I don't want to be a Struldbrug

[lpetrich]

Jonathan Swift's satire Gulliver's Travels covered a lot of territory, and one bit of it was the issue of immortality. Gulliver learns that the Struldbrugs, certain inhabitants of Luggnagg, are immortal, and he thinks about how great it must be, all the things one can learn and the things one can do and all the places one can visit. But there is a catch. The Struldbrugs suffer from aging, and they spend all but the first half-century or so in the decrepitude of old age, unloved by the rest of Luggnaggian society, unable to enjoy very much, and wishing that they could die.

Advancing technology has enabled us to live longer and longer, but has it improved our quality of life enough to keep us from becoming real-life Struldbrugs?

Ezekiel J. Emanuel has written Why I Hope to Die at 75 - The Atlantic, "An argument that society and families—and you—will be better off if nature takes its course swiftly and promptly"

Though he never mentioned the Struldbrugs, his article could be summed up as "I don't want to be a Struldbrug".

I am sure of my position. Doubtless, death is a loss. It deprives us of experiences and milestones, of time spent with our spouse and children. In short, it deprives us of all the things we value.

But here is a simple truth that many of us seem to resist: living too long is also a loss. It renders many of us, if not disabled, then faltering and declining, a state that may not be worse than death but is nonetheless deprived. It robs us of our creativity and ability to contribute to work, society, the world. It transforms how people experience us, relate to us, and, most important, remember us. We are no longer remembered as vibrant and engaged but as feeble, ineffectual, even pathetic.

Though he feels that his life will be complete at age 75, he nevertheless does not believe in offing himself:

Since the 1990s, I have actively opposed legalizing euthanasia and physician-assisted suicide. People who want to die in one of these ways tend to suffer not from unremitting pain but from depression, hopelessness, and fear of losing their dignity and control. The people they leave behind inevitably feel they have somehow failed. The answer to these symptoms is not ending a life but getting help. I have long argued that we should focus on giving all terminally ill people a good, compassionate death—not euthanasia or assisted suicide for a tiny minority.

He states that he prefers a purely passive approach. He will accept only palliative care and not any attempt to cure any disease after 75.

The American immortal desperately wants to believe in the “compression of morbidity.” ... The claim is that with longer life, an ever smaller proportion of our lives will be spent in a state of decline. ...

It is true that compared with their counterparts 50 years ago, seniors today are less disabled and more mobile. But over recent decades, increases in longevity seem to have been accompanied by increases in disability—not decreases.

Thus becoming real-life Struldbrugs, long-lived but decrepit.


The problem is that we've slowed down or stopped a lot of diseases but we have not slowed down aging.

Half of people 80 and older with functional limitations. A third of people 85 and older with Alzheimer’s. That still leaves many, many elderly people who have escaped physical and mental disability. ...

Even if we aren’t demented, our mental functioning deteriorates as we grow older. ...

It is not just mental slowing. We literally lose our creativity.

It's been studied in detail.

Dean Keith Simonton, at the University of California at Davis, a luminary among researchers on age and creativity, synthesized numerous studies to demonstrate a typical age-creativity curve: creativity rises rapidly as a career commences, peaks about 20 years into the career, at about age 40 or 45, and then enters a slow, age-related decline.

The article contains a diagram:

• First: 26
• Best: 39
• Last: 61

One may still be able to do valuable things when one is old, like mentor younger generations.

Mentorship is hugely important. But it also illuminates a key issue with aging: the constricting of our ambitions and expectations.

As one becomes less capable, one ends up doing less-difficult things and fewer things.


Unless we can slow down or reverse age-related degeneration, more people will end up becoming real-life Struldbrugs.

Slowing down or reversing aging may produce problems of its own, it must be pointed out, but that's another issue.

 

[PyramidHead]

Though he feels that his life will be complete at age 75, he nevertheless does not believe in offing himself:

Since the 1990s, I have actively opposed legalizing euthanasia and physician-assisted suicide. People who want to die in one of these ways tend to suffer not from unremitting pain but from depression, hopelessness, and fear of losing their dignity and control. The people they leave behind inevitably feel they have somehow failed. The answer to these symptoms is not ending a life but getting help. I have long argued that we should focus on giving all terminally ill people a good, compassionate death—not euthanasia or assisted suicide for a tiny minority.

