Sociologists have identified another age period in humans - the end of life.
If you are frail, go straight to the coffin
Previously, people came to visit God without much delay. Death was usually a sudden and unexpected event. Wars, epidemics, lack of elementary medicine - all this led to the fact that the interval between a serious health problem and a trip to the churchyard took a few days or weeks. Today, thanks to modern healthcare, the transition to another world, even in the presence of a fatal diagnosis, is most often accomplished by long wires and painful delays. It can take many months or years. Deborah Carr, a sociologist at Boston University, summarized the sorrowful experiences of dying citizens in the End-of-Life Wellbeing study and concluded that it was time to identify a new age stage in humans - the end of life. This period is different from aging and refers to the timewhen a person is already facing the approach of death.
“The end of life is a product of modern civilization,” says Deborah Carr. - In the same way, at the turn of the 19th and 20th centuries, due to the industrial revolution, people developed a need for adolescence to prepare for adulthood. In this regard, compulsory schooling and a ban on the use of child labor were introduced. Today people go to another world for a long period of time. They can suffer from cancer, and senile dementia can destroy their intelligence. But feeding tubes, ventilators and other technologies can significantly prolong their life. And the question arises: how to leave life well and with dignity, without torturing yourself and your loved ones.
Three rules of a "good death"
In general terms, the problem that Deborah Carr studied was described by Mikhail Bulgakov in the novel The Master and Margarita. Remember the conversation between Woland and the barman of the Variety Theater, Andrei Fokich Sokov, to whom Koroviev predicted death, which in 9 months would come from liver cancer in the clinic of the First Moscow State University. Here is how Woland reacted to this prophecy: “… I would not advise you to go to the clinic, what is the point of dying in the ward under the groans and wheezing of hopeless patients. Wouldn't it be better to have a feast … and, having taken the poison, move to another world to the sound of strings, surrounded by drunken beauties and dashing friends?"
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Radical advice about poison should be attributed entirely to the devilish temptation with which Woland often seduces fragile souls. But on the whole, the topic is outlined accurately. Deborah cites statistics for the United States: today, 20 percent of older Americans die in an emergency hospital, and 25 percent in a nursing home. Another 33 percent of patients spend an average month before death in the intensive care unit, where life is supported by special devices without any hope of healing. But at the same time, polls show that 75 percent of people would like to meet their last hour not in a hospital ward, but at home.
And this is one of the three main criteria for a "good death", as the American researcher put it: people want to choose the place where they will have to die and the help that will be provided to them. What are the other criteria?
- First of all, it is freedom from pain. Approximately 50-60 percent of elderly patients experience suffocation in the last two weeks of life, and approximately the same number suffer from physical pain. Fortunately, modern medications eliminate pain and allow a person to breathe comfortably. And there is an opportunity to provide such help to terminally ill people at home.
- People want to leave with dignity. This concept includes not only the confidence that the nurse will not hit you in the face with a doormat if you "hooligan" past the duck. People want to be reckoned with despite helplessness. For example, someone, in order not to torture relatives, insists on stopping senseless treatment, deliberately speeding up their departure. And someone treats the funeral like a wedding: determines the composition of the guests, menu and music …
These three factors for a “good death” were formulated from interviews with people who were struggling with death at the very end of life and family members who were caring for hopeless patients.
When will the devil take you?
Eugene Onegin happily passed the trap that his uncle was preparing for him - the one who "was seriously ill". Remember?
It is a pity if relatives consider you only as a source of inheritance. But if you want to make life easier for dear and close people, then Deborah Carr recommends planning your departure in advance. In other words, draw up a kind of "road map". To do this, you need to choose a person who will make decisions when you are no longer able to do it yourself. As a rule, this is a spouse, child or other close relative. And instruct him at least in the most general terms: where do you want to spend the last days? With whom? What kind of help do you want to receive? Do I need to turn off life support systems if it turns out that you are already in a "vegetable" state? It is clear that relatives will be “delighted” with the prospect of such a conversation. But in the end, you did the obligatory program at one time,when they taught their children about the dangers of drugs and the benefits of condoms. Now the case is exactly the same.
Most importantly, studies have shown that the relatives of those people who made such orders experienced less stress, suffering and pain during the most mournful days and weeks. And this is the last thing that we, leaving, can do for those we love.
YAROSLAV KOROBATOV
