Why I Hope To Die At 75 Revisited (Atlantic article)

[RetMD21]

I liked the article when it came out 10 years ago. I think it's worth thinking about the decline in quality of life with age.

 

[sengsational]

What resonated with me from the essay was how you might be remembered by those you leave behind.

If you go out quickly at 75 by some infection or something, then when people think of you, it will be based on a more vital person, probably a more positive image. That, as opposed to a person who, for the last X years was somebody's "job" to take care of, or even if hired out health care, somebody's "job" just to visit (and maybe even not be recognized). That just seems like a poor taste to leave the living with. And to what end?

 

[MuirWannabe]

What resonated with me from the essay was how you might be remembered by those you leave behind.

If you go out quickly at 75 by some infection or something, then when people think of you, it will be based on a more vital person, probably a more positive image. That, as opposed to a person who, for the last X years was somebody's "job" to take care of, or even if hired out health care, somebody's "job" just to visit (and maybe even not be recognized). That just seems like a poor taste to leave the living with. And to what end?

Everyone who remembers you will all be gone themselves soon enough. So that doesn’t seem like a big concern. Certain I’m in the minority here, but totally opposed to MAID. Having a living will makes good common sense to me though.

 

[jollystomper]

Interestingly (and sadly) I lost a very good friend last year who was 75. He was an active guy, "wiry" build, still doing physical electrical work. We saw him the week before we left for Paris, when he wished us a good trip. A few days after we returned, he took sick, as diagnosed with multiple cancers, and was dead within 2 weeks. It was a shock to us - but in retrospect, that was the way he would have wanted to go. His dad lingered for years and died in his late 80s. He was close to him, but said he hated seeing him in that completely physically dependent and mentally impacted state, and that he himself would not want that.

 

[Midpack]

I am most grateful for what everyone has shared on this thread. A lot of thought provoking posts, that reinforce my thinking (similar to Emanuel). Again, I respect those who choose otherwise, and acknowledge that it’s hard to predict what any of us will actually do when facing real choices.

 

[jollystomper]

What resonated with me from the essay was how you might be remembered by those you leave behind.

If you go out quickly at 75 by some infection or something, then when people think of you, it will be based on a more vital person, probably a more positive image. That, as opposed to a person who, for the last X years was somebody's "job" to take care of, or even if hired out health care, somebody's "job" just to visit (and maybe even not be recognized). That just seems like a poor taste to leave the living with. And to what end?

I would disagree with this. I believe people remember you based on the time(s) when you were most important in their lives. Maybe the immediate memory after your death is of your last years, but I think you are remembered most when you meant the most to them.

 

[sengsational]

When I think of relatives that have died, with just a little effort, I can skip over the final, feeble year or two, with a little effort, and remember the vital person and associated good times. But I noticed when reminiscing with those closest to the person, they are often stuck on the version of the person that they last dealt with. It sometimes takes considerable time to get them to the good memories. Of course this is just my family and culture, and not every group is the same.

It's certainly true that everyone who knows me will be gone not too long after I go, on a cosmetic scale, and so that would suggest how they remember me doesn't matter. But thinking about things in that way, nothing matters. On the scale of when I die to when my children die, I'd rather they remember a vital me than a decrepit me. But I don't want to go out doing something dumb or cowardly either... either of those would be an unpleasant thing for survivors to live with.

 

[misanman]

I personally have never known a 90+ year old who was enjoying life.

My brother is 93 and is slowing down but still drives his corvette and runs his business. He just had a heart valve replaced and is doing well with recovery (resumed dancing, etc). I would say he is still enjoying life but he's outlived a wife and two "companions" and that has been hard on him.

 

[Teacher Terry]

Admittedly, not the same thing, but I was told by three doctors/neurologists at the best hospitals in Boston that my brother would never walk and would be bedridden with feeding tube in a nursing home for the rest of his life. "The damage is too severe. Don't even think of him ever coming home".

Within a year he was semi-independent, fully cognizant, living alone (with help at dinner time), feeds, dresses himself and goes for long walks on his own.

My point is that " you never know " and that the experts aren't always right. I'd hate to short-change my life based on what the experts tell me is going to happen.

Your brother wasn’t old and that makes a big difference.

 

[marko]

Your brother wasn’t old and that makes a big difference.

He was 62 but I'm sure that all three neurologists took his age into consideration when they gave me their 'expert' prognosis.

My point was that it would be a shame to take an expert opinion to heart, refuse treatment and die when the original diagnosis was flawed. Incorrect medical assessments happen all the time on each side of the equation.

If they didn't take his age into consideration my point is even stronger.

