Broken Father, Brokenhearted Family

Katy Butler, writing movingly in The New York Times Magazine on Sunday, paints a portrait of her dying father kept alive — if you can call it that — with the help of a pacemaker, causing pain and devastation to ripple through the family.

The piece is all about the medical establishment's push (through financial and professional incentives) to extend life even when death might actually be more humane.

But Butler's piece is most powerful when she describes the ordeal her mother endures as caretaker, watching her husband descend into dementia and physical ruin, while his life is agonizingly prolonged by technology. It is, sadly, a familiar story:

His stroke devastated two lives. The day before, my mother was an upper-middle-class housewife who practiced calligraphy in her spare time. Afterward, she was one of tens of millions of people in America, most of them women, who help care for an older family member.

Their numbers grow each day. Thanks to advanced medical technologies, elderly people now survive repeated health crises that once killed them, and so the “oldest old” have become the nation’s most rapidly growing age group. Nearly a third of Americans over 85 have dementia (a condition whose prevalence rises in direct relationship to longevity). Half need help with at least one practical, life-sustaining activity, like getting dressed or making breakfast. Even though a capable woman was hired to give my dad showers, my 77-year-old mother found herself on duty more than 80 hours a week. Her blood pressure rose and her weight fell. On a routine visit to Dr. Fales, she burst into tears. She was put on sleeping pills and antidepressants.

My father said he came to believe that she would have been better off if he had died. “She’d have weeped the weep of a widow,” he told me in his garbled, poststroke speech, on a walk we took together in the fall of 2002. “And then she would have been all right.” It was hard to tell which of them was suffering more.