Blogging from A to Z April 2024 Challenge: D

Aging: The Good, the Bad, and the Tolerable

D is for Death

I believe that ageism is intertwined with our cultures’ avoidance with dealing with death. Which is why aging has a bad rap. Older people serve as a symbol of the eventual ending of life.

As a new gerontological nurse practitioner who worked with the elderly in the beginning of the 80s, I experienced this avoidance firsthand. Once, I was interviewing a new patient, a woman probably in her late 70s, when the patient’s daughter leaped up, interrupting my line of questions, and asked to talk to me in the hallway. “Don’t tell my mother that she has cancer,” she said. I was so taken back that I nodded and returned to the exam room. Neither the daughter nor I said anything to the patient why we had stepped outside. I sat back down in my chair and continued to take the patient’s medical history, avoiding the fact that my patient did indeed have cancer. I thought at the time that the daughter was delusional. I wouldn’t have been surprised if my patient did know she was dying of cancer. She was keeping her daughter’s secret. I don’t remember how we ended the visit. However, I well remember that they never came back.

What I learned while working in the clinic where we provided health care for those over 60, was that older patients were more comfortable than the rest of us younger providers (I was in my 40s) were in talking about death—their own.

As a society, we are more outspoken about discussing dying and death topics and end of life choices then when I started caring for the elderly some 40 years ago.

A wonderful resource is available in Atul Gawande’s book Being Mortal: Medicine and What Matters in the End. He gives advice how patients can become knowledgeable and empowered when they interact with health care providers and the tools to control their own end of life decisions. Well worth the read.