Month: March 2019

Soul Calisthenics

Maybe this is all just a long way of saying that when my friend texted me with his momentous question—death doula or hospice volunteer?—I wasn’t ready with a snappy reply. If anything, it got me thinking about how working as a hospice volunteer is kind of like the new AA. It draws in people who are seeking to find themselves or, as my friend put it, “attempting self-love.” I don’t mean this as a knock on my friend. After all, there aren’t enough hospice volunteers to go around and he’s a good person. But the transactional ethos that infects all forms of volunteering starts to sound a bit facetious when you apply it to death-watching: It won’t be fun but it will get you into spiritual shape.

Need someone to “be present” for your final hours? Need music, aromatherapy, reiki? A death doula will, for a fee, swoop into your home and help.

As for the death doulas, the promise of self-actualization they extend to others tends to rebound on them in an even trickier way—one that hints at how circular and Sisyphean our market-approved quests for self-improvement really are.

The International End of Life Doula Association (INELDA) will host twelve trainings this year for hopeful trainees. “BE A PART OF THE MOVEMENT,” the ad copy urges. Over two and a half days in a Hilton or Embassy Suites conference room, attendees will take the first steps toward becoming Certified End-of-Life Doulas (CD) or Certified Advanced Doulas (CAD). Don’t forget your check for $600, plus $100 for the annual membership fee.

Good Endings for Sale

“The Lonely Death of George Bell” is just one example of how colossally we can miss the point when we try to sensationalize or pathologize a trend—living and dying alone—that is as deeply rooted in our social institutions as it is in any personal failing or individual aberrance of the mind.

Lots of people live alone as they get older, and most of them won’t end up like Bell. His was a story worth telling, but it is not the whole story of how “bad” and “death” now overlap. If we’re looking for a problem that is quintessentially American, there is really only one that every aging person shares: we all face a health industry—and by default, a death industry—that treats patients as purchasers. Forget the crazy cat ladies and the scary hoarders and all the other reductive stereotypes that get trotted out to prompt a shiver of “There but for the grace of God go I.” Here’s a fable that should really chill our veins: in a country of mind-boggling wealth, health outcomes are as divergent as our incomes, professional care is held hostage by profit, and more often than not, the kind of death you get is the best one you can buy.

The command to improve yourself to avoid a lonely death is not just a social media meme; it is the white noise that drowns out our calls to improve end-of-life care in the United States. It masks the real challenges that some elders face by diverting attention to self-betterment—and away from systemic issues like poverty, racial and gender disparity, lack of caregiver resources, and a health care system that saves its best for those who can pay top dollar.

Where There’s a Will

We think we know what failure looks like in our grand meritocracy—obsolescence, uselessness, the wrong consumer choice—and that’s what we imagine a bad death looks like too. But this picture is a product of reverse-engineering; we work backward from the remedies we’re sold. Before swallowing, we might pause to remember something about our innovative market solutions: they have a funny way of floating free of real-world problems.

The command to improve yourself to avoid a lonely death is not just a social media meme; it is the white noise that drowns out our calls to improve end-of-life care in the United States.

Consider the case of the “The Lonely Death of George Bell,” a New York Times feature that ignited readers’ imaginations in 2015 by detailing, with no little melodrama, the solitary end of a man with few friends, no immediate family members, and a longstanding hoarding problem.

While fifty thousand New Yorkers die each year, as N. R. Kleinfield wrote, “A much tinier number die alone in unwatched struggles. No one collects their bodies. No one mourns the conclusion of a life. They are just a name added to the death tables. In the year 2014, George Bell, age 72, was among those names.” Even so, as soon as this macabre tale hit the newspaper, Bell’s death became a metonym for the plight of America’s aging baby boomers.

Plague of Lonesomes

The Japanese, adding to their rich and ancient vocabulary of loss, have given it a name: kodokushi, or “lonely death,” meaning the quiet but messy end of a solitary life. With family far away and neighbors respectfully or distractedly distant, a decomposing body can sear its dark shape into the dirty mattress or the floor boards of a home, to be found days, weeks, or even years later.

Dying alone is seen as a character flaw—an imperfection growing somewhere deep inside of you that, provided it is caught in time, can be rooted out or zapped away.

Multiple factors over the past few decades have made Japan ripe for the kodokushi coinage: an astounding 26 percent of the Japanese population is now over the age of sixty-five, the result of a post-war baby boom and a long-declining birth rate. Elders increasingly live longer and live alone, separate from the daughters and daughters-in-law who would once have been their caregivers. And the Japanese economy took a nasty hit in the 1990s (soon after kodokushi first came into use), pushing aging adults out of the work force and relegating them to poverty, isolation, and less respected roles in society.

Death Trips

Everything you could possible want to know about death trips. Here. Soon.