CITIZENS Barbara's Column The Salem Evening News Part 1 If you grew up in an orphanage, or, like Romulus, Remus
and Mowgli, were raised in the wilderness by wolves: this column is not for you. We who have parents are going to talk about that "final
taboo" subject: dying. Not about death, mind you. Death has always been a subject of discussion, drama, even
poetry: from Saint Paul's "Death, where is thy sting?" to the latest screen version of
Romeo and Juliet. You're young, beautiful, you lie down on a slab next to your young
beautiful true love, take poison and fall asleep, then are made immortal by Shakespeare. No, we're not going to talk about young lovers. We are
talking about our parents. And in the back of our minds, we know we are talking about ourselves, someday, sooner than
we'd like. The relevant quote for us is Woody Allen's "I don't mind
dying; I just don't want to be there when it happens." Or even better, our own John Silber's "when you're ripe, it's time
to go." Remember his saying that during his campaign for Governor
in 1990? The media immediately called it "another Silber shocker." A lot of the rest of us, however, including
many senior citizens, said nothing. Taboo. His was a brave, politically incorrect statement, and
it's been on my mind lately, as I spend several hours a day with my mother at a nursing facility here in western
Pennsylvania. As nursing homes go, this one if quite nice. Clean,
cheerfully decorated, and you hardly notice "that smell" in the hallways - you know the one. Decay. Anxiety. Fear. The
last two are produced not only by the patients, but by their visitors as they wonder: how can I help
them? Who will help me when it's my turn? When I'm not thinking about John Silber, I'm thinking
about Edward G. Robinson. He starred, with Charlton Heston, in a 1973 movie called "Soylent Green," which I've noticed
coming up in conversation lately. People who saw it seem to vividly remember not the
out-of-date premise, that the overpopulated world would run out of food, or just the
shocking conclusion when the secret of soylent green was discovered, but the part
where Edward G. had to die because it was time to make room for new people. Everyone was required by the state to die at -- I think
it was age 55. So while Charlton fought big government, as usual, Edward G. sat in a comfortable reclining chair and
watched his favorite scenery on a movie screen while playing his favorite music and
sipping his hemlock or something from a handsome goblet until he fell asleep for the last
time. Well, Malthus' population bomb hasn't gone off, 55 is
considered young, and my alert 85 year old mother is still eating easily-available meals and watching real movies on TV.
But she fights for every breath, and around us, people stare vacantly into space or talk
nonsensically to themselves, and you wonder - what is the point anyhow? And I think:
when it's me, pass the hemlock, put Hawaii in the VCR, and play Queen's
"Who wants to live forever?" in my headphones. The Senate Ways & Means budget contains several health
care initiatives: some of them are intended to help prolong life, others to deal with the cost of long living. The budget
summary states that nine out of ten Medicaid dollars are spent on long term care in
institutional settings. The document creates a commission to study the future of long term
care in the commonwealth, "the health care needs of elders 65 and older." I hope they
realize the problem is much bigger than money can solve. I hope they put John Silber on
the commission if he's still in a mood to continue the discussion. He never had a chance to follow through with a suggestion
on what to do even if it's acknowledged that it's time to go. Despite what you might be thinking, I'm not talking
about assisted suicide here: legal euthanasia is a subject for which the phrase "slippery
slope" is a barely adequate warning. Meanwhile, in western Pennsylvania, there is an attractive elderly man who pops into his
wife's room every day with a cheerful "good morning sweetheart!" and then spends the
day sitting with her or wheeling her around the nursing home, taking her to the community
room where local people come to entertain or lead prayers. I don't think she knows him. I know him, though. He's Romeo, and his Juliet didn't
die; she just started dying, several years of daily visits ago. This is the real world, and it's time to talk about
dying, but I ... have no idea what to say. Part 2 "I would not stay here if I could Archibald MacLeash As life's juxtapositions go, it was an interesting few
hours. On Sunday evening "60 minutes" re-ran its segment on Dr.