Regardless, had I taken the doctor's advice, my brother would be in that nursing home today, 8 years later. Instead, (against doctor's recommendations) I moved him to a facility with extraordinary therapies and was able for him to get home after a year.

 

[PatrickA5]

Dad had prostate cancer at 82. The doctor said it was up to him if he wanted treatment and he could probably make it another 5 years since it was slow-growing type. Dad agonized over the decision for about a year and then decided to do radiation. He ended up living independently at home until age 97. He got to see his grandchildren grow up and got to hold several great-grandchildren. The last couple of years weren't fun, but he never said he was ready to go. He made the right decision, due mainly to no huge side-effects of his treatment.

Mom, on the other hand, got BC at 72. Did the chemo and was never the same (or close to it) until she died 5 years later at 77.

I'm on the fence on what I would do in either circumstance. One worked out and one didn't.

 

[Koolau]

I would disagree with this. I believe people remember you based on the time(s) when you were most important in their lives. Maybe the immediate memory after your death is of your last years, but I think you are remembered most when you meant the most to them.

This is the way I remember both my parents. Yes, there were some "bad" times toward the end, but I remember mostly the good times - even during the later years when things weren't going so well.

Another thing (and this probably sounds selfish): I came to respect myself as a "good" son as I became a sort of "parent" to each of my parents as needed. You never know what you're capable of until you are tested. I treasure most of those last years because my relationship with each of my parents was reinforced. All the giving they had done on my behalf over the years had taught me how to be the son they needed at the right time.

 

[kgtest]

2 trains of thought. 1, when you know, you know. 2. It's too late, you lost your mind.

That's why you can plan as best you can for tomorrow today, and tomorrow revisit today's plan. If it makes sense to make a change, do it before it's too late or you've lost your mind.

 

[ychuck46]

I think it’s easier to take a position to reject treatment when one isn’t facing a bleak outcome. I don’t doubt Dr. Emanuel’s resolve, but when he faces death he may reconsider his opinion.

Bingo. I am 70 yo and have never been on meds in my life, always staying active in sports when I had leagues and the like to join, and now just doing all the work around our large property and acreage. But I am not a fool. Someday that will change and my outlook likely will as well. But for my whole life up until this day I have always felt it best to live as long as possible, all things considered, if for nothing else to make sure my wife is well taken care of, and to see our daughter/SIL continue their success. Maybe I will reject treatments if required or not, but as you stated, until to face a serious situation you never know exactly how you might respond.

 

[shafer9]

I’m 79 so I missed the 75 cutoff. Oh well. 19 years ago I had a nasty sarcoma with a 12% survival rate. Additionally, my mom died at 92 of dementia. Her last 8 years were atrocious. Not for me, and I am pretty frightened of it. Obviously, I survived the sarcoma and am now in the bonus round.

I hit the gym 6 days a week and eat reasonably well. I’d love another 10 years if everything holds up. No one knows.
Thats why I bought a pistol a few years ago as plan B. Messy, but an additional option. No way I’m gonna go through what my mother did.

 

[msanniee]

I am sure this topic isn’t for everyone, and that’s fine. I assume the majority want as many years of longevity as possible no matter what, also fine.

And 75 is an arbitrary age, please don’t fixate on 75, that’s not the point.

Quality of life over quantity has always been my goal. As of now, I'm 70, and I am planning another 15 years. After that, or before that if appropriate, I am off to Switzerland.

 

[Lisa99]

I recently learned that VSED (Voluntarily stop eating and drinking) is legal in all 50 states.

Dementia and Alzheimer's is in both sides of my family so I have a directive that says when/if I'm no longer able to feed myself then VSED kicks in.

 

[HI Bill]

For me, it's not about a number, but about Dr. Peter Attia's concept of healthspan (increasing the number of healthy years you have left and decreasing the time span of your great and final decline) in his book, Outlive.

My mom had dementia starting in her mid 70s, and died at 81 after a fall that resulted in a broken hip. I just returned from a trip with an 81-year old that kept up with my wife and I, including walking 48 miles a week, bicycling, etc.

And then there's my 86 year old dad. He had the "Five Wishes" on his refrigerator for the past 20+ years. He had a book on ways to commit suicide, and that was his plan for more than 30 years, rather than waiting for a slow decline to death. Now that he's 86, with limited mobility, in a care facility, and with Parkinson's, he's wishing he was dead. But he seems strong enough that he could live for years. He decided not to receive any medical treatment that will prolong his life.

For me, it depends on when the quality of life is so poor that it's not worth continuing. That's undoubtedly a judgement call, and likely what's 'acceptable' will change with time and my body's decline.

I do find it ironic that most here plan financially for a lifespan of 95-100 years, when the last decade will likely be a 'decade of decline" (Peter Attia's term from the book Outlive.

 

[winyaz]

I don't really understand the idea of stopping preventative medicine. People don't die of old age anymore, there is always a diagnosis. If you can prevent something that may kill or disable you, why wouldn't you want to do that?

I get choosing not to have an invasive procedure or treatment late in life, when it may interfere with the quality of life that is left, but that is not the same thing. Still it is difficult to know how many years, or how many good years are left. My Mom is living a good life, independently at 91. My FIL had colon cancer surgery and chemo at 83 and lived another 10 years. It never came back, he died of something else.

I think MAID (Medical assistance in dying) solves some of the issues. I feel like we treat our pets better than our elderly.

 

[GoodbyeYellow]

I doubt Dylan Thomas would be a fan of this thread. Do not go gentle into that good night

Actually I'm one of those who believe he meant something altogether different by that. He wanted his father to be strong (raging) till the end.

 

[RobLJ]

I'll probably chicken out when I get to facing the Grim Reaper, but my father (who had diabetes) was in horrible pain his last year; I had never,ever seen him complain about anything until then, in the hospice. And he didn't complain, he just moaned. I didn't think he had a pain nerve until then.
My twin had a very rare form of progressive myclonic epilepsy, was saved by a new anti-seizure drug and was bed-fast his last two years (it's kind of like very slow-acting ALS since you lose control of nerves and functions, but slowly) . He was the first generation with his illness to live past 16-18 and he made it to 43 but the last 2-3 years were tough. I would drive up from Houston on the weekends a couple times a month to give my parents a bit of a break; luckily my wife and two sons were very understanding during that period. I'm a chicken compared to my father and brother.
Put a bag over my head and cinch it down. My pain threshold has steadily gone up since I was a dad 30 years ago, but I'm still a chicken.
My family, other than my brother, and dad tends to live well into their 90's, so it is a dilemma. Mom, at 92, is having hip surgery, so I'll probably be in Texas for 4-6 weeks in a month or two, to make sure she is alright. I'm beginning to think my older sister who lives with my mother has premature dementia, but I'll have a better view when I go to Texas next month. Her memory is really, really bad, which I noticed last Thanksgiving when I went up to help her and Mom during and after her colon surgery. I could just be paranoid, but I don't think so since my Mother has also commented on my sister's inability to remember quite a bit.

 

[us271934]

After reading this thread I thought I'd put in my two cents. However it has made me revisit too many of my family and friends' deaths. The clincher was opening an old family photo album from the 90's and realizing in the first picture I looked at I was the only one of the 5 people and family dog still breathing. Of those 4 family members two of them had long declines and two passed quickly. The dog got old and things were getting tough for her so we made that horrible trip to the vet. Only the dog had a 'planned' passing and it wasn't her idea.
I do think discussions like this thread should be more commonplace and happen across generations but I'm tapped out. Later....

 

[RobLJ]

Actually I'm one of those who believe he meant something altogether different by that. He wanted his father to be strong (raging) till the end.

It's a great poem, along with "The force that through the green fuse drives the flower", although I haven't read either in 30 years. Took the book off the shelf (I had a grad school prof who had met Thomas).

"Old age should burn and rave at close of day;
Rage, rage against the dying of the light."

 

[NXR7]

My wife's aunt is a perfect example. She passed away a few weeks ago at 89. She began deteriorating around February this year. Last Thanksgiving she drove 45 minutes to our home and refused our offer to pick her up. She was teaching piano, kayaking, you name it just last year.

But she did have some medical problems where treatment took months off her life with recovery but gave her years and she was OK with that.

Her 30 year-old artificial heart valve began leaking two years ago and she refused the treatment because she felt it would not prolong her life quality. But she did undergo abdominal surgery two years ago to treat a recurrence of her stage 3 colon cancer. All in all it worked for her.

The fellow who wrote that article? I think he got paid by the word.

Surgery has enabled me to continue a quality of life I could not have had otherwise. Two rotator cuffs, prostate reduction, cataract surgery, cornea surgery, all in the last ten years and I'm almost 70. No cancer that I know of (and the Galleri test found none). It's risk versus reward for me.

But dementia or a debilitating stroke? That scares the heck out of me. I'll end it all if I can. I have no desire to burden my family while making hospitals and doctors wealthier.

 

[Lewis Clark]

I feel like we treat our pets better than our elderly.

I agree completely and have been saying this for years.