WHEN it comes to getting old, my standard advice is: surrender! Apologies to Dylan Thomas, but it's better to go quietly....just fold and walk away while you can still do so with some dignity. If I seem overly focused on the benefits of renouncing independence, I have good reasons. My experience in the health care field, mostly with older adults, presented too many train wrecks to count—a host of disasters, many of them avoidable, usually brought on by people’s stubborn insistence on not accepting the help they needed, always trying to do things “on their own” even when such an attitude becomes virtually suicidal.
I’ve said nothing so far about my mother, who died in 2007. She spent the last nine years of her life in a nursing home, suffering, because she refused to move out of her house when she should have. A combination of living alone, being confined to a wheelchair and unable to manage most of her basic activities set the stage; a defective lamp that caught fire while she was in bed finalized the deal. By sheer luck (if that’s the word) she was rescued by firefighters who that very day had been trained to use a new infrared detector that can locate people under water or in the thickest smoke.
Burned severely over one third of her body, she was in the ICU for weeks. Tube-fed, on a respirator and completely helpless, she was hit by multiple infections and a stroke. Amazingly, she pulled through but was never able to leave the nursing home, and on a regular basis made it clear she would rather be dead. It would not have been helpful at that point to mention that we’d warned her repeatedly of the dangers inherent in her living situation; we’d even found decent board and care homes that she could have afforded, but she always refused to leave “home” even though she needed plenty of support to stay there.
Our American obsession with independence and individuality—what we call freedom—becomes a trap when the elderly do their best to carry on alone after they’re clearly not able to. It’s not like this everywhere. In fact, years ago our own culture dealt with aging relatives differently. When people became old and frail, they’d move in with their adult children (or nieces and nephews), and that was considered a good thing. But these days it’s almost unthinkable.
The results play themselves out daily throughout our society. An 82-year-old woman I know is so close to the edge, almost in free-fall, yet she won't accept reality. Living alone in a 2-story house, she has plenty of money and nobody to leave it to, but won't hire anyone (other than a twice-monthly housecleaner) to help. She's already had a couple of falls, and is so crippled she can hardly lurch across the room--she only makes it by clutching furniture the entire time. The fact that she can (barely) drag herself up and down the stairs and somehow stagger to her car gives her the idea that she's just fine, thank you, and can manage on her own...
Yet she asks strangers passing by on the street if they could please carry her groceries upstairs. When she gets occasional visitors, the first thing she does after saying hello is to have them take out the stinking garbage since she can't do it herself. Bathing? I guess if sponge baths twice a week do the trick, good for her. Cooking? Forget it, she just orders takeout or has canned soup. The mere suggestion that she might hire an agency to send a bonded caregiver who could make her life much easier brings up a predictable response: "That's crazy, I don't know those people. And it would cost $100 a day." Does she know that a nursing home will cost her nearly $300 per day? That's where she's heading--unless she gets lucky and just breaks her neck falling down the stairs.
My parents, so far, are more intact, but they too are playing with fire. I hope to be somewhat tactful on the day I tell them that they can’t continue in their current situation, that their desire for independence could result in their losing the very thing they're trying to preserve. And I can only hope they'll listen.
