We fail to make old age worth living


December 23, 1992|By Arthur Caplan

VINCENT Topel was a regular visitor to the St. Anthony Eldercare Center on Main Street in North Minneapolis. He came to the nursing home frequently to see his wife, Elizabeth.

On his most recent visit he brought a small-caliber pistol. While most of the residents were at a Christmas party, Vincent brought his wife into the bathroom of her room, shot and killed her and then killed himself.

The Topels were married for more than 60 years. The 84-year-old man had lived with his 86-year-old wife until a year ago. He found himself unable to cope with the disabilities brought on by her Alzheimer's disease.

A neighbor said Vincent had taken care of Elizabeth for many years. But after his own health began to flag and she started falling and became hard to feed, he felt he had no choice but to send her to the nursing home. During their year apart, Vincent Topel apparently became so despondent over the separation that he decided to end their lives.

Elizabeth Topel's death took place during the same week that Jack Kevorkian used carbon monoxide gas to kill 70-year-old Marguerite Tate and 67-year-old Marcella Lawrence at Marguerite Tate's Auburn Hills, Mich., home. Tate, who had amyotrophic lateral sclerosis, and Lawrence, who suffered from heart disease, emphysema and arthritis, were the seventh and eight women Kevorkian has helped to die.

Many continue to hail Jack Kevorkian as a hero. But Dr. Death is not the answer to the problems of old age, disabling disease and pain, any more then is Vincent Topel's gun.

Guns and gas are not solutions but rather symptoms of a crisis that this nation refuses to face -- our failure to make old age worth living. America is unwilling to admit that it has failed its older and disabled citizens.

A nation that can find no other alternatives for a marriage of 60 years than expecting an 84-year-old to care alone for his ailing wife or to force them apart is not trying very hard.

A nation that can think of nothing better to offer older women who are depressed, disabled or in pain than to have a doctor strap on a carbon monoxide mask is a nation that really does not give much of a damn about its mothers and grandmothers.

While we spend tens of billions of dollars annually on medical technology that allows us to yank older Americans back from death's door for a few weeks or months, we seem unable to do anything to make old age a more attractive prospect.

Our system of housing, care and support for the chronically ill, the disabled and the frail elderly is a pathetic disgrace. Our health-care institutions do not come close to addressing the problems of old age. Our schools and businesses see the elderly as useless. Our urban elderly sit terrorized in their own homes.

If you think we have done all that we should to provide for older Americans in their final years, then please tell me what image comes to mind when you hear the words "nursing home."

Before we have more Elizabeth Topels, Marcella Lawrences and Marguerite Tates -- before we decide that the easiest, fastest, cheapest answer to the problem of chronic disability and old age is a bullet, poison gas or a lethal injection -- could we at least admit that we might try with a bit more enthusiasm to avert the deaths of women like these?

Upon assuming office, President-elect Clinton ought to direct his secretaries of health and human services and housing and urban development to create a national blue-ribbon task force to find answers to the problem of aging in America.

If we can launch a $3 billion research project to decipher our genetic code, can we not launch a $300,000 national study to examine alternatives to institutionalization and isolation for millions of frail elderly Americans?

A nation that can get to the moon, create babies in a test tube and diagnose cystic fibrosis in an embryo ought to be able to figure out a way to let elderly men and women live out their lives in peace, dignity and security.

Arthur Caplan is director of the Center for Biomedical Ethics at the University of Minnesota Medical School.

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