"Hope to Die at 75"

[ziggy29]

I want to die when I can no longer perform the basic functions of life, when my body won't let me do it, when it hurts too much, when I clearly become a significant burden to family, friends and the state. Not a moment sooner, whether that comes at 65 or 95.

 

[robnplunder]

Well, we need more people like the author to control the global elderly population explosion. The world will have (if not already) too many old farts in years to come, and not enough young ones to support them. Let's make 75 the mandatory lifespan for everyone. That's will speed up ER for many including mine.

 

[bjorn2bwild]

One other bit that stuck in my craw was his position on the elderly refusing flu vaccination. HIGHLY illogical, selfish, and unethical IMHO. Flu kills thousands in the US annually. As an academic physician he should be well aware that the non-vaccinated population is a vector for spread of the disease. Accepting vaccination is ethically well-justified on an altruistic basis alone. Unless he is proposing that altruism should also be abandoned at age 75

The altruism implied in his statement -

What about simple stuff? Flu shots are out. Certainly if there were to be a flu pandemic, a younger person who has yet to live a complete life ought to get the vaccine or any antiviral drugs.

In the advent of a flu pandemic, there would be a shortage of vaccine, and he would forgo his shot to save younger lives.

 

[iac1003]

Isn't he the architect of Obamacare, Rahm Emanuel's brother and an MD/PhD to boot? True, he looks a lot older than me and he is a good 6 years younger than I am.

Then he should know better. A leading secondary cause of mortality and morbidity from the flu in the elderly is pneumonia. So he plans to not get a flu shot but take an antibiotic for pneumonia that he'll get from the flu? Gack.

There's the young 75 and the old 75. My DH at 72.5 years old exercises 2 hours a day, lost 25 lbs since retiring 4 years ago, leads an active retiree life with volunteer activities, friends, interests, hobbies; we go to concerts, movies, travel, etc. He's not going to live forever but at least he does what he can to keep himself active and alert.

The old 75's are my nursing home patients who have had a number of chronic diseases, some lifestyle-induced, like type 2 diabetes, COPD from smoking, cardiac disease from bad dietary habits and being sedentary, too much stress and strain.

There's a world of difference. Most of the ones who really really want to die in my medical experience are depressed. We usually cling onto life until the end, even when we should want to let go.

Just my $0.02 as a geriatric psychiatrist.


Sent from my iPhone using Early Retirement Forum

 

[robnplunder]

In the advent of a flu pandemic, there would be a shortage of vaccine, and he would forgo his shot to save younger lives.

That's a pleasant thought. OTOH, I keep imagining people roaming the streets with their guns blazing to get their hands on the vaccine to save themselves over others . Was it just last week that a few Ebola health workers and accompanying journalists were killed in a remote village in Africa for fear of the pandemic? Ok, I digress. Back to OT, I consider myself starting late in enjoying my life. That should buy me a decade or two over 75 before I feel I've lived my life to the fullest.

 

[rodi]

I think his point is being missed. It's about quality of life and some of the horrible side effects of life extension efforts.

I get the rejecting colonoscopies and mammogram... because if it turns up bad news, you're looking at surgery and chemo... not so easy to take at any age - and hellishly awful when you're old. Not sure I agree about antibiotics... but I can see his point, and will be pondering it, about some of the other medical intrusions and treatments.

But then again - I've seen 3 family members go through the horror of chemo. Two spent their last days in the ICU with vents and pain and open surgical wounds from failed attempts to rescue them temporarily from a terminal disease. There is not dignity or quality of life in that. The third, my dad, did it on his terms. He died of cancer... and was taking an oral chemo for it, but not a horrible chemo. He died quickly when a cold turned to pneumonia which turned to septic shock. He was very afraid of the ravages of cancer, and the pain... and my sister and I believe that he somehow orchestrated this much more peaceful, and quick, death. He'd already buried my mother and brother after seeing them go through extensive painful lengths to extend their lives by days and months. (They were already terminal.)

