It is for good reason that I have become so enamored of the words “Courage My Love”. It is absolutely because I am in need of encouragement to speak my mind even here. I have been told often that I am already courageous for speaking openly about my views in some of the hallowed halls of academic medical institutions. It is my firm belief that this wasn’t a career enhancing action for me to take. But there are no regrets and all is most certainly as it should be for me. After two years far from the front lines of care, I am more free to consider the ways things might have been. By which I mean, the way things might have been if the medical model of care did not dictate the care of nearly ninety percent of elders as they die. After spending so much time and energy creating new and better ways to care for frail elders in hospital, I am more clear than ever that the hospitals and nursing facilities that we have created to care for elders will never be able to give elders the dignified death that they desire.
But I do often lack the courage to say exactly where all this continued looking and listening and learning has taken me now. After the publication of Letters To The Editor in my local newspaper I have been accused of supporting euthanasia. (I don’t) I have been contacted by some heavy hitters who challenged my support of Death With Dignity/Right To Die legislation. I don’t like it when others refuse to dialogue with me. I realize that I am far too sensitive and sometimes seek to avoid confrontation in any form. But it is exactly that same sensitivity that has led me to feel the prolonged distress that I have felt when I see the plight of frail elders whose care is prolonging their suffering. Care that is dictated by a system that is skewed in ways that are both subtle and direct but always lacking in peace and comfort and oh yes, very expensive.
More and more I am hearing from others who insist that they will commit suicide before they will allow this to happen to them. I am also hearing about increased rates of suicide in those of advanced age. Sometimes I hear about murder/suicide in an elderly couple who are reported by elders to be wonderful neighbors whose health had begun to fail them. I hear from folks who work at the front line of care where they see first hand the awfulness of being completely dependent on others for all your care needs…others who demonstrate their own distaste for the work of providing that care. I am one of those persons who says, “I will kill myself before I am forced to accept care from others in such environments.” And for those without a great deal of financial resources, it is only this sort of care that is available.
But the stated intention to commit suicide before accepting the fate of dependent care in a Medicare supported facility will really require a lot more planning and that is something I have been thinking about for a long time. And it is certainly something that will require a huge dose of that courage I sometimes lack.