Such were my thoughts after a conversation with Martha Tecca about the recent meeting of Lyme NH residents, based loosely upon the principles of Atul Gawande’s Being Mortal. The simple paraphrase of the book is this: have conversations about end-of-life choices, many; pick a person who will speak for you; do the legal paperwork and get those advance directives drafted and signed. While I was attending my first Death Café in another Upper Valley town (see previous post), several dozen people in Lyme turned out to share supper and talk about What Matters in the End .
The new Community Care of Lyme, who co-sponsored this event with Partners for Community Wellness and several Lyme organizations, wants Lyme to become “the warmest community in New England” with “the coolest model for community health.” It is partnering, coordinating, cajoling, and creating with the residents of Lyme, the town’s longtime parish nurse, the Lyme Inn, the Grafton County Senior Citizens’ Council, and others such as Those Guys (my favorite name—volunteers that help with home projects) to address health and other issues of aging in place. It is a work in progress with differences from, but a nod to, the widely-publicized program in Boston’s Beacon Hill.
Aging in place is the term and the movement that calls upon communities to identify and address the needs of elders who would like to remain in their own homes but face challenges in doing so. Beacon Hill provides one model in which participants pay membership fees in exchange for services like transportation to doctors’ visits and help with grocery shopping . Tecca, who is among those bringing this concept to Lyme, sees a more inclusive model for her own community. “We’re all aging,” she says, “not just the old. Fifty-year olds can fall and break an ankle and require help from neighbors.” The Lyme model , while recognizing that age probably brings more of these challenges than youth, understands that a more universal program could work to increase the health of all of its residents. Sort of like many universal design principles that have been developed for specific groups, but may benefit all of us. Think OXO Good Grips, or shower rails.
Back to the Lyme School on a cold night in February. Organizers saw this as a way to present something concrete and educational to Lyme folks. Advance directives, while certainly not the only issue of concern to community members, aging or not, are seen as important in maintaining independence and self-determination. (There was a similar and sustained approach in LaCrosse, WI, described in Gawande’s book, that increased the number of people with advance directives from 15% to 85% of LaCross citizens, compared to a national average of 26.3%).
In Lyme fashion, local restaurants donated food. 60 residents of Lyme and other Upper Valley towns , of varying ages, showed up for conversation. Sitting in small groups with family and neighbors, they played the game called My Gift of Grace. My Gift of Grace is one answer to how to talk about the end of life without the usual doom and awkwardness. It consists of a series of cards that are distributed to each participant. Each card has a question, like “What 3 non-medical things should you tell your doctor about yourself ?,” or “Write your epitaph in 5 words,” or “What music do you want to be listening to on your last day alive?” People ponder, and share their responses. I wasn’t there, but I imagine moments of laughter, and listening, and even surprises that people are still talking about. And isn’t that the point?
As an aging person myself who wonders how we are to navigate growing older in winter-infested New England, I drove away hoping that Lyme is able to export this concept to every other Upper Valley town, including mine. Then I rethought, for a moment, my Vintage Motown response to the question of what music I would like to be my last. The Beatles? British tenor Alfie Boei singing Les Miz? Clearly I may need to pick a person who can burn me a mixed-CD, or its then-technological equivalent.
Photos courtesy of Dartmouth-Hitchcock Medical Center.