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.