Kevorkian, during which a patient was euthanized on camera. At the nursing home, my mother's sweet, occasionally
addled roommate was perched on the bottom of her bed, watching intently. It was her television so it wasn't my place to turn it
off; I distracted mother with conversation on other subjects. Assisted dying was not a discussion that I wished to share
at that time in that setting. Our living wills were prepared and filed when the need was
perceived to be far in the future; enough said. The next morning, murderer Timothy McVeigh was also
peacefully put to death; his executioner was the federal government. I've often wondered what Dr. John Silber was going to
say, before he was so rudely interrupted, after his 1990 campaign statement "when you're ripe, it's time to go." Did he have a plan? Did it involve Dr. Kevorkian or the
federal government? I once asked a libertarian friend if he thought the
government should allow assisted suicide. He said that people commit suicide all the time without assistance or the
government's involvement. True enough. Unless we are suddenly disabled, we are all the
"masters of our fate." And most of us choose to live, no matter what. In Archibald MacLeish's JB and Job, God and Satan were
playing the game of "test Job." As in the Bible story, Job lost everything: his herds, his house, his health, his
children. When the children all died, Job's angry wife, apparently missing the point of God's wager
with Satan, considered suicide by the river. But she returned to the hovel
in which they were then living, explaining that "even the forsythia by the stairs" was enough to stop her. Here at the nursing home, you hear people cry out, but
they are not saying "I want to die." They are saying "I want to go home," or "I want to go to the bathroom." My mother says
"I want my feet rubbed." Mostly I think she feels bad for me, away from my other
loved ones, home and job, unable to visit my new grandchildren. I can relate to the fear of being a burden; I'm
determined not to let my son even know when I get old. I'll put a message on his answering machine when he is at
work: "leaving for Europe, impossible to reach, see you when I get back." The next call he gets about me will be
from the funeral home. Ah, we have such brave plans when we are (relatively)
young, don't we! A nurse told me that even the most self-sufficient people get demandingly dependent eventually. But I
wonder. I read recently about a woman who told her kids goodbye when she entered a
nursing home and ordered them to never visit; they honored her last request. My guess is that some of us do go out the same way we
lived our lives. My mother always wanted her feet rubbed, even when she was young, and I suspect that I will
remain master of my fate until I die. I'm quite sure I'd consider hiring
someone like Dr. Kevorkian if the alternative was total dependence and I was too disabled to act alone. I admire him for making us face these issues, and am
grateful to the other pioneers who advocated living wills and have put an end to "extraordinary measures" that unnecessarily
prolong undesired lives. But for now, I've ordered her own television for mother's
room so we can choose our programs. It has a built-in VCR so we can watch home videos of the grandchildren as
they are growing instead of people being put to sleep. I am lucky to have a job that I can do, at least for
awhile, from 524 miles away, using my computer: I am able to get state budgets, legislative debates, and Massachusetts
newspapers on line. Ten years ago this would not have been possible. Ten years from
now technology will make being old and caring for elderly parents much easier. The requests of residents of mother's nursing home will
be more easily heard. Homes will be more handicapped-friendly so people can stay there longer. Virtual reality will allow
the homebound to experience daily visits with distant families. Robots will make up for a shortage of health care assistants. Some of them will be
programmed to help get us to the bathroom, some to rub feet, and some to tend to the
forsythia by the stairs. Part 3 I once joked that when the "Me Generation" joins the
AARP, the boomer seniors will be voting to harvest teenagers' second kidneys for replacement parts. Someone assured me that when it came to that, the computer-raised kids will simply hack
into nursing home computers and shut off the support systems. Just kidding, right? Cloning technology will probably make kidney harvesting
unnecessary. But seriously, folks, if technology also keeps people alive well into their second century, who is going to
pay for longlonglong-term care? Will middle-aged children be caring for parents, grandparents, and great-grandparents
until they all drop dead together? Or will there be skyscraper nursing homes and a
Medicaid budget that consumes most of the remaining workers' paychecks? Whose
bright idea was longevity, anyhow? One of my many friends who are also dealing with an aging
parent sent me an e-mail, excerpted here: "From a historical and cultural perspective we have two
extremes: the Eskimo villagers sending their elders out on an Ice flow; and the Chinese family almost worshiping their
parents for their wisdom. In-between lies us. "We have the science to keep our parents and grandparents
alive through multiple illnesses to a great age but we don't have the ethical answer as to what we do next. It
wasn't too long ago that children left home never to return and parents
worked till they could no longer function and died after a short illness caused by a lack of medical
knowledge." He added "Some of us live and work at great distances
from our parents and cannot just pick up and devote years of our lives to their final care." Then he told me about a
friend who left his job to care for his mother in her home. When she finally died he remained in
the house, government dependent, for he never made enough to let him retire without
public assistance. Actually, few of us make enough to retire without public
assistance. One can fairly argue that Social Security and Medicare are the direct benefits from a lifetime of paying
taxes, at least for some years after retirement, but by the time one gets to Medicaid one is on
welfare, no matter how little we want to admit it. My mother has just moved into a Pennsylvania nursing home
at her own expense, and I find myself defending myself to the system and to friends here. "Yes," I feel compelled to
say, "I do know that assets can be transferred to the children several
years before entry, but we didn't do that because I don't want my mother on welfare any sooner than
necessary." I get the distinct impression that this is not a common attitude. I hear lawyers on radio ads assuring us that taking our
parents' money and spending it on ourselves while letting the taxpayers support them in a nursing home is legal, and I guess
it is. Ethical is something else. Regardless, the time will come, quickly, when she is out
of money. I discussed the issue with my friend Carla Howell, who believes that "small government is beautiful." Does
"small government" include taking care of the frail elderly in nursing homes until they die? Carla responded: "If we FIRST eliminate the federal
income tax and all the Big Government Programs and Big Government Regulations that drive up the cost of nursing
care, drugs, hospital visits, etc., costs will go down dramatically. And with family
members and other charitable people keeping the money they earn, many who are now
scraping to make ends meet will be able to help. Government meddling serves only to
make things worse -- and makes health care a crushing liability." Whether you agree with that, or just consider caring for
the elderly a proper function of the bigger government you prefer, this care will not be affordable when the boomers
reach retirement age if government continues to indulge in wasteful spending, corporate
welfare, and its usual assorted nonsense. Better to lower taxes so we can start our old-age saving
accounts now; this will have an added benefit of encouraging government to begin setting priorities, knowing that the "Me
generation" will consider its long-term care one of them. If we don't face the financial future now, that soon-to-be-overtaxed Generation Z might
as well turn over both kidneys for recycling, because it literally won't have a pot in which
to catch what they produce. Barbara Anderson is executive director of Citizens for Limited
Taxation. Her syndicated columns appear weekly in the Salem Evening News and the Lowell Sun;
bi-weekly in the Tinytown Gazette; and occasionally in other newspapers. |