I leave my glasses?

What was I just saying?

What did I come in here for?

What did I ask you to remind me to do?

What’s her(his, its) name?

Lear’s book may be wittily written, but it is also thorough and well-informed in exploring aspects of normal memory and memory loss, including why we are actually wired to forget. She covers a range of topics including sex differences in memory function and deterioration, different types of memory, how to train the aging brain into being more efficient at remembering – and most fascinating of all, the future of memory enhancement in a culture where increasingly we are living longer than biology built our bodies to last.

I found “Where Did I Leave My Glasses?” enormously comforting and reassuring in the face of the spectre that haunts our increasingly long-lived Western populations – Altzheimer’s. Lear’s book’s central message is that most memory lapses beginning in middle age are universal: a normal part of the inevitable process of aging.

In short, don’t worry if you don’t know where you left your glasses. But do worry – and seek help – if you can’t remember what your glasses are for….

(this is the slightly edited and re-published version of a book review published on this site in 2009)

800 words copyright Anne Whitaker 2010

Licensed under Creative Commons – for conditions see Home Page

To the website! Chapter Three (at last!)

“Welcome to Facebook! Say goodbye to your life….”

(Message from a friend on the day I joined)

Now read on!!

Chapter 1

“……Much of 2007 was taken up in reflecting on a challenging topic: should I become more computer literate – a writer with a website – or sink slowly to the bottom of an ageing and increasingly befuddled slime of computer-refusing baby-boomers?

Befuddled slime did not appeal……”

….. To the website! Chapter One (c/f July 08 archive) described the process of acquiring a new AppleMac laptop and getting on the Net via mobile broadband – both accomplished during April 2008.

Chapter 2

“……Still can’t quite believe this….it is September 2008 and I am now a writer with a website. To inspire and encourage other writers in the same direction, the first thing to say is this: the process of moving from dinosaur to cyber-babe has been great fun, very creative, and not that difficult…..”

……To the website! Chapter Two (c/f Sept 08 archive) chronicled my progress – as I slowly built Writing from the Twelfth House – from bottom of the cyber-literacy food chain to a few links up, ably aided by my web person Susan Elena and my highly cyber-literate friend Willie Miller. In September 2008, not without some trepidation, I started posting articles weekly. Traffic soon increased….

and I said “……To the website! Chapter Three…... will appear in a few weeks, to give you some ideas and tips on the very important ongoing task of publicising your site. Watch this space…”

Chapter 3

Nine months and a considerably longer number of weeks later than I had intended, many apologies to those (three? four? two? one?) addicted writer followers, gazing at an empty space, whose lives have been blighted by the persistent non appearance of Chapter Three. Sorry. Sorry! OK?

Seriously though – it has taken much longer than I thought for a perspective to emerge which I hope may be useful to other writers who are still contemplating the leap into cyberspace. The terms of reference of this third article, therefore, have broadened somewhat from my originally stated intention….

Regular readers will know from the ‘Just let me get old, ok?’ theme that one of my preoccupations is how to face the reality of growing older with as little denial and as much grace, humour and realism as possible. An aspect of ageing which needs to be resisted is that increasing pull to stay with the familiar, avoiding taking on new challenges.

I feel a great sense of satisfaction at having managed to tackle and overcome my own fears and resistances, succeeding (with a lot of help!) in setting up a site which not only pleases me, but more importantly – judging from the messages and emails I have received – does offer support, information, entertainment and inspiration: my stated aspirations in setting up Writing from the Twelfth House.

Here, then, are a few perspectives I have gained in the last year which may be of use:

* realise from the outset how addictive the internet is – if you aren’t disciplined your whole life will get sucked into it. How much time do you want to spend? If you don’t build in restrictions, the Web will take over. Networking sites need to be especially watched for this reason. My friend’s sardonic comment on my joining Facebook could have been predictive!

That same friend thinks I’m mad (he’s a 12 hour a day minimum web nut) to lock away my computer over the weekend in the office, and to have a policy of not checking emails every day – though at times I do give in. If you aspire to a balanced life, and are too weak-willed to resist the siren call, use tactics which will separate you from the Web.

* set your site up as a blog – initially I was rather dubious about a blog format – I’m not interested in daily chatter about my cat etc, which was rather the way I perceived blogs until I researched other people’s, set up my own, and became more knowledgeable about how flexible an instrument this format can be. It can be adapted for whatever your purpose is.

The interactive nature of blogs is also ideal, opening your Web experience out to a positive and creative sense of community-building. If you join eg WordPress which I really like, there are various safeguards built in – great spam filtering and ease of monitoring comments, enabling you quickly to get rid of anything you do not wish displayed.

I can see that my own site is more like a magazine than anything else, since I use it to republish articles which I still think are of interest, offer new material, and publicise my books. From June 2009, I am pleased to be launching an occasional Guest slot, in which I will be publishing material from writers whose work I like which fits into the ethos of “Writing from the Twelfth House”.

* it is very important to keep in mind what your site is for – and what your aims are. Your Home Page should state this briefly, simply and compellingly. Humour helps in getting the message across – as does an arresting visual image. It keeps focus to refer back to your objectives often.

* have lively and varied content – post regularly, interact with your readers, cultivate contacts with sites you like and build relationships, trade links, be generous. Post articles on showcasing sites eg Author’s Den, Creative Carnival, Blog Carnival, Technorati, Zimbio: get listed as much as possible.

