Parents of a certain age

Unclear what stage of life you’re in? Here is a surefire way to tell: Check the titles of the books and magazines sitting on your nightstand or downloaded onto your Kindle.

Over the past 20-something years, the magazines next to my bed have gone from Brides to Pregnancy to Parenting to More (for women older than 40). And because I buy books the way some women buy shoes, I’ve had all of the corresponding book titles.

If you stopped by my house today, you would find two books that speak to the next stage: being the child of aging parents. Now, before you get the wrong idea — and before my mother reads this and freaks out — my divorced parents are currently both fine. In fact they are more than fine. My father is an attorney who still works full time in his thriving practice and travels frequently, and my independent mother has no trouble keeping track of her four children and nine grandchildren. 

But … the reality is, they are in their late 70s, and if my friends’ parents are the proverbial canaries in the aging coalmine, a slowdown is inevitable. One close friend is navigating the assisted-living circuit with her 90-year-old mother as they look for a place for her to live; another friend just helped her parents move from her childhood home to a senior “lifestyle” complex. Other friends are marching in the Doctor of the Week Parade with their parents. 

Which brings me back to my nightstand. The first book, “Can’t We Talk About Something More Pleasant?” is a sometimes-funny, sometimes-painful graphic novel by Roz Chast detailing the final years she spent managing her aging parents. The opening cartoon-style sequence shows Chast sitting on a couch with her mom and dad attempting to initiate “The Talk”:

Roz: So … do you guys ever think about THINGS?

Father: What kind of things?

Roz: You know … THINGS.

Roz: PLANS. (Mother and father sit silently with question marks hovering over their heads.)

Roz: I HAVE NO IDEA WHAT YOU GUYS WANT!

(Mother and father remain silent but look nervous.)

Roz: Let’s say something HAPPENED.

Roz: You know what? Forget it. Never mind. Que sera, sera.

Later that same day …

Roz: “Whew.”

Father: “Whew.”

Mother: “Whew.”

Chast’s explanation for why that first conversation was so hard is something to which most of us can relate: “It was against my parents’ principles to talk about death.” It’s no different for my generation. We prefer to pretend that every disease has a treatment, that every infirmity has a fix. Run any of your parent’s health issues through WebMD and they are as good as cured, right?

But that is not always the case. My mother-in-law drew the short straw, dying of pancreatic cancer at the young age of 56. She spent the 14 months after her diagnosis chasing treatments, following the lead of her doctors, but never had any closure-type conversations with her loved ones because she was unwilling or unable to look at the possibility that her diagnosis was simply not survivable. Treatment decisions were made based only on whether they might extend her life, not on whether the side effects of more chemotherapy were worth the days or weeks it purchased. 

This brings me to the second book on my nightstand, the best-seller “Being Mortal: Medicine and What Matters in the End,” by Dr. Atul Gawande. The book is mostly about Gawande’s epiphany that doctors’ knee-jerk reactions to extend life at all costs have “caused callousness, inhumanity, and extraordinary suffering.” The doctor notes that when people are “aware of the finitude of their life,” the things that were priorities when they were healthy no longer matter.

“They do not seek more riches. They do not seek more power. They ask only to be permitted, insofar as possible, to keep shaping the story of their life in the world — to make choices and sustain connections to others according to their own priorities,” he writes.

After sharing dozens of stories of terminal patients who were able to design their own final days, and contrasting them with stories of those on the “give me more treatment” bandwagon, Gawande concludes that “our most cruel failure in how we treat the sick and the aged is the failure to recognize that they have priorities beyond merely being safe and living longer; that the chance to shape one’s story is essential to sustaining meaning in life.”

It is impossible to help a parent shape his or her story if you don’t know what the story is that the person wants to tell. In my case, my father is remarried and his wife presumably knows what he would and would not consider a meaningful life. But the situation with my mother, who lives by herself, is different — she’s given me power of attorney. My mother has witnessed too many people suffer needlessly at the end of their lives because modern medicine doesn’t know when to say when. Unlike Chast’s parents, my mom has been very clear about what she does and does not want. 

I listen, but it is hard. Because underlying each of these conversations is a truth that I can’t fathom: If one day I am making these decisions for her, that means she can’t. It means that as sad as these conversations make me now, it will pale in comparison to the time when I’m not able to have any conversations with her at all. 

So what do I do? I listen. I just listen.