I just got out of rehab this week following total hip replacement surgery. While in rehab, I witnessed a very sad reality of getting old.

While most of the people in rehab were between 65 and 90 years old, and wanted to be treated, there was one older lady who appeared to have no interest in voluntarily taking part in any aspect of the rehabilitation process.

This patient, whom I’ll call Betty, was wheelchair bound, and had limited capability to lift her own body weight and transfer from the wheelchair to the platform mat for physical therapy.

This isn’t too unusual, as there are many clients who are unable to transfer on their own, which is often part of the reasoning for their being in therapy.

Betty is a short woman, about 5-feet tall and weighs about 170 pounds. But when the patient can’t assist with her movement, she becomes virtually dead weight.

Trying to lift Betty was very difficult, and as you might expect, the effort involved didn’t please her.

Finally, with the assistance of a third aide, Betty was carefully transferred onto the therapy mat. It was at that point where the rubber met the road, and the question of patient’s rights and wishes versus the idea of health care and quality of life all converged.

While I have no way of knowing for certain, I guessed that Betty’s family and her doctor had decided what was best for her, and possibly without her input.

Unfortunately for the therapy staff, they had no choice but to follow doctor’s written orders. So as soon as the therapist began to touch Betty’s body, starting with her feet and legs, Betty began yelling, “No. I don’t want it. Leave me alone.”

This didn’t deter the staff, because a number of patients protest the initial discomfort of some of the therapy. But Betty continued, saying, “No. I’m 92 years old. I’m old. I’m done. Leave me alone. I don’t want it. You can go to hell.”

She did this repeatedly, all to no avail as the therapy had to be done.

To their credit, the staff kept telling her, “Betty, we have to help you get better and stronger.” It was an interesting mix of psychology, tough love and caring being applied to a very difficult situation. This went on for almost 30 minutes until, at last, the session was concluded and Betty was placed back into her wheelchair.

I wondered as I had watched and listened to this scene unfold, whether Betty was benefitting from the discomfort she was asked to endure for her therapy?

Was her quality of life going to be improved, or were her days on Earth simply going to be extended with no improvement to her life in exchange for her pain and discomfort?

I will never know the answers to those questions, but with our country deeply in debt, our health care costs skyrocketing and Medicare facing tens of trillions of dollars in unfunded liabilities and heading for bankruptcy, I thought that perhaps, just perhaps,

Betty was trying to do what’s best for her and indirectly best for us.

Betty’s situation made me think about the lives of millions of aging boomers and seniors.

How many of us have not had that important end of life conversation with loved ones?

Too many boomers and seniors have yet to complete their living wills and other advance directives. As a result, how many of us may someday become the next Betty?

It’s something to think about and to act on now, before those decisions are taken out of our hands.

Ron Kauffman is a geriatric consultant and planner, and certified senior advisor. He is the author of Caring for a Loved One with Alzheimer’s Disease, available at www.seniorlifestyles.net, where you can also listen to his weekly podcasts. He can be reached at 561-818-0039 or by email at drron561@gmail.com.