* be happy to take critical feedback on board – for example, in the autumn of 2008 I had an email from a visitor to my site saying that she found my use of colour – mostly black and green, with some purple –confusing. She had clicked on some parts highlighted in green or purple thinking they might be links: they weren’t.

Not having had anyone else comment on this, on checking I discovered that I had not followed an early golden rule, ie underline all links: do not use underlining in editing UNLESS it is a link. I could see where there might be some confusion, over the next couple of weeks re-editing the whole site to fix this problem. Thanks, Linda!

* keep adding new links – I have begun to date the links I add, partly to let readers see how up to date they are, but also to keep me on my toes!

* don’t get complacent and sink into a comfort zone – be aware that your site is a work in progress, and keep an eye open always for ways to improve it.

* know yourself and be realistic about your limitations – this applies to everything in life, including running a website. For example, although I have got myself listed on Facebook, Twitter, LinkedIn (professional networking site) etc, I simply cannot be bothered chattering for chattering’s sake and acquiring scores of cyberfriends (I prefer the flesh and blood kind!) although I know perfectly well that this is one of the best ways to build up a big following. (it is also a major way of saying goodbye to your real life!) I also don’t want to carry ads or do any of the commercial things which will bring traffic to my site but distract attention from the content.

My overall aim is for gradual growth of traffic, and moderate success in attracting a regular group of visitors who share my interests and preoccupations – as well as now having an essential tool for promoting my books. This is happening. I am a happy cyber-babe!

STILL teetering? Go on – jump!!

*********************

Licensed under Creative Commons – for conditions see Home Page

Book Review:” Where Did I Leave My Glasses? ” by Martha Weinman Lear

” Where Did I Leave My Glasses? “

The What, When and Why of Normal Memory Loss

by Martha Weinman Lear

I infer from the book that she is a person past the first flush of youth. Here she is, inviting us to

“Consider our own memory situations, yours and mine.

Here is mine:

These five were:

Where did I leave my glasses?

What was I just saying?

What did I come in here for?

What did I ask you to remind me to do?

What’s her(his, its) name?

In short, don’t worry if you don’t know where you left your glasses. But do worry – and seek help – if you can’t remember what your glasses are for….

Licensed under Creative Commons – for conditions see Home Page

To the Website! Chapter One

Susan Elena is quite a woman! I am a person of somewhat fixed ideas, and she has proved herself expert at dynamiting them. For example, I would have spent months angst-ridden over exactly WHEN to launch the website – but she simply went ahead and did it in mid May. I had no intention of posting anything else on this blog page until September – but, quailing under her humorously withering look when I said I’d post an article for practice then take it off, I have as you can see simply left it on….

The intention in posting To the website! Chapter One is very simple : to encourage all writers to GET A WEBSITE ! I hope this encourages you, wherever you are….

” Much of 2007 was taken up in reflecting on a challenging topic: should I become more computer literate – a writer with a website – or sink slowly to the bottom of an ageing and increasingly befuddled slime of computer-refusing baby-boomers?

Befuddled slime did not appeal, and my old second hand laptop was throwing minor but alarming wobblers. Then the decision was sealed late January 2008 by a visit to the Women Writers Network website, an excellent organisation of which I am a member. I couldn’t believe my eyes. Only four members of the network had sites listed then.(2009 update: sadly, Women Writers Network is no more….)

Researching writers’ websites glaringly exposed the limitations of my dial-up. Its slowness made it impossible to access many sites. Something else became very clear. Having a website meant investing in a new computer and some form of broadband. I could access broadband and WiFi from home. But my office building has no WiFi and my office – being a place to hide – has no phone line. Next conclusion: I needed mobile broadband.

Three things became evident from my restricted and patchy research. First, it is mad to be a writer, especially if like me you will shortly have a book to promote, and not have a website. Second, you need to decide on a focus: author-focused, book-focused, or issue-focused. Third, if you are not technically-minded, you need to find an anorak, preferably under thirty, who won’t charge you the earth, will set up the site competently, and steer you patiently through the whole process.

I found my anorak, a can-do, competent young woman of twenty-eight : Susan Elena. Then I hit the wall, waking up at 3 am with acute anxiety. The prospect of what lay ahead felt overwhelmingly daunting. My state of retreat and paralysis lasted much of March.

However, early in April the paralysis broke with a simple decision. I would set aside website building meantime, to concentrate first on acquiring the new computer and going on mobile broadband. The very next afternoon I was able to go into my office – where, incidentally, the building, being tarted up to enable a public enquiry, was crawling with noisy workmen – and get down on paper my website requirements and sample home page. I had been putting off this task for weeks.

On Monday 14 April I had a one-hour shopping appointment to discuss my requirements with one of the staff at the AppleMac store in central Glasgow – Justin. He was great. Tuesday saw me buy a new MacBook, taking out a three-year aftercare plan which a friend described as “the best value on the planet”. He was right. The support I had initially could not have been better. Further visits on Wednesday and Friday ironed out some initial teething problems. On Friday morning, I returned to the store with a mobile broadband package, which Justin installed in a mere fifteen minutes.

At 3pm on Friday 18th April, I sat in my office and stuck the mobile broadband dongle into my new Mac. I am now connected – watch this space! “

600 words copyright Anne Whitaker 2008
Licensed under Creative Commons – for conditions see Home Page

Chapter Two of To the website! will appear when the site is ready to go live officially….ie in September 2008

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Chapter 2

Chapter 3

STILL teetering? Go on – jump!!

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