My DNR is already filled out. I'm not sure about an arbitrary age... but 75 is about the ballpark I see as reasonable...

 

[robnplunder]

I think his point is being missed. It's about quality of life and some of the horrible side effects of life extension efforts.

I get the rejecting colonoscopies and mammogram... because if it turns up bad news, you're looking at surgery and chemo... not so easy to take at any age - and hellishly awful when you're old. Not sure I agree about antibiotics... but I can see his point, and will be pondering it, about some of the other medical intrusions and treatments.

But then again - I've seen 3 family members go through the horror of chemo. Two spent their last days in the ICU with vents and pain and open surgical wounds from failed attempts to rescue them temporarily from a terminal disease. There is not dignity or quality of life in that. The third, my dad, did it on his terms. He died of cancer... and was taking an oral chemo for it, but not a horrible chemo. He died quickly when a cold turned to pneumonia which turned to septic shock. He was very afraid of the ravages of cancer, and the pain... and my sister and I believe that he somehow orchestrated this much more peaceful, and quick, death. He'd already buried my mother and brother after seeing them go through extensive painful lengths to extend their lives by days and months. (They were already terminal.)

My DNR is already filled out. I'm not sure about an arbitrary age... but 75 is about the ballpark I see as reasonable...

My brother died at age 49, after 8 years of struggle against cancer. The treatments, side effects, and pain he went through, especially, the last 12 months, was horrific. Despite it all, he clung to his life until the day he died. He could have ended sooner by just stop trying to extend his life. But he didn't. For everyone like the author, there are others who will fight until the end. 75 has no meaning in that sense.

 

[Midpack]

I want to die when I can no longer perform the basic functions of life, when my body won't let me do it, when it hurts too much, when I clearly become a significant burden to family, friends and the state. Not a moment sooner, whether that comes at 65 or 95.

+1. I don't know what age exactly, but when I'm no longer enjoying life due to physical and/or mental limitations, that's enough.

None would end their own life, but my 92 yo parents have lost most of their independence and DW's 87 yo Mom can't do anything for herself anymore and is miserable 24/7. None of them enjoy life much anymore...

 

[haha]

I think his point is being missed. It's about quality of life and some of the horrible side effects of life extension efforts.

I get the rejecting colonoscopies and mammogram... because if it turns up bad news, you're looking at surgery and chemo... not so easy to take at any age - and hellishly awful when you're old. Not sure I agree about antibiotics... but I can see his point, and will be pondering it, about some of the other medical intrusions and treatments.

But then again - I've seen 3 family members go through the horror of chemo. Two spent their last days in the ICU with vents and pain and open surgical wounds from failed attempts to rescue them temporarily from a terminal disease. There is not dignity or quality of life in that. The third, my dad, did it on his terms. He died of cancer... and was taking an oral chemo for it, but not a horrible chemo. He died quickly when a cold turned to pneumonia which turned to septic shock. He was very afraid of the ravages of cancer, and the pain... and my sister and I believe that he somehow orchestrated this much more peaceful, and quick, death. He'd already buried my mother and brother after seeing them go through extensive painful lengths to extend their lives by days and months. (They were already terminal.)

My DNR is already filled out. I'm not sure about an arbitrary age... but 75 is about the ballpark I see as reasonable...

I agree with your take on it. I have a friend, no older than 75,who has always been a most compliant patient. Nevertheless, or perhaps because of this, he has had one problem after another, many of them caused by the previous interventions of his doctors.

Ha

 

[ERhoosier]

The altruism implied in his statement -

In the advent of a flu pandemic, there would be a shortage of vaccine, and he would forgo his shot to save younger lives.

