Our aging crisis: the need for a dignified death - September 14, 2013 : 6:14pm In his final published work, “Mortality,” written while succumbing to esophageal cancer, Christopher Hitchens captures in one sentence the unavoidable truth of the dying process: “I don’t have a body, I am a body.” No one understands this truism quite as well as journalist Katy Butler, who witnessed the prolonged process of dying that her once-formidable, war-veteran father underwent after suffering a stroke in 2001, devolving into dementia and then finally dying from pneumonia seven years later. As doctors pushed life-support surgeries, new medications and cutting-edge interventions, Butler and her mother didn’t pray for a cure. Instead, they wished for his death, all of which is chronicled in her troubling investigative memoir “Knocking on Heaven’s Door.” The “end-of-life crisis,” or as Butler calls it “the caregiver crisis,” has hit epidemic levels as the number of Americans over 85 doubled to 6 million since 1990. Baby boomers, like Butler, must now wrangle with what to do with sick elderly parents, asking questions of themselves they probably thought would never be fathomable: What can be done when a person lives too long? And has science gone too far in its mission to ward off death? Through her experiences with her father, Butler is unwavering in her answers. “Our optimistic science-worshiping culture wants to medicalize aging and make it nothing more than a collection of specific diseases that medicine can prevent or fix,” she writes. “But no matter what deal we make with the devil, nature outwits us. Dying can be postponed, but aging cannot be cured.” These are bitter pills to swallow and many might fall in the trap of citing Dr. Kevorkian, death panels, and agism in health care as reasons why these end-of-life conversations should never start. But Butler argues that this very fear, our culture’s unwillingness “to engage with death until it is in our faces,” is what has gotten us so deep in trouble in the first place. For example, 75 percent of elderly patients would rather die in their homes, yet 44 percent of them will die in hospitals, she writes. Last-ditch defibrillators, surgeries for incurable cancers and chemotherapy that only buys a few days continue to be the norm; while what she calls “Slow Medicine” �" home and palliative care �" remains on the fringes and is rarely covered by Medicare. Meanwhile, about a third of Medicare patients will have surgery in the last year of their life and a tenth will have a surgery done in the last month of life, she writes �" costing us an estimated $158 billion to $226 billion in medical overtreatment costs. But what is perhaps worse is the emotional and traumatic toll continual care for a dying relative takes on the survivors, which is the true core of her book. When Jeffrey, Butler’s hyper-intelligent Wesleyan history-professor dad, who lost his left arm while fighting in Italy during World War II, suffered a stroke at the age of 79, he was reduced to something much, much less: “With the memories, mind and reading comprehension of a highly educated 80-year-old; the spoken speech of a 4-or 5-year-old; and the physical dependence of a boy of 6.” He could comprehend his shortcomings, and it made him “miserable,” she writes. At one point, he even commented that he had “lived too long.” The stroke devastated not one, but two lives. “The day before [the stroke], my mother was a talented amateur artist and photographer, a woman of intimidating energy, and a spectacular housewife . . . After the stroke, she cared for my father the way she cared for my brothers and me when we were 3 or 4.” At 77, her mother had become one of the 29 million “unpaid, politically powerless, and culturally invisible family caregivers,” while Butler herself joined the 24 million baby boomers now tending to sick parents. When it became necessary for Jeffrey to undergo hernia surgery, his cardiologist suggested that they implant a pacemaker. The family agreed, unaware of the downsides of what was such an (they would only later find) unnecessary preventative treatment. Now, Jeffrey’s heart would tick on, long past his time should have been up. “Not having a pacemaker would not have guaranteed my father a quick or easy death,” she writes. “But having a pacemaker deprived him of his best chance for one.” Despite the surgery �" or perhaps because of it �" Jeffrey quickly got worse. Like about one third of those over 80, he suffered from dementia. His eyesight went, then his mobility. He began misspelling words. Then he began to see things that weren’t there. He became bladder and bowel incontinent. “I woke up some morning in a fury. Why had his doctors not let nature take its course? If the pacemaker had never been implanted, I thought, my father might well have been out of his misery, and so would my mother and me,” Butler writes. The family begged his cardiologist to turn off the pacemaker, but he refused. Other cardiologists refused, as well. In 2008, Butler’s father contracted pneumonia. Knowing that sending him to the hospital would only prolong his suffering with “life-saving” procedures, they avoided calling 911. He eventually became sick enough to be accepted into hospice care, where he finally died. Here is a link that might be useful: Our aging crisis: the need for a dignified death

