Part memoir of her father’s dementia and evential death, and treatise on how we came to the situation of people dying in Intensive Care Units being kept alive at extreme costs for a few extra days or months. At 79 Butler’s father was active and enjoying retirement when he suffered a stroke. Soon after hospitalization a “discharge planner” told the family that Jeffrey had to be immediately transferred to a neurological rehabilitation facility. “Only later would I understand the rush,” Butler writes. “The hospital was losing money on him with every passing day. Out of $20,228 in services performed and billed, Medicare would reimburse Middlesex Memorial only $6,559, a lump sum based on the severity of my father’s stroke diagnosis.” A year later he recieved a pacemaker. It was a rushed decision. The heart specialist was concerned only with keeping her father’s heart pumping to keep him alive. Butler’s mother wasn’t given all the information to make an informed decision, nor was she given the time to think and consult other professionals. A team approach would have been much better. The device would keep his heart functioning even as he descended into dementia and almost total physical helplessness over the next five years. With out the pacemaker he likely would have died peacefully in his sleep after a couple of years. “On the phone with my brothers and me that winter, she cried. She loved my father. She’d vowed to be with him in sickness and in health, she told us — and who was she to think they’d escape the sickness part? He’d taken care of her for 50 years, and now it was her turn. But in ways we were only beginning to fathom, my father was no longer her husband, and she was no longer his wife.” “At 77, she had become one of 29 million unpaid, politically powerless and culturally invisible family caregivers — 9 percent of the United States population — who help take care of someone over 74.”
Butler is an excellent writer and researcher which makes this book a must read for all people who are aging or who’s parents are aging. Another excellent book on aging and death is Final Gifts.