His statement was simply "Flu shots are out". I see no altruism in his words. He made this statement in the same context as his plan to refuse antibiotics for "pneumonia or skin and urinary tract infections". He made no qualifier of a vaccine shortage. In fact most pandemics are NOT associated with vaccine shortage but by folks not getting their vaccination. Ezekiel makes the erroneous assumption that his refusal of vaccine would save younger lives in the event of a pandemic. This violates the basic principle of herd immunity upon which population protection depends. Such vaccination refusal could likely INcrease the spread of infection and INcrease the risk to "younger lives".
Community Immunity ("Herd" Immunity)

I have no quarrel with someone declining medical care as they wish. I fully support one's right to refuse colonoscopy, PSA testing, cancer treatment, or heart surgery (to use his examples). However refusing to participate in public health efforts is quite different as it may be reasonably expected to have negative consequences for others.

 

[walkinwood]

I found the article very thought provoking. I have long held the belief that simply extending my life - with a low quality - is not for me. This guy has certainly put a lot of thought into that sentiment. Kudos to him.

 

[chris2008]

A lot of my relatives lived without severe health issues till high in their 80s, some tilll their 90s.
So 75 looks a bit early to me.

I would not be surprised if the article writer gets a sudden attack of OMY syndrome once he is in his 74th, happy with family, friends and funds but just this one health issue that everybody tells him to get taken care of...

 

[MichaelB]

I think his point is being missed. It's about quality of life and some of the horrible side effects of life extension efforts.

This. His point is how much preventive effort should be put into remaining alive and "healthy" given the physical and mental deterioration he (and we) will suffer. He may feel differently about some of these things once he reaches 75, but it's a legitimate view.

The results show that as people age, there is a progressive erosion of physical functioning. More important, Crimmins found that between 1998 and 2006, the loss of functional mobility in the elderly increased. In 1998, about 28 percent of American men 80 and older had a functional limitation; by 2006, that figure was nearly 42 percent. And for women the result was even worse: more than half of women 80 and older had a functional limitation. Crimmins’s conclusion: There was an “increase in the life expectancy with disease and a decrease in the years without disease. The same is true for functioning loss, an increase in expected years unable to function.”

 

[Letj]

My friend's mother was 'diagnose' with uterine cancer at 80. After one radiation treatment, she refused any more. She said to me that she has raised all her 9 children who are all successful living good lives, have seen her grandkids and great grand kids and have lived a good life and so was prepared to go. 12 years later she is very much alive, healthy and lucid.

 

[ls99]

Me thinks we need more like minded people like the him. Would keep SS solvent. I am not volunteering unless I can't make it to the bathroom under my own power and wipe my own butt.

 

[Balance]

I respect the thoughts conveyed in the article about quality of life near the end of Life. Like many of you, I have had my share of exposure to people dying of cancer and other drawn out painful terminal diseases. I pray that when it's my time it is short and painless. Of course, I would prefer it be at least in my 80's.

Interestingly, I think he used 75 yrs old because he knew that would draw attention and get people to read it. Let's face it, if he used 80 or 85 which are above the current average life expectancy most of us probably don't bother reading it.

 

[stepford]

Back when DW's Mom was slowly dying of Alzheimers I remember how DW became furious when she found her Mom was still being prescribed statins and other life extending drugs. She loved her Mom dearly, but recognized that past a certain point life extending treatments weren't helping anybody.

As a result of this and other experiences with parents and older relatives we both hold views rather similar to those in the linked article. We certainly have no arbitrary age to end it all. We intend to avail ourselves of medical care for as long as it enhances our lives and if we're still enjoying life at 95+ then so much the better. But when we recognize that infirmity, immobility and the other ravages of age have taken all the fun out we both hope to have the ability and the nerve to end things quickly without the wretched extended and expensive endgame we've seen too many times already.

 

[Bikerdude]

If I die before 90, I think it would be tragic (for me, that is; most of the world wouldn't notice).

Every life is a Tragedy because in the end the main character dies.

 

[explanade]

He's being interviewed.

His point is that statistically, people over 75 will see more and more debilitating.

For instance the incidence of Alzheimer's is 1/3 to 1/2..

He notes that one common reaction to the article is that people think of acquaintances already over 75 leading relatively active lives, with good health. His contention is that those are statistical outliers.

