WESTMINSTER — With 78 million baby boomers turning 65 this year, they and their respective aged parents will need to make important medical and legal decisions before it's too late.
Thus, according to longtime New York Times Personal Health columnist Jane Brody, it's crucial to know what is necessary to enter this stage of life gently and with dignity.
“No matter how healthfully you live, there is no cure for mortality. We all come to an end. If we didn't, we'd be overrun and have to go to another planet,” said Brody, who recalled telling her grandson these words in response to his question, “What would happen if we found a cure for mortality?”
Brody, a best-selling author and speaker, will be in Westminster on Tuesday, April 16, at 5:30 p.m., at Kurn Hattin Homes, in a series called “Speaking of Aging,” hosted by Westminster Cares, Inc.,
Westminster Cares, celebrating its 25th anniversary, is a local community-based volunteer organization that works with seniors and disabled adults in Westminster to help them remain healthy and independent in the community.
Volunteers deliver meals, visit those who appreciate some company, and help with rides to the grocery store and appointments. Their healthy aging programs provide social and educational opportunities in exercise, art, and nutrition.
The “Speaking of Aging” series will present four speakers who will explore key issues in aging such as physical and mental health, financial wellbeing, maintaining social connections, and end-of-life issues. The series is sponsored through a generous grant from the Fanny Holt Ames and Edna Louise Holt Fund.
Although she is best known for her books on health and nutrition, Brody begins this series by speaking about her recently published “Guide to the Great Beyond: A Practical Primer to Help You and Your Loved Ones Prepare Medically, Legally, and Emotionally for the End of Life.”
Speaking by phone from her home in New York, Brody jumped to the heart of the aging issue for millions of Americans and their parents.
“The issue is that we have a medical culture in this country that everything that can be done, should be done and will be done, which often results in patients who are dying being subjected to unwanted interventions that make them miserable, that are frightening, and are distressing to their loved ones, costing the country millions if not billions of dollars, that are wasted.”
Brody said that dying “should be like birth - it should be comfortable.” She laughed, noting birth is often really not all that comfortable. “We really have to work very hard on that.”
When people reach a point where it really makes no sense to pursue aggressive treatment, Brody said it is important “for both families and patients, and physicians, to come to some agreement about this,” remembering “that dying can be a more comfortable and enriching experience.”
What can the aging population do to advocate this for themselves?
“First of all, they must, must, must make their wishes known to their next of kin and to their physicians,” Brody replied.
She gave an example from personal experience.
“When my husband was diagnosed with Stage 4 cancer, he said in no uncertain terms to his doctor, 'I want no aggressive treatment. Just keep me comfortable.' There was no arguing with that. There was no 'maybe we should do this, maybe we should do that.' He did not want it and therefore he said clearly at the beginning, 'Please don't do this.' So you have to make your wishes known.”
Brody said some people may want everything that medicine can offer but, if that is the case, “you have to tell people what you want.”
Is telling them enough? No, said Brody.
“Telling them is not always enough and that is why you need a patient advocate,” she said. “You need someone who is in your corner who is going to insist things be done the way you want them.”
Brody said this can be done by an advocate, but in addition, “It is best to have a completed health care proxy that is signed preferably by two people, who can be your representative when you can't speak for yourself.” It is best to get this done in advance before something happens.
Brody said there are two legal documents to prepare while you can, as well.
Documents called the “MOLST or POLST” (medical or physicians orders for life sustaining treatment) forms apply to what paramedics are legally required or allowed to do when responding to a call outside the hospital. Most hospitals carry these.
“You have to have your personal physician complete and sign it, and it applies as a do-not-resuscitate order for outside the hospital. For instance, if you are terminally ill and you have a heart attack and you are home, and the paramedics are called, and if you have that form completed, then the paramedics are free to do nothing.”
If you don't, Brody explained, “the paramedics are obliged to try to bring you back to life, which is futile in most cases, more than 80 percent of the cases anyways. But it's traumatic for the family to watch this, and ribs get broken and all sorts of things happen. It's very uncomfortable.”
And getting a last will and testament completed, Brody said, is another legal point on the checklist.
She said it happens that “people sometimes forget and that leaves the family at a loss. Let's say you wanted your cousin to inherit something, but you forget to put it in the will, and the next of kin says 'I want it.'”
Brody laughs, saying she often tells people, “My mother-in-law, in anticipation of conflict, assigned her personal property to different members of the family and put their names on the back of the furniture as to who she wanted to have it.”
Of course, if you didn't really want it, and someone else did, “you could give it to whoever really wanted it. It was very cute and made us laugh and it was very sweet. But it obviated any disagreement - among grandchildren or great-grandchildren. So it doesn't have to be in your will,” Brody explained. “It's best if it gets written down.”
She said one aspect of a will is that of legacy.
“This goes into the emotional aspect - leaving a lasting legacy. Everybody has something wonderful to impart to people we leave behind - a recipe or a story from childhood or a family secret - something they want people to know about when they're gone. Get this thing down in writing. Just get it written down.”
Brody said another thing survivors can do before it's too late is interview the parent or loved one, “and record the interview. What were the most important things to (them) as children? It could be anything,” Brody noted. “It's a valuable resource that too often gets buried and goes to the grave.”
She said she will always regret that because her mother died when she was just 16, and since she was not cooking much at that age, “I miss having some of the recipes she made.”
“I have spent my adult years trying to recreate one special recipe, sweet and sour stuffed cabbage. It took a long time,” Brody recalled. “I searched around until I found one and tried and knew that's it when I tasted it and looked at it. That is definitely one of the wonderful things to have.”
Brody spoke of two other important concerns with aging and caregiving:
“The truth is that the cheapest foods are the ones that are worst for you.” So Brody recommended eating “less food but more of the good stuff, and scrimp somewhere else,” so one can buy the good food.
And she advised, as a caregiver, “The time to seek additional help with whatever you are doing in caregiving is when it is wearing you down to a frazzle or you begin to resent.”
But, she said, “If you really love it and it has some meaning to you, and you don't mind the sacrifices, then fine, continue.”
But, she cautioned, “if caregiving becomes an insurmountable burden causing undue stress on the caregiver or is physically unmanageable,” then seek help.
She said that moment came for her when “I could not keep my husband at home because I couldn't turn him in bed. He either had to be in the hospital or in hospice.”