Not Your Typical Dinner Conversation—But A Great One

As I am aging, I find that conversations seem to be focus on end of life issues more than ever. The mother of a good friend is in a nursing home following rehab from a fall. At this point, no one knows for sure when, or whether, she will be able to return to her home. Needless to say, my friend is both distressed and stressed trying to make sure her mother is being cared for properly while she keeps up with all the demands of her own life. We talk about this a lot. What type of help will her mother need when or if she goes home? For how long will her mother be able to afford an assisted living residence if she needs a higher level of care, or a nursing home? How will my friend manage to juggle her life and trips to see her mother who lives about 80 miles away?

And then, the other night my husband and I had dinner with a group of friends—all in their 70’s and 80’s. We talked about movies, food, politics—but inevitably discussion shifted to issues concerning the end of life—both theirs and their parents. A few of these people are helping their parents who are now failing. They ask, “How do you tell someone they can no longer drive? How do you say to a parent that they have to move into a more supportive living environment—to senior housing or assisted living or a nursing home?” Some of the talk is amusing. One man related that when he raised the issue of driving with his father, who was over ninety, his father replied, “What do you mean I should stop driving. I’ve been driving all my life.” But underneath the laughter is real concern and fear.

Others are active themselves but have children who are suggesting that they should be thinking about moving out of their big house into a continuing care community. One person present, a former attorney, thought that in addition to advance directives related to end of life care, we should also have advance directives that identify how we want to be cared for as we age. Do we want to remain at home with care takers? Do we want to move into some type of community? It was his thought that we should make those decisions when we are healthy—and long before we actually need to change our lifestyle.

We talked about death also—not our own deaths but our experiences with dying parents. How difficult it is to make those decisions that end up being life and death ones. Not necessarily dramatic ones like pulling the plug but big ones nonetheless, like do we discontinue chemo today. What measures will we authorize to revive someone having a heart attack? Directives that seem so clear on paper are harder to interpret and implement in real life. What is an extraordinary measure?

You would think that all this talk would be depressing, yet it was not. I think we need times and spaces where it is okay to talk about the dark side of life. And then we can move on as we did at that dinner—to dessert, to laughter and appreciation of good food and good friends.

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