People would like to think they'll have good health and active lives until their 90s or whenever they're suppose to die and then their health will fall off a cliff in a short time right before they go. More likely is a slow and drawn out deterioration, perhaps prolonged by efforts to remain active, be healthy, etc.

It's more of a intellectual perspective than an emotional one. Especially here at ER, few people will go along with this largely intellectual exercise.

 

[donheff]

His point is that statistically, people over 75 will see more and more debilitating.

For instance the incidence of Alzheimer's is 1/3 to 1/2..

He notes that one common reaction to the article is that people think of acquaintances already over 75 leading relatively active lives, with good health. His contention is that those are statistical outliers.

People would like to think they'll have good health and active lives until their 90s or whenever they're suppose to die and then their health will fall off a cliff in a short time right before they go. More likely is a slow and drawn out deterioration, perhaps prolonged by efforts to remain active, be healthy, etc.

I get his underlying stats and and agree with them but not him. I am on the fanatical edge in terms of wanting to avoid aggressive life prolonging treatments for myself. I would welcome physician assisted suicide and am unhappy that I can't set things up to provide for my quick and merciful demise if I become unable to do it myself due to a sudden trauma. I am outraged that doctors can't even legally give me a simple prescription for a life ending drug that I could administer myself in the event that I find myself on a debilitating downward path. But I don't think this guy's rant will be of much help in getting us to where I would like to be. His talk of aggressive anti-life actions like not treating infections feeds right into death panel talk and other alarmist predictions of doom if we open the door to sensible end-of-life care. I fear he is provoking the wrong discussion.

 

[Silver]

I get his underlying stats and and agree with them but not him. I am on the fanatical edge in terms of wanting to avoid aggressive life prolonging treatments for myself. I would welcome physician assisted suicide and am unhappy that I can't set things up to provide for my quick and merciful demise if I become unable to do it myself due to a sudden trauma. I am outraged that doctors can't even legally give me a simple prescription for a life ending drug that I could administer myself in the event that I find myself on a debilitating downward path. But I don't think this guy's rant will be of much help in getting us to where I would like to be. His talk of aggressive anti-life actions like not treating infections feeds right into death panel talk and other alarmist predictions of doom if we open the door to sensible end-of-life care. I fear he is provoking the wrong discussion.

I agree with you 100% But our current health care system does not want to fast-track the dying process. The majority of profit is made from people over the age of 65.

Until health care is no longer viewed as an opportunity for profit, people will die slowly and badly.

 

[rodi]

Where in the article does he advocate his plan for anyone but himself? How is this advocating a death panel, he's advocating for HIMSELF to choose an arbitrary age.

The controversial part is the age he chooses... and the first few paragraphs address that his family thinks he's wrong about that.

 

[HFWR]

My thought is that when I'm no longer "living", but just "alive", then it's time to go, but I have no arbitrary age in mind. Plus, I may or may not feel differently when I get there.

 

[Bestwifeever]

He looks pretty healthy. I get the impression from the article that until he hits 75 he will get flu shots and take antibiotics etc. but will not do so after he hits his magic number? If he reaches 75 in perfect health as a result, he will probably be disappointed to live another ten years or so. I found this statement of his interesting and somewhat of a hedge:

If I were diagnosed with cancer now, at 57, I would probably be treated, unless the prognosis was very poor.

in that the treatment would likely also prolong his life past his optimum lifespan.

He will probably update his feelings as the years pass. It will be interesting to read his future thoughts.

 

[Midpack]

He might indeed change his mind when he gets closer to 75, but I don't think the exact age was the point of the article (prob chosen deliberately low to increase readers/provoke discussion). I think his POV is sound, the only question is at what age? Those here who hope to live to 90, 100 or some other stated relatively advanced age, may also regrettably change their minds (re: prolonging life) when they get closer to that age.

And it's pretty well documented that one of the reasons for much higher health care costs in the USA is end of life health care costs, often for patients whose quality of life has all but disappeared. As a country, we may have to confront the issue one of these days.