Thursday, March 5, 2015

Being mortal

Yesterday was my second annual annuitants luncheon since retirement. It was held at Penney Farms near Jacksonville, FL. J.C. Penney began it in the early 1900s to meet the needs of retiring ministers and missionaries who had no other means of support. It has grown into a full blown retirement facility with full end of life care options. In a beautiful park like setting with nature trails, bike paths and a golf course, it offers plenty to keep retirees busy. Housing is not free any longer but it is affordable considering today's options. There is something for everyone: a pottery kiln, weaving looms, wood shop and gardening center. The residents volunteer to care for many of the maintenance needs of the campus and it's members. Need your watch repaired, or your taxes done, or trees trimmed or a personal trainer in the gym; it all can be had for free or nearly so. There is a post office, library and coffee shop. Need a minister? There are a number of them available for pastoral calling, worship leadership and preaching. One former pastor joked at lunch that if you don't like the preaching one week at the Penney Farms Church, try it the next week when someone else is filling the pulpit and chances are good the preacher you didn't care for may die before his turn comes up again!

The annual meeting of annuitants took place before lunch. Once again I didn't have much luck understanding the formula for figuring out how our annuity payout is decided each year. But, it did go up a few cents and we were all good with that. Most of the retirees were older than I am ( I was even mistaken for an employee of our benefits board!) And I doubt I am ready for the golf course or rehashing pastor war stories at lunch but I saw things differently this year.

I had just finished the book by Atul Gawande titled, Being Mortal. Gawande, a surgeon, writes out of a concern for end of life care. I think he would approve of what is going on at Penney Farms. Gawande says medicine takes over at the end of life and although it can prolong our lives - to what end, he asks. Nursing homes which are the fate for many of us have patient safety and efficiency as their primary concerns. Assisted living facilities are marketed to family members who are concerned that their elderly loved ones are safe and well looked after so they don't have to worry.  End of life surgeries are scheduled to gain a few more months of life even if the quality of those days is miserable. Who asks the person facing end of life issues what they want, and how they want to live the rest of their lives and what are they willing to lose if they choose surgery or more treatment for their illness? There is always a trade off, Gawande says, even if the treatment is successful. We are aging and it is a terminal process, after all.

Gawande wants to see more human options presented at end of life. People should be able to stay at home as long as they want - as long as there is help available. Hospice is a good choice. Medicine and it's technological alternatives do not necessarily have the best interest of the person in mind.

I think Dr Gawande would approve of Penney Farms. There is a warm human environment, a community of people who care about living life and helping each other live, too. They work together, learn together, and worship together. When living options diminish due to physical and mental deterioration the same people are there to provide support. At my lunch table yesterday one woman had stopped to pick up another woman from the Alzheimer's unit to join her for lunch out.

As we grow older longer we need to envision other ways to live our lives. The doctors do not know best. In fact, most of the time they are not asking the right questions. It is in our interest to know what those questions are and where to find answers. Gawande's book is a great place to start.

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