If end-of-life discussions were an experimental drug, the FDA would approve it.
We want perfection without practice. Yet everyone is harmed if no one is trained for the future.
One has to decide whether one’s fears or one’s hopes are what should matter most.
The lesson seems almost Zen: you live longer only when you stop trying to live longer.
A nurse has five seconds to make a patient like you and trust you. It’s in the whole way you present yourself. I do not come in saying, ‘I’m so sorry.’ Instead, it’s: ‘I’m the hospice nurse, and here’s what I have to offer you to make your life better. And I know we don’t have a lot of time to waste.
We’re always trotting out some story of a ninety-seven-year-old who runs marathons, as if such cases were not miracles of biological luck but reasonable expectations for all. Then, when our bodies fail to live up to this fantasy, we feel as if we somehow have something to apologize for.
There have now been many studies of elite performers – international violinists, chess grand masters, professional ice-skaters, mathematicians, and so forth – and the biggest difference researchers find between them and lesser performers is the cumulative amount of deliberate practice they’ve had. Indeed, the most important talent may be the talent for practice itself.
People die only once. They have no experience to draw on.
The only way death is not meaningless is to see yourself as part of something greater: a family, a community, a society.
For all but our most recent history, death was a common, ever-present possibility. It didn’t matter whether you were five or fifty. Every day was a roll of the dice.
Death, of course, is not a failure. Death is normal. Death may be the enemy, but it is also the natural order of things.
We want autonomy for ourselves and safety for those we love. That remains the main problem and paradox for the frail. Many of the things that we want for those we care about are things that we would adamantly oppose for ourselves because they would infringe upon our sense of self.
Block has a list of questions that she aims to cover with sick patients in the time before decisions have to be made: What do they understand their prognosis to be, what are their concerns about what lies ahead, what kinds of trade-offs are they willing to make, how do they want to spend their time if their health worsens, who do they want to make decisions if they can’t? A decade.
He moved his line in the sand. This is what it means to have autonomy – you may not control life’s circumstances, but getting to be the author of your life means getting to control what you do with them.
All we ask is to be allowed to remain the writers of our own story. That story is ever changing. Over the course of our lives, we may encounter unimaginable difficulties. Our concerns and desires may shift. But whatever happens, we want to retain the freedom to shape our lives in ways consistent with our character and loyalties.
The three primary risk factors for falling are poor balance, taking more than four prescription medications, and muscle weakness.
When the prevailing fantasy is that we can be ageless, the geriatrician’s uncomfortable demand is that we accept we are not.
But as your horizons contract – when you see the future ahead of you as finite and uncertain – your focus shifts to the here and now, to everyday pleasures and the people closest to you.
Our reverence for independence takes no account of the reality of what happens in life: sooner or later, independence will become impossible. Serious illness or infirmity will strike. It is as inevitable as sunset. And then a new question arises: If independence is what we live for, what do we do when it can no longer be sustained?
Old age is not a battle. Old age is a massacre.