Monday, July 10, 2006

Reflections on Extreme Old Age

“I want to go home,” Bea says this morning.

“You are home,” I repeat, bewildered by her inability to recognize the bedroom in which she has slept for 35 years. “Look. These are your things. Remember this statue? You got it in Greece? It broke when I was a child. You let me play with it. Remember?”

Bea nods. I detect a glimmer of recognition.

“And this oil lamp? Definitely from Greece. Maybe you got it on the Odyssey Cruise.”

Bea reaches out and touches the old lamp. If only one rub might make a genie appear who could reverse the aging process and bring back my vibrant mother!

It is hard to be so diminished. Being bedridden does that to a person.

We sit there in silence for a while. Then Bea asks, “When are my mother and my father going to come and get me? I want to go home …”

Joared’s comment on yesterday’s blog set me to thinking yet again about elderly care options and the importance of familiar surroundings to the bedridden person: “Visual familiarity can be so important, whether it's the physical environment or the people, in helping someone find some sense of reality periodically.” Yes, I agree. Home care is definitely better than being in a nursing home. However, it takes a toll on the caregiver.

Has any society come up with an ideal solution for the elderly?

Americans, with means, can now prepare for old age by signing up for assisted living facilities. I have a friend whose parents are in such a place now. She is trying to convince them to move into the nursing care building, a choice they resist, despite a stroke and diagnosis of Alzheimer’s Disease.

But not everyone likes life in a retirement community. My brother’s in-laws moved into, and then out of, assisted living. They decided staying home was the best choice for now, proof that Scarlet O’Hara’s “Tomorrow is another day” mentality applies to people of all ages.

Three summers ago a heat wave in France caused a number of elderly people to die in nursing homes. The plight of the elderly came to national attention there, but I am not sure much has changed, besides an increase in nursing home personnel during the month of August.

I visited a French nursing home 30 years ago to see my aunt Liza. Old age had put her in a rotten mood. I remember how the building, formerly a manor house, smelled of urine. I didn’t visit as often as I probably should have.

Sweden provides good home care for seniors, financed by high taxes. Once the elderly person can no longer remain in his/her own house, he/she ends life in a nursing home, run by the Swedish government. I had the opportunity to visit Sven’s mother in such a nursing home once. It may have been state-of-the-art but remained an institution. And her “roommate” kept calling out, "Mama! Mama!" …

The Japanese used to take good care of their elderly folk, who were treated with respect and cared for by family. I do not know if this is still true.

I read once that some Native Americans, less elderly than Bea, would leave their family and journey out into the wilderness to die. They figured their time on earth was up and did not want to burden the rest of the tribe. There is wisdom in this approach. I imagine “civilization” has put an end to such behavior.

Modern medicine keeps people alive way beyond their time, when quality of life is no longer optimal, creating a situation like the one I find myself in today.

The problem with old age, whether spent in a nursing home or in familiar surroundings, is that no one really wants to depend entirely on other people, be it family members, paid staff, or hospice workers, and when one becomes bedridden, that is the only option ...

1 Comments:

Blogger joared said...

Interesting to read about the nursing home care in other countries. Expect they are pretty much like ours in the USA, in terms of really good ones being limited in number and expensive.

I agree that too many times nature's way of taking us from this life is thwarted by medical care extending loved ones into a life they might not want for themselves if they truly knew what was happening.

That's why I think it's so important for parents and children to talk thoroughly about life and death issues, medical care scenarios, etc. Additionally, of course, is an Advanced Directive for Health Care we should all have no matter what our age.

Some years ago I recall reading a book entitled "How We Die" written by a physician whose name I do not recall, now. But I remember thinking at the time what a rational realistic presentation of information was given, such as pneumonia sometimes being the patient's friend rather than an enemy to be barred at the door through administration of our new potent medications.

1:27 AM  

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