I’ve got thoughts about this.
Ya I got me some thoughts on this entire dying alone cluster spinning in our collective minds. Well those of us who are old, widowed, no family, isolated, and ersatz stoic. (aka stubborn males).
This rant or more like my agonal breathing popped into my field of vision from an article in KFF Health News An Age-Old Fear Grows More Common: ‘I’m I Going to Dye Alone’. An excellent examination of dying alone as we age. Now what to do with this? I learned some new stats.
Between 20% and 25% of older adults who are not living in nursing homes are not in regular contact with others
Greater than 15 million people 55 or older do not have a spouse or biological children.
Nearly 2 million have no family
Hospice is underused: Fewer than 1/2 of older adults under 85 take advantage of hospice.
An article from PubMed in the same vein. ‘Aging-related fears and their association with ideal life expectancy’
Grim as hell isn’t it? Ya kinda for me too since I tick off some of these boxes. Which brings me to the let’s talk about me.
When Donna and I were married. In fact on our wedding day a standout moment was during the ceremony. The Rabbi was doing his magic and said: ‘Marriage is the one major life event we do with another person. We’re born alone. We die alone.’ It’s odd how for decades I remember that and my bride.
Fast forward to Donna entering hospice. While she was getting set up in her room I spoke with the director of palliative care. Specifically asked about being with Donna at her end-of-life. He said in a very comforting way, “When a patient dies in unit rarely are family members there. It is just the timing of death. In a way you can think the patient knows how painful their death will be for a loved one and they die when no one is there.” Final act of kindness I guess.
Not sure how I felt about that then. I do now but that’s an entire other post. At that moment it had been three and half years since Donna was told she had six months to live. I was her caregiver. Even with anticipatory grief in those years, here I was standing with her on the edge of her death leap. So ya okay cool. I will be with her. What hell does a palliative care physician know. (Turns out a lot)
At the time the data for in unit hospice life was on average 21 days. Surprise. Surprise. On day 21 I was home walking Nina our Westie. I got a call from the hospice nurse saying to get my ass back to the unit Donna was having death breaths. Took Nina home. Hopped in a cab give the driver explicit directions. Dude failed. I had to jump out of the cab three blocks away and run to the unit.
Donna had passed. The hospice nurse said it was only a couple of minutes ago. (Can’t help but think of her kindness to tell me I was close but no cigar.) I keep thinking nah I missed it by a bunch of minutes. She died alone.
Y’all seeing a theme here. In olden times when we all lived in villages and communities. Not suburbs or vertical spaces in neighborhoods where nobody knows your name. In them olden days the village gathered around the dying. Supporting those left behind. Now, well the odds of dying alone is a parlay bet on Fanduel.
Here I am. Alone. No fam. Isolated. Thinking what if I choke on a baby aspirin. There is no one to administer the Heimlich Maneuver.* I mean like ok groovy. All good. In a few weeks the Halloween like corpse of mine would be wafting through the building. Teach them not to check on me.
There is always the Inuit myth of being put an ice flow when old. But, it was a myth. Though my parents did reference it in my youth. Kinda like ya need a few people to get you to the edge of the ice flow. Good luck with that. Besides climate change guarantees ain’t no ice around. Next random thought.
How about the myth of animals at the end-of-life heading into the jungle to die alone. Myth. Damn the beauty of myths are that they point to an oh yeah that’s an idea I can get behind. Though no woods to wander into in NYC.
Myths are less cautionary tales and more aspirational. Hint. hint.
Back to the case in point. The isolation and fear of death in the elderly is real for the myriad of reasons. It has real world consequences. There is an increase in older Americans dying by suicide. This is being driven by firearms.
“Gun suicide is a greater killer of men over 70 than car crashes, our analysis showed. And if older men are in trouble, older white men are especially in trouble. They die by gun suicide at the highest rate — a rate more than triple that of Black and Latino men of the same age, and 19 times the rate of women 70 and over.” Link
The article from KFF offers links to help the elderly. One of the most interesting is ‘No One Should Die Alone’. The No One Should Die Alone Foundation believes that small acts of compassion will have a profound impact on the lives of hospice patients and their loved ones. The downside here is this program is not available for those in at home hospice.
More importantly there’s you and I. Sometimes to save a life we need to go all DIY. Ain’t no shame to call a geezer in your world. Or adjacent to your world. Just yell into the phone since hard of hearing is a thing for us old ones. HEY, HI what’s the haps? Would mean the world to them. Be forewarned...they will talk your ear off. But shit you got this. In fact we all got this. Connection is at the heart of our humanity.
*Donna would make fun of me about my baby aspirin consumption. I needed to drink 8oz of water. She’d be all humble brag that she could back in the day swallow a quaalude without water.