“Life is a journey from beginning to end, measured not in time but in quality.”
This is the first sentence in a pamphlet produced by The Hospice of the Florida Suncoast, the largest hospice in the United States, based in Clearwater, Florida. With an average of 2,400 patients and a staff of 1,500, this exemplar organization has played a major role in the evolution of hospice since the movement became popular in the U.S. shortly after introduction of a trendsetting book in 1969: On Death and Dying, by Elisabeth Kubler-Ross, M.D., an eminent psychiatrist. Her book demystified death and the dying process, making the final stage of life more comprehensible and manageable — for those who are dying and their caretakers.
Many prefer not to think about the inevitable conclusion to life, but for Baby Boomers, the end of life is becoming more concrete and palpable. Boomers are losing their parents, and a surprising number of their peers have begun to succumb to fatal illnesses, including high-profile personalities such as newsman Tim Russert, folk-rock-star Dan Fogelberg, and Carnegie-Mellon professor Randy Pausch.
I recently addressed marketing professionals for hospices from around the nation under the auspices of the National Hospice Work Group (NHWG) and then later that same day, the leadership team of the Suncoast Hospice.
NHWG is “a professional coalition of executives from some of the largest and most innovative hospices … committed to increasing access to hospice and palliative care.” These compassionate leaders want to eliminate “bad deaths”: dying in pain and in places other than in accordance with the wishes of the dying person. NHWG hospices strive each day to fulfill one overriding promise: that each patient may die with dignity — as each person defines it.
According to Carolyn Cassin, NHWG president & CEO, this association’s members take care of about 12 percent of the nation’s hospice patients every year. Ms. Cassin, like a majority of her NHWG colleagues, is a Boomer. It’s not merely coincidence that many of the CEOs of the nation’s hospices are Boomers who have pursued this profession with passion since the 1970's and 1980’s — another tangible testament to the beneficent values of the “sixties generation.”
Hospice provides care for those who have terminal medical conditions. Either in free-standing, often home-like facilities, in patient homes, or in hospitals and nursing homes, hospice practitioners deliver palliative care. Services include pain control, nursing care, spiritual counsel, and many other nurturing services. One major goal of hospice is to help patients experience maximum possible peace and comfort during the final months, weeks or days of life. Hospice also provides bereavement counseling and support groups for family members of those who are dying or have passed away.
My presentations addressed some boilerplate topics, including an overview of all living generations, the sociological and cultural factors constituting each generation, strategies for marketing to generations, emerging business trends, and current life-stage issues confronting Boomers. I also shared my assessments of how Boomers might challenge the traditions of dying, including hospice.
For example, healthcare policymakers can expect this generation to test inflexible traditions that reduce the fullest possible expression of life experiences during final months and weeks. A trend emerging now is “slow medicine,” in which those confronting difficult medical choices slow down the process to assess fully the restorative potential of yet another medical procedure.
Life-prolonging medical intervention has its value when the outcome allows greater life quality if not extension of time remaining, but when medical procedures only promote more pain and weakness without recovery, then many Boomers will reject last-ditch procedures. Many will put the brakes on “heroic medicine.”
A Boomer neighbor of mine had brain cancer last year, and surgeons recommended a biopsy, which she reluctantly approved without further investigation. She later lamented not traveling to Europe with her husband for a couple of weeks instead of suffering the brutal and lingering side effects of the biopsy. She never regained enough strength and stamina after the biopsy to enjoy any of her remaining time.
Many Boomers will endeavor to make their final days as meaningful as possible by recording and preserving their legacies. This will lead to dramatic growth of personal historians and online resources for those with terminal diseases to “upload” life experiences, values, philosophies, photographs, videos, insights and hopes for humanity.
Researchers at Johns Hopkins University have recently isolated the psychoactive compound in the hallucinogenic mushroom psilocybin, one of the drugs some Boomers experimented with during the sixties. Researchers have tested the synthesized drug on adults who have never experimented with recreational drugs to determine the potential impact of psilocybin on spiritual exploration. In various studies, those who have taken the synthesized drug have reported experiencing some of the most profound spiritual events of their lives. Someday, hospice may offer psilocybin or other consciousness-altering medications for their patients who are seeking profound experiences of the divine but who are unable to get to this state of awareness through prayer or meditation.
Experts predict that nearly half of those who die in another 20 years will choose cremation. This will have significant impact on the funeral industry. Some Boomers will have their carbon ashes compressed into manmade diamonds. Others will choose “green cemeteries,” where remains are buried legally in public parks and inside cardboard boxes with no grave markers. Others will choose to have their remains buried offshore in artificial reefs. Hospice personnel will likely become involved in helping patients plan more creative funerals and burials.
We can expect Boomers to transform the final stage of life with as much creativity as they changed the nature of being a teenager, a middle-aged adult and now a grandparent. They will embellish the dying process with new customs that allow people to reach the conclusion of life with the greatest possible dignity and grace — a genuine sense of completion.
The last slide of my presentation revealed a graying Boomer man holding a protest sign, hearkening back to the sixties and a time of strident protest marches; he bore one possible concluding aphorism for this generation: