Mom herself, she’s all for it, though my sister Nancy and I have avoided this conversation like the plague. Mom is 85 years old. She lives in Pennswood Village, an old-age home outside Newtown with more than 400 residents; it’s the sort of place where you can show up fully capable, like Mom, and stay until — well, that’s what Mom and Nancy and I are talking to Barbara Mack about. Mack is a Pennswood social worker who knows all about living wills and what happens if dementia strikes. She also knows that every now and then, Pennswood residents get taken to St. Mary Medical Center just down the road but then are brought back, because the patient — or the patient’s family — decides that some treatment or other is too much, that it’s time to die.
Mom’s living will reflects what she’s been hammering home for years: Don’t keep me going if I’m not going to be myself. Also, as she says to us now, “I want an organized death.”
“If anybody can achieve that, Betty,” says Barbara Mack, who has gotten to know my mother quite well, “it’s you!”
Even Mom laughs. But we’re not sitting in this small conference room around a rectangular table for the chuckles, so my sister dives right into the deep end:
Nancy: Without having thought about it ahead of time, what is an unacceptable level of mind deterioration to you?
Mom: Certainly, if I couldn’t read a book or watch a program and get any sense out of them. I’ve walked down halls here with people laid out …
Nancy: Suppose you were able to recognize Bob and me. We know that you’re connecting, but that’s all we see going on.
Mom: I wouldn’t be thrilled to live that way. What joy in life would there be? Whatever you decide, it doesn’t matter.
Nancy: I hate that! There are things to look forward to, grandchildren. As if we’re not worth living for! And I see so much vibrant curiosity.
Barbara: If you get pleasure in the moment but can’t remember 10 minutes from now, is that quality of life for you?
Mom: I don’t see how you get joy …
Nancy: If you smiled at me?
Mom: I like to eat three meals a day.
Indeed. You don’t weigh 114 pounds at the age of 14 and maintain it for 70 years without a disciplined diet; you don’t hit 85 ingesting no daily medications whatsoever without a lot of clean living. Mom knows she doesn’t deserve trouble at the end.
Of course, the grim reaper might have other plans. And if Mom isn’t able to make her own medical decisions, Nancy and I will have to. Which for me is not so simple. I was a child of my era, the late ’60s and ’70s. That means Mom and I have a complicated history, and I consider this idea — that I’m the grown-up here — as if it’s brand-new. I’m only 56.