There are two beliefs many of us hold as gospel: One, we should do all that we possibly can to develop medical treatments that prolong life, and, two, we should do all that we possibly can to care for our parents through their final years.
But what if both of those beliefs are wrong, and simply prolong suffering?
That's the dilemma posed in a compelling cover story in New York magazine by journalist Michael Wolff, who normally writes about the media industry. In the gut-wrenching article, he tells of the seemingly unending decline of his mother, the strain it puts on him and his siblings, and the disturbing conclusions it leads him to draw about our health-care system and our society.
Wolff's mother, 86, suffers from severe dementia. For the past 18 months, she has not been able to "walk, talk, or to address her most minimal needs," Wolff writes. "What I feel most intensely when I sit by my mother’s bed is a crushing sense of guilt for keeping her alive. Who can accept such suffering — who can so conscientiously facilitate it?"
The answer: Almost all of us.
Wolff admits that he and his siblings — and all American taxpayers, through Medicare — have bought in to the expensive realities of long-term care. But he shudders at the thought of how it is about to grow. More than 5 million Americans suffer from dementia today, he reports, and by 2050, "15 million of us will have lost our minds." By then, according to some estimates, the annual national bill for dementia care will be $1 trillion. Our extended life spans, he believes, will lead to "some of the greatest misery and suffering human beings have yet devised."
A friend of Wolff's with two long-suffering in-laws asks him: "Why do we want to cure cancer? Why do we want everybody to stop smoking? For this?” Wolff can't help but agree: "This is not just a drawn-out, stoic, and heroic long good-bye. This is human carnage."
Wolff's mother is a former journalist and public-relations executive. She returned to the workforce with great success at age 58 after Wolff's father died at age 63. Her resources, and those of her children, enable her to live on her own in a small Manhattan apartment, with 24-hour care delivered by two shifts of caregivers. That doesn't mean she's not suffering:
But she lives on, even after major heart surgery two years ago at age 84, which Wolff wishes someone had had the courage to protest. But when it comes to our parents' care, he writes, "we all mess it up." And the suffering goes on.
"I do not know how death panels ever got such a bad name," Wolff writes. "What I would not do for a fair-minded body to whom I might plead for my mother’s end."
Wolff ends his article with this challenge:
Meanwhile, since, like my mother, I can’t count on someone putting a pillow over my head, I’ll be trying to work out the timing and details of a do-it-yourself exit strategy. As should we all.