Friday, March 27, 2009

Managing Death

I have a friend -- let's call her "Leone" (since that's her name) -- who had four strokes about six years ago. She just had her fifth stroke and spent a short time in a hospital, then a couple weeks in a rehab center where she wasn't allowed out of her wheelchair. Hm. Now she's been in an assisted living facility (ALF) for another three weeks or so, having the kind of rehab that includes, um, moving.

All the people at the facility want her to move from their facility into another that may or may not provide kickbacks to staff members who urge patients to go there. They even think perhaps she could stay in the Independent Living section. This would provide an apartment and one meal a day. A second meal could be had for a mere three dollars.

One difference between that place and home is that home has a staircase. "What if you have a stroke at the top of the stairs?" asks Leone's concerned son. Yes. And what if she doesn't? What if she instead chokes on a plasticky piece of Bac-O-Bits that's loving served in the iceburg salads she's getting now at the ALF? What if she catches a fatal infection in the bathroom that hasn't been cleaned since she got there or the sheets that haven't been changed since ditto? What if she simply keels over from the toxicity of the condescending attitudes she faces each day? I know I would.

One of her outside doctors told her if she's ever somehow forced into a nursing home, she should commit suicide first. I told that to an eighty-two-year-old friend last night. She'd done some time in a rehab, too, and she concurred. In fact, she and her husband have decided to die in their home.

Well, good luck with that. I'm not sure people get to choose where they die. I mean, one of them could fall down and break a bone, so the other calls an ambulance, and then there's the hospital stay and the rehab and possibly death. Still, this couple has chosen at least not to go live in the downward spiral of Independent Living > Assisted Living > Skilled Nursing Facility > Funeral Home.

Hm. Are they still called funeral homes? It seems that "home" is out of the language. Perhaps there have been too many jokes and horror stories about The Home, so a PR group got to work. Instead of a Nursing Home, it's a Skilled Nursing Facility. Yeah. I feel so much better now. Maybe funeral homes are Final Resting Facilities, as if decomposition is a nap. Well, heck. Maybe it is. I've not been there yet.

Why not this selection: Living at Home > Funeral Home? What the heck. Retro's cool.

Leone's beautiful condo -- with a baby grand, several enormous paintings, stone floors, flourishing plants, lots of light and openings for breezes, a patio -- also has neighbors with whom she's had a years-long arrangement: If the blinds aren't open by eight in the morning, the neighbors are to use their key to enter the condo and see what's up.

At Independent Living, she'd push a button each morning.

So the only real problem is those stairs. Except that the real problem is that some people think there's a way to prevent other people's deaths. There isn't. Yes, Leone could slip at the top of the stairs and fall down and die. She's okay with that. Her children aren't. The Facilities aren't. Shouldn't her vote be the weightiest one, possibly the only one?

I don't know how long Leone has lived alone, but I know that I've lived alone for about twenty-four years (so far), with three six-month slips in between, which hardly count. Those were more like extended sleepovers. The idea of dying alone is not offensive at all. It's a pleasure. It seems that that's the way it should be. I've never entertained ideas of a Hollywood death.

Now, if someone has lived within the affectionate bosom of her family all her life, moving from parents to husband to adult children, well, maybe she dreams of a death bed surrounded by grieving, loving people. I would be appalled by that.

My point is that while Leone's children are terrified by the idea of her having a stroke and falling down the stairs, she's not. She's okay with that.

To end my life engulfed by strangers holding out their hands to catch me, wash me, guide me, officially worry about me while they narrow their eyes at my one nice ring and wonder how much that would get, would be an absolute hell. They'd talk to me using the first person plural, wearing scrubs printed with childish, chaotic designs in horrid colors. I'd get a check mark every time I expressed an opinion. I'd be called "emotional" if objected to a male aide with small, mean eyes and harsh, rude hands bathing me.

I'd rather die from starvation in my own bed because I didn't have the wherewithal to order a pizza than to die after months in a building with stale air, with fear roaming the halls -- not fear of death but fear of insult, of disrespect, of minor terrorism from people who are underpaid, under-motivated, sickened by their own lives, searching for a mote of power and finding it in nursing homes ... er, um, skilled nursing facilities.

I'm with Pat Henry: Give me liberty or give me death.


tbone said...

I go by a ALF every day and sometimes see people sitting in there wheelchairs,smoking cigs,and watching traffic go by.Now thats something to look forward to.I wonder if theres a non smoking section.

jeepgirl said...

Hey, remember when they were called "Funeral Parlors"? I guess that's because of all the make-up and stuff, huh?

skymetalsmith said...

NPR Terry Gross is doing a show today about "Medical Tombs". A place away from the hospital that is set up just to keep the person alive and to funnel money into a somebodies pocket.