Susan Jacoby

One of the saner investigative journalists writing today. Excerpts from NEVER SAY DIE:

“The worst thing about having lived too long is you know you are of absolutely no use to anyone.”

We need to look at old old age as it is, not as the middle-aged and the young old would like it to be.

 The middle-aged, not the old, are the instigators and disseminators of most of the pop culture gibberish about the wonders of the new old age.

Marketing and media hype (the latter created by the former and vice versa) have misled the public in two fundamental ways—by suggesting that cures for mankind’s most serious and frightening diseases are imminent and that the medical reversal or significant retardation of aging itself may not be far behind.

The prevalence of Alzheimer’s doubles in every five-year period over age sixty-five.3 These statistics cannot be cited often enough.

This insistence that depression is not a part of “normal” aging—like the assertion that dementia is not a part of normal aging—is a ubiquitous feature of the happy talk promoting the myth of a new old age.

The sanitization of death was an inevitable part of this decreasing tolerance for evidence of physical decay, and America led the world in the process of segregating the dying.

 It is, in my view, much more rational to contemplate suicide at a time when one still has the capacity to act than it is to simply deny the terrible fate that awaits everyone with Alzheimer’s, thereby condemning oneself through inertia to months or years of institutional care.

Let us be honest with the old, and with their relatives, about what can and cannot reasonably be expected from medical treatment near the end of life. Let us offer palliative care liberally in nonhospital settings, so that people who do not want to die hooked up to machines are not forced to do so. But let us also respect the wishes of the few old people who have had enough and want to end their own lives on their own terms. Let us not insult them by dismissing their justified fear of lingering too long as a mental disorder.