I recently attended an all-day workshop sponsored by local health care providers that focused on doing the detailed planning for one’s “end of life.” There were about 40 of us in attendance that sunny Monday morning at the Salvation Army in Rockland. It felt like a Monday morning, too, as we began real nuts-and-bolts planning.
We learned, for example, how important it is to appoint a “health care agent” who is empowered to make decisions when one is no longer clear-headed. It’s important to have an up-to-date will with lots of exact details. And it’s important to fill out an advance directive form, specifying how you want to be cared for. None of these things even crossed my mind at age 73.
The workshop began with watching a documentary called “Consider the Conversation,” which is so provocative I think every adult should see it. At one point, a doctor suffering from ALS — a progressively debilitating disease — talked about writing out his “100 things,” that is, those things that make life worthwhile, then watching them, one by one, become impossible. This allowed him to measure more accurately the point at which his life was no longer worth the increasing effort and determination necessary to sustain it.
When I got home, I felt envious of his forthright clarity, because I’ve always been sure I didn’t want to outlive the enjoyment of life. So I took out blank paper and began filling in those activities that give me joy. I put them in three categories. In “presently doing,” I put the things I love and still can do: swimming, hiking, kissing my wife, morning tea, being outside, etc. There were 57 of them. In the category “in transition,” I put the things I’m slowly letting go of, like world airline travel, fixing my own car, sailing oceans, etc. I still do these sometimes, but there’s not the old zing. Finally, in the category “no longer doing,” I put things like downhill skiing, running, intense yoga postures, etc., which are no longer wise or perhaps are no longer enjoyable.
Now I could look at a map of my own personal aging. As years pass, items will move from the upper category to the middle and then lower category. In my upper category of enjoyable things, I also scanned for activities so very vital, that I couldn’t imagine living without them. Could I live without walking, without being outdoors or without recognizing friends and family? I decided these last two were absolutely essential, and I would instruct my health care agent — aka my lovely wife — to discontinue food and drink when either of these two became impossible.
You might notice I’m assuming that to some degree we can choose death. I notice people do choose to die, often by simply giving up the will to live. My fear has always been I won’t have the clarity to make such a decision; but now, with a health care agent — who hopefully will not sabotage my wishes — I can live this next period with more peace of mind.
We often live additional years, or even decades, because of recent high-tech interventions. We’ve managed faulty hearts and have driven cancers into remission. Living in this recently available encore with good quality of life is wonderful. But at that mysterious tipping point, when perhaps we’re wearing out the quality of life of a caregiver or using more than our fair share of health or natural resources, it’s an act of compassion to return to a more natural lifespan.
I know this isn’t a happy subject, but try doing this thinking and planning. Make your will, share your passwords, appoint your agent and make your directives. Like me, you may actually find yourself not cast down by it all but rather more energetic. Something that was nagging, denied, postponed and half-done has been faced, thought through and taken care of. You’re more aware now your joys and your days are numbered. You may find the morning toast and tea, or the hug from an 8-year-old, is better than ever.
Jory Squibb is a 73-year-old retired boat captain from Camden.