Working for hospice for the past 12 years I’ve had the opportunity to see how we age in this country, and I keep coming back to a disturbing thought: in many ways our health care system is intended to keep people alive forever and in many cases we sacrifice quality of life for quantity of life.

Now, before you start making unkind comparisons between me and Jack Kevorkian let me assure you that I’m not talking about death panels and assisted suicide. I’m also willing to concede that long life sometimes goes hand in hand with good quality of life (my 91 year old father in law who still drives, sits on several boards, and plays bridge every Thursday is a case in point).

I’m also aware that average life expectancy in this country has grown from 46 years in 1900 to 76 years now. Vaccines, clean water, antibiotics and many other avenues of health care have given us this gift.

But we also see improved health care can cause us to live longer, but live sicker and we accept this because we are obsessed with living as long as we can. Look how much we cheer the centenarians that Willard Scott brings us on the Today Show. I love Willard but he shows these people looking good and talks about how everybody loves them. Just once I’d like to see him celebrate someone who has advanced dementia or has been bedridden for the past 5 years. Those centenarians never seem to get on the show.

I’m guessing that this obsession for living to be 100 is rooted in our fear of death. On one level that makes sense and we are often guided by fear more than anything else. But on another level, we need to stop fooling ourselves. The oldest documented person in the world was Jeanne Calment (1875-1997) who lived to be 122. And the death rate for all of us is the same: one per person.

The harsh truth is that no matter what we do, if we eat healthy, eschew alcohol and tobacco, exercise, moderate fat intake, whatever, we’re going to die. We can’t control that. We can, however, control how we live given the finite nature of our lives.

I think we need to rethink our goal. Instead of trying to live forever, or at least as long as we can, we should think about living well for the time we have. That sounds easy, but it’s not what we do. It means we have to acknowledge the point where it’s not working. For my part, here’s what I’ve decided:

• I’m currently 49. On May 11th I turn 50. I acknowledge that I probably have more yesterdays than tomorrows.
• If I make it to 80 I will have outlived half of my grandparents. At that point I will have ice cream for breakfast and stop caring what I eat.
• I hope to retire at an age where we can enjoy our retirement. I don’t know if this is possible but if it is, I will accept the fact that I will have to live on a fixed budget for the rest of my life
• I hope to travel but will accept that this may not be possible. If I never see Paris or Mongolia before I die, I will live with that fact.
• I don’t want to spend my last years in a nursing home, but if it happens, I will make the best of it.
• If the last years of my life are centered on caring for someone at the expense of my fulfillment, I accept that fact with grace and gratitude
• None of us chooses the disease that takes our life. I pray that it is not ALS (Lou Geherig’s disease) or Alzheimer’s, but I accept that it may be a disease I wouldn’t choose.
• I accept that at the end of my life I may need someone to do personal care for me. That means when I can no longer bathe or toilet myself, someone else will help me. I pray for the ability to accept this help without shame or embarrassment
• I don’t want to live to be 100 unless I am reasonably healthy. If I am diagnosed with advanced cancer at age 90 I don’t want to spend the rest of my life in the hospital. If I choose not to undergo chemotherapy or radiation I hope my family can accept this.
• Finally, I pray for the opportunity to die well: I hope my death will cause those who survive me to to find my death peaceful enough to not fear their own death. I hope my funeral is a joyful one where people can laugh and celebrate my life.

I can only imagine how strange this posts looks for most people, but accept it for what it is.