I wonder: why is the presence of depression, hopelessness, and fear not a good reason to pursue assisted suicide, and only "unremitting pain" (presumably physical?) is a valid justification? I am hesitant to immediately ascribe the label of mental disorder to people who are chronically unhappy and want to end their life. It could be that life does not offer them anything to be happy about, and it would be better for them if they ended it. Of course, we have to be careful that they aren't acting on the basis of a neurological condition that is clouding their judgment. But all things being equal, I disagree that we should automatically think that all suicidal people need rehabilitation.

My grandmother decided yesterday to go into hospice. She does not want to be Struldbrug, and will not last long without regular dialysis. My family is saddened by this, as am I, but I can't bring myself to be upset at her. I'm upset about the situation, but I don't think I can fault her for being tired of life at this point.

 

[Bomb#20]

Ezekiel J. Emanuel has written Why I Hope to Die at 75 - The Atlantic, "An argument that society and families—and you—will be better off if nature takes its course swiftly and promptly"

Though he never mentioned the Struldbrugs, his article could be summed up as "I don't want to be a Struldbrug".

Though he feels that his life will be complete at age 75, he nevertheless does not believe in offing himself:

Since the 1990s, I have actively opposed legalizing euthanasia and physician-assisted suicide...

He states that he prefers a purely passive approach. He will accept only palliative care and not any attempt to cure any disease after 75.

For some perspective, he should run that theory past a few veterinarians.

 

[Tom Sawyer]

He states that he prefers a purely passive approach. He will accept only palliative care and not any attempt to cure any disease after 75.

That's a random number. I know very active 90 year olds. Why should they be treated the same as someone who's on a respirator at 76?

 

[TV and credit cards]

My last lunch with my 81 year old mother ended with a statement by her that she is ready to die now. I thought to ask her to go into detail but also felt I knew where she was coming from from our conversation throughout lunch. She's simply done and ready to go. When you have no work and no plans for the future, what else is there? She is at that point where she is playing solitaire on the computer, literally and figuratively speaking. To my knowledge, she is not in any pain physically or psychologically. She enjoyed lunch. Ate nearly the entire thing. She just feels she's reached the end. There's nothing left to do but wait around.

 

[Rhea]

Though he feels that his life will be complete at age 75, he nevertheless does not believe in offing himself:

I wonder: why is the presence of depression, hopelessness, and fear not a good reason to pursue assisted suicide, and only "unremitting pain" (presumably physical?) is a valid justification? I am hesitant to immediately ascribe the label of mental disorder to people who are chronically unhappy and want to end their life. It could be that life does not offer them anything to be happy about, and it would be better for them if they ended it. Of course, we have to be careful that they aren't acting on the basis of a neurological condition that is clouding their judgment. But all things being equal, I disagree that we should automatically think that all suicidal people need rehabilitation.

I'm curious about this, too. That physical pain is the only kind of unremitting pain in the minds of some folks. I'm relentlessly optimistic, so it is hard for me to picture myself having those symptoms, but it is not hard for me to have empathy with those who do. I've read works by those with depression and bipolar and seen alzheimer's patients wiith unremitting fear. I can't imagine the torture of being fearful, genuinely afraid, _every_day_ with no end in sight. Why would we force someone to live that way if they don't want to? Isn't that kind of like a POW who is either killed or is tortured for 10 years and then killed? Wouldn't we call such a situation inhumane? So why are we willing to let nature do it to people when they themselves ask not to let it?

My grandmother decided yesterday to go into hospice. She does not want to be Struldbrug, and will not last long without regular dialysis. My family is saddened by this, as am I, but I can't bring myself to be upset at her. I'm upset about the situation, but I don't think I can fault her for being tired of life at this point.

My mother's quality of life is very low right now. But she keeps thinking it will get better (it won't). As long as she's getting something out of it, I support her completely. But she has expressed that at some point she does not want to be "kept alive." And when she makes that determination I won't fight her because doing so would be choosing to torture her for possibly years.

I already think that if I were in her place (and might be some day) that it's perhaps beyond where I'd get anything out of it. Sleeping, trying to get dressed and eat, and that takes so long it's time to sleep again. It could go on for years and I am not sure I would get any enjoyment out of that. Why should I be forced to endure it?

 

[fromderinside]

Though he feels that his life will be complete at age 75, he nevertheless does not believe in offing himself:

I wonder: why is the presence of depression, hopelessness, and fear not a good reason to pursue assisted suicide, and only "unremitting pain" (presumably physical?) is a valid justification? I am hesitant to immediately ascribe the label of mental disorder to people who are chronically unhappy and want to end their life. It could be that life does not offer them anything to be happy about, and it would be better for them if they ended it. Of course, we have to be careful that they aren't acting on the basis of a neurological condition that is clouding their judgment. But all things being equal, I disagree that we should automatically think that all suicidal people need rehabilitation.

My grandmother decided yesterday to go into hospice. She does not want to be Struldbrug, and will not last long without regular dialysis. My family is saddened by this, as am I, but I can't bring myself to be upset at her. I'm upset about the situation, but I don't think I can fault her for being tired of life at this point.

Gosh. What a little money-in-pocket can do. My daughter-in-law's mom is 86, requires daily dialysis, yet she came up with the family to tuck my granddaughter into college in Portland. She has partial in-home care, her daughters share connecting and disconnecting her from her portable device - they both are professionals at manager level with children - and now she gardens. A while back she was pretty down. Maggie's conditions were really wearing on her. So her whole family, us included kicked in a bit each and shoe got a pretty good long term care policy. As witnessed by her visit with us for a week as they traveled up the coast to deliver Jasmine that policy was a game changer. She may not go any further than she would have gone without the policy, but, her quality of life is completely different from before it was in place.

It really takes a family because what you describe is above the norm.

End of life care is not about prolonging life, it seems, it is about improving the quality of life. Its a priority item on our final years punch list.

I don't think that end of life care in-home is as expensive as is hospice or warehouse care. In-home care seems to be a whole lot better for the person getting it. Its got problems beyond cost. Children or caring others need to pitch in, modify their goals for a time, and do some heavy personal lifting.

Of course if the issue is something like dementia or Alzheimer's or severe stroke the only good reason for in-home care is for the sanity and well being of caring others.

For this to work there need be more than one caring offspring in the neighborhood who is willing to go balls out for up to a year or three. Such requires switching our apparent direction in families to enough to provide such support about which I'm not very confident will happen. I've seen similar plans work where I am now, very rural farm, fishing, and foresting country where big nuclear families, permitting enough hands to carry out such programs without policies beyond supplying equipment and med. Face it, personal in-home care is pricey if one need out-of-family trained personnel.

 

[arkirk]

He states that he prefers a purely passive approach. He will accept only palliative care and not any attempt to cure any disease after 75.

That's a random number. I know very active 90 year olds. Why should they be treated the same as someone who's on a respirator at 76?

That's a good point. I am 71, go to the gym nearly every day, and can do many exercises at the gym many people half my age cannot duplicate. What I find funny is that for 70 years, I never had a regular exercise regimen and the August before last, I set out with high blood pressure and a pot belly. I have already gotten rid of both these things simply with a rigorous exercise program. I admit I am lucky, but more and more of us are getting lucky and possibly in the best shape of their entire lives and retirement age. There's nothing sure fire, but I really do not see a major correlation between age and weakness. At some point, sans cancer, or serious liver or kidney or heart disease, our poor brains will ultimately break down simply due to age and a lifetime of genetic damage. What I am really saying is that if some painful or incapacitating illness is not present, there is no reason to pick a specific age and then stop treating seniors as if they were capable adults. They very well might be...or they could be wretched. It appears to me that depression is endemic in the entire population once they reach about 40. That is not due to weakness of the mind but instead due to social conditioning....the same conditioning that keeps our country at war and makes the big banks grow and pollutes our land, water and air.