Consentual sex - didn't anyone tell the boy the law? Or did the parents just hand him some condoms and tell him to have safe sex as he was going out the door? I understand that some boys may be on the registry for stupidity and they will live that mistake for the rest of their lives. But let's not forget that men can always stop - stop if someone says no, stop if they think the girl is underage, stop if they are aware that the parents at at any time could charge them, stop if they have any concerns whatsoever that this isn't right. Stop. That's within their control, not the woman's. Do I feel sorry for these young men who couldn't control their hormones? Yes. Would I throw out the registry of animals because their stupidity put them in the same boat? No. Was it a case where a gal was putting out to a group of men and decided man number 6 was a rapist and the first 5 were not? I have a major problem with this comment. Is this the reason you would have done away with a registry? Because some woman put out for 5 men and on the 6th she said no? This is the very reason women don't charge men with rape. Because some snail of a defense attorney is going to put the victim on trial claim because she put out for 5 men, the 6th was no different. Shame on you Wildchild. Shame. When a woman says no, she means no. And no rational man is beyond their ability to stop. Only the animals keep on going. As for consentual sex with a minor, whatever your personal experiences are, a boy, no a man, should know and understand the consequences. I don't care if some woman sings him The Song of Sirens. If he puts his hormones in front of the law, he takes his chances. Even if the girl consented. Often times they consent because it's the captain of the football team and they want to be accepted. That doesn't make the man any less responsible. It takes more than a "he said, she said" to get put on that registry. It takes a trial, a hearing, a judge and maybe even a jury to hear all the evidence, including dragging the so-called "victim" through every relationship and every photograph and every friend she's ever had. So no, I don't cry for those on the registry, although I do agree there are some on there who may not belong. But take a look at the registry and some of the people in your neighborhood on it, and tell me they are all just poor misunderstood souls caught in a web of a lying female.

While I appreciate your post writers block, I am at the mercy of houzz. I asked them to pull it and obviously they have not yet. Another poster here just recommended deleting the messages. I've never done this before but once people started to post about how violent some neighbors can get etc. I thought it was best to try to take down the post. I got a lot of great feedback on here and I appreciate it and everyone seemed to say what they wanted to say and I got a lot of great advice so as far as I'm concerned, it's OK to take down. I think it's ridiculous when the website doesn't allow you to delete your message. The funny thing is you can delete all your messages but the original one, that seems odd to me.

I've got to weigh in here. We are currently under mandatory evacuation orders for Harvey, and we are still in our house. I'm the person who has previously sat in front of the tv watching rescues of people who were told to evacuate but did not, and thought those people were idiots. Like so many other things, walking a mile in others' shoes teaches you a lot. When we got the order to evacuate, it was 11 o'clock at night. The city carefully spelled out which portions of the city were on mandatory evacuation and which parts were voluntary, and why. What they didn't tell us was HOW to evacuate. Maps were being updated by the minute, and there was so much inconsistency between them, nobody really trusted the information, not to mention that roads were being closed and flooded literally every minute or two. Add to that this: during Hurricane Ike, many, many people who evacuated spent more than TWO DAYS on the road in really difficult circumstances, without gas, without water, etc., because they had left home on a two-hour drive, but it took 30 hours. Many, many people here fear this very thing happening to them. So that's a big part of the reason we didn't leave. We also factored in that we have a two-story home, and so felt that we were not risking our lives, that we could, in fact, live for weeks if needed, on the second story with the right planning and supplies. Nobody on our street evacuated. I knew a bunch of people who did evacuate. All but one had to return, after hours, feeling as if it was just too dangerous to continue, due to the constant high water, the dark (which is even darker when power is out everywhere), the closed streets, having to turn around at times and drive the wrong way on roads. In sum, it can be really, really dangerous to evacuate, and each person has to weigh that very real danger against the danger of flooding where they are, in the type of house they are in. Regarding the issue of leaving animals behind... I'm a huge animal lover. I've spent the last two days helping at our local shelter and navigating streets to get food to stray pets. I've noticed a huge difference in this disaster -namely that many shelters and rescuers allowed people to take their animals with them. This has made such a difference, not only for families and their pets, but also for the general level of chaos it leaves for the community. But not everyone could take their pet. Some people had to make really difficult decisions. Like the woman who swam nearly a mile with her toddler in one arm to a helicopter and had to leave her dog behind (fortunately her dog is fine). The people I've known who did leave pets behind did it in the most caring, responsible way possible (upstairs, on the second level, etc.). It is actually against the law here to abandon an animal during a disaster and the idiots who left dogs chained should be charged (and hanged as far as I'm concerned). I hate to see people focus negatively on the animal situation, because honestly, everyone I know here feels it has been done really well. So many shelters have willingly taken them in, etc. Anyway, just my two cents, and I'll admit I'm exhausted and probably cranky, so please don't take offense.