Monday, January 30, 2012

Declining With Dignity - from The Huffington Post

He is almost completely blind, extremely hearing-impaired and unable to walk without assistance. He is 94 years old. Eight months ago, his wife of 70 years died. After the funeral he announced his intention to move across the country to be closer to immediate family. When asked if the move would be permanent, he replied, "I'm 94 years old. I don't make long-range plans." Four months later, my father-in-law did, indeed, move from New Jersey to California.
In the best of all possible worlds, each of us would grow old in our own home and ultimately slip gently away lying in our own bed. The best of all possible worlds, we realize, reflects not reality but a shared vision of what life might someday become. For John, my father-in-law, remaining in his own home would mean isolation interrupted by three visits a day from a well-intentioned and well-paid caregiver to serve him meals he would likely eat in solitude. He has outlived almost all of his friends. He is the last of his siblings. His children and grandchildren are scattered across the country. Remaining in his New Jersey home was not a viable option.
Our next best of all possible worlds would be, we initially reasoned, for John to live with us. A quick appraisal of our floor plan indicated several flaws in the burgeoning next best of all possible plans. Since stairs are insurmountable barriers for John, he would be confined to the first floor of our home where there is no bathroom. Even if we did extensive and impractical remodeling, John would spend his Mondays through Fridays alone while we worked long days at demanding jobs. The isolation of these days would be interrupted by one if not two visits from a well-intentioned and well-paid caregiver to serve him meals he would likely eat in solitude.
We reluctantly abandoned our vision of John growing older in if not his own home, then at least surely in our home. There appeared to be no best of all possible worlds for a man practical and courageous and trusting enough to move across the country. And so it was that we began our search for an assisted living facility near our home.
There's nothing quite like "placing" an elderly family member in a "facility" to conjure up feelings of guilt and shame and anger and, yes, failure. None of those feelings was communicated to us in any way by my father-in-law. His original intention was to move into "some sort of facility." He is blessed with the financial resources necessary for such a choice. Our negative reactions were born of the stigma attached to "placing" and "facility." We forgot that what society fears it stigmatizes. And doubtless we as a society fear the incapacitations associated with growing old.
John now lives in a senior residence two miles from our home in a conservative Los Angeles suburb. Two flamboyantly attired middle-aged men, who might under different circumstances be themselves stigmatized, manage the "facility," which is licensed and tightly regulated by state and federal agencies. In addition to their flair for personal fashion, the managers have an equal flair for decorating and for throwing good old-fashioned parties. They find occasion to celebrate just about anything from birthdays to new arrival days to Fridays to calendared holidays to "Irv plays the harmonica so let's hear him" days. My father-in-law eats his meals in the communal dining room at a table with three friends. He goes to exercise class where other friends save his special hand weights for him. He attends movie matinee Wednesday even though he can't see the screen or hear most of the dialogue.
I've spent a lot of time in this "facility" over the past several months, and I've observed several constants. The first constant is that John and his cohorts take care of each other in very subtle ways. An example of this quiet caring takes place every meal at the table he shares with three friends. One friend, like John, sits in his wheel chair at the table. Another friend uses a walker and would have great difficulty arranging himself at the table if the fourth friend did not see his approach and use his foot to -- without being noticed -- position the chair for easy table access. It is possible that few people notice this constant act of caring. Perhaps not even the man receiving the assistance notices. Nevertheless, the chair is always in the right position. I've also noticed the constant power of community and, overwhelmingly, the constant turning toward life at a time when compelling evidence might dictate a different turning.
Things seemed to be going so well for John in his new home that we were understandably devastated when he began to complain. His new friend at exercise class forgot to save him his weights. The kitchen staff served his coffee at the end of lunch instead of the beginning. The musicians hired for the party didn't play any songs he knew. Careening mentally from complaint to catastrophe, we asked John if he wanted to move to another "facility."
Stunned by our question, my father-in-law replied, "Why would I want that? I like it here!"
And then we got it. John is living his life and life lived well is full of challenges and complaints and quiet caring for others. Yes, he is declining. So am I. So are you. But in his full throttle claiming all of life's vagaries, my father-in-law has forged dignity into his decline and that might truly be the best of all possible worlds.

to see the actual post go to

No comments: