Departments: Family: Doesn’t Mom Look Great?

But the reality is, she’s 85. And it’s time to have a conversation about dying, and death — the talk none of us wants to have

Before I mentally got to “she’s old,” I’d slip back, back to busyness as mindless as everyone else’s. Mom would occasionally issue edicts about her own end: “If I get stuck in a wheelchair, I’d rather be dead. I’ve lived long enough.” I think you’ve got a point there, I started thinking.

I’d consider: Mom isn’t exactly rich, but my haul post-funeral would pay for, let’s see, my son Nick’s college education. In the dead of night, that deserved another sip of scotch.

If this sounds a bit cruel and heartless, that’s because it is. I didn’t like having these thoughts at 2 a.m., with or without scotch. But I’m going to make a small leap here: I am not a cruel and heartless person.

Certainly, though, there were some things to figure out, before it was too late. Which is what brought my sister and me to Barbara Mack at Pennswood, to talk about Mom’s death.

It becomes clear pretty much right away, as we talk: It’s simple enough to follow DO NOT RESUSCITATE orders if Mom would have, say, a catastrophic stroke, to avoid her ending up a lifeless vegetable attached to machines. And certain procedures, like intubation to help her breath, are nonstarters for her. But at some point, decisions about her care probably will have to be made in real time, as her condition changes. For example, if Mom has some level of dementia and contracts an infection, do you treat it? Or do you let pneumonia have its way without prescribing an antibiotic?

We plug away for answers:

Mom: I’m thinking that if you’re in bed all day, or in a wheelchair being pushed around, and can’t walk yourself, no control over kidneys and bladder — you lose all your dignity. With your hair sticking out all over, and spotty clothes.

Nancy: That’s just physical stuff. If you’re able to watch TV and talk about Republicans winning Massachusetts, then —

Mom: If that’s the case, ask me!

Nancy: What would you do?

Mom: I don’t know. Nobody does, until you get there. I’ve often wondered, when push comes to shove, what my decision would be.

Barbara: That’s the hard part. Every decision going down that road feels like the right decision at the time.

Barbara’s point is that you can’t make the end of life into a program, too organized, because, well, you don’t know what’s going to happen, or when. It’s a continuum. You have to see where you’re at, at any given moment. You map guidelines of your wishes, and designate the people to make the call on fulfilling them if you can’t.

Finally, an hour into this, I ask my mother what she’s thinking.

She laughs. “We’re never going to solve our problems.”

“I think Bob and I are philosophically on the same page,” Nancy says. “It’s not like we’re going to pull the plug when you don’t turn on CNN in the morning.”

Of course not, because, as Mom reminds us, “I usually watch C-SPAN.”