Friday, October 31, 2014


Several years ago, I developed a list of requests to have followed for me in the event I was unable to make decisions for myself. Then things changed. Over the last two years I have visited more retirement homes, nursing homes, and hospitals providing eldercare than I care to remember. I saw and spoke to older men and women who were alert, and enjoying their lives. I also saw older people, whose minds were deteriorating, and those who now spent most of the day sleeping. Then my parents moved into a retirement home. I revised my end of life requests in response to what I saw.

I wish that I had read Atul Gawande’s Being Mortal: Medicine and What Matters in the End before the events of the last few years. I’ve been reading his work for years, and think of him as the checklist doctor, who wrote The Checklist Manifesto: How to Get Things Right.  After Gawande observed a number of problems develop during the course of surgery in hospital operating rooms, he developed a checklist procedure which is now in place in many hospitals. Before an operation proceeds, the checklist involves each doctor and member of the operating team introducing themselves to each other, and describing what each member of the team is responsible for.

In Being Mortal, Gawande has examined something that many of us put off until it is too late. The gasps in the movie theatre during Michael Haneke’s film Amour, as Georges (Jean-Louis Trintignant) kills his beloved wife, Anne (Emmanuelle Riva), after she has become incapacitated by a stroke, suggest that many of us have not thought through “what matters in the end.” What will matter in the end, for the largest generation in history, the aging boomers, will loom very large for that generation. 

If you were born between 1946 and 1964, this is a book for you. If you’re a boomer, plan now—the last thing we need is retirement and nursing homes full of old boomers who didn’t make their end of life plans. Gawande’s book contains few examples of those who planned, and many examples of those who didn’t plan for the decisions necessary as the end of life approaches.

Talk to your parents about what they want. Talk to your partner. Talk to your kids. And do it soon. “Death has a thousand doors to let out life.” Read Being Mortal, and sort out what matters in the end, with whoever may be there for you, as you approach that last door. Before it’s too late. Gawande’s Being Mortal is a clearly written, deeply informed, and compassionate book.

And by the way, one more little thing for you guys who have stopped updating the Boomer Deathwatch site.


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