LIVING and dying with dignity can cost a very high price in money. Often it costs more than people have readily available to them, particularly if it is in the under-insured area of long-term care. The last days of a
Hawaii labor leaderThe dilemma it poses was illustrated recently for the Governor's Blue Ribbon Panel on Living and Dying With Dignity with a frank personal report on the death two years ago of Robert McElrath, 77.
He was the colorful "voice of the ILWU" in some of its most dramatic strikes and organizing efforts in Hawaii following World War II. His evening radio shows during strike crises drew massive listenership. He disclosed things the established media missed.
In his later years, McElrath was separated from his wife, Ah Quon, also a key ILWU figure, but they remained married. She lived on St. Louis Heights. He was in an apartment near the union headquarters on Atkinson Drive.
As he developed cancer, which finally led to a brain tumor operation, she visited him daily. When he fell down she was unable to lift him. She had to call for help from the union members next door.
The two agreed he had to go to a care home. The attractive one they found in Manoa cost $3,000 a month. That was $1,300 more than his combined income from Social Security and his union pension. He drew reduced benefits because of early retirement.
He had some checking account savings plus a $25,000 certificate of deposit. Because of his wife's assets he could not qualify for Medicaid to help pay his care-home bill. He had to spend down his assets. He calculated he would run out of funds after 18 months.
That he died after only four months is partly because he worried about money, his widow believes. It also was true, she said, that his quality of life had greatly deteriorated.
He was a distant relative of Bret Harte, the novelist. He loved words and the ability to frame thoughts and messages compellingly. Aside from his radio show he handled publications and public communication generally for the ILWU in its turbulent organizing years.
He and his wife were at the side of leader Jack Hall in all of this. Organization of the pineapple industry was mapped out in their home.
AS McElrath's illness developed, his wife said, he recognized that his memory was poorer and his capacities were fading. Along with this fading, his once-extensive interests in reading, speaking and writing diminished.
A.Q. McElrath's personal experiences with terminal illness and several deaths, plus her long involvement in social work and advocacy for the ILWU, prompted her to form a committee to lead the successful effort to persuade Governor Cayetano to appoint the Blue Ribbon Panel on Living and Dying With Dignity. She declined to serve on it but continues with her original committee to promote greater public awareness of the options with terminal illness.
Well apart from the public focus on doctor-assisted death, her work illuminates far wider areas of concern. These include the costs of dying with dignity and the care choices associated with final illness. These are not fully understood and utilized ... and could be improved.