Thursday, December 18, 2014

Either Laugh or Cry

Roz Chast, staff cartoonist for The New Yorker, has a new book out on care of her elderly parents.

I haven't read it yet, but it's probably a great gift for anyone involved in elder care.

It was a finalist for the 2014 National Book Award, as well as a #1 NYT bestseller and one of the top 100 books chosen by Amazon's editors.

Here's a quote from them:

the themes are universal: adult children accepting a parental role; aging and unstable parents leaving a family home for an institution; dealing with uncomfortable physical intimacies; managing logistics; and hiring strangers to provide the most personal care.

Saturday, December 06, 2014

Older and More Joyful

My friend Sharon Billings and I are closely tracking the event of aging and its effects on our lives and the lives of our friends.

I thank her for pointing out David Brooks' essay in the New York Times this week about the emotional effects of aging:

He confirms what I have long suspected: old age can be a time of greater happiness, even in the presence of health issues and other losses.

I noticed how happy my mother was in her last several years--not all the time, but on the whole.  She had to live in assisted living, but it was a comfortable and warm environment with great caregivers.  She didn't spend any time focusing on the large home she had sold a few years earlier.  

When she came to my house on Sundays and holidays, she often said she wanted to stay and spend the night, but she accepted the reality that it was easier to return and sleep at Sunrise Assisted Living.  

There was a sharpness in her face during her fifties and sixties, when she was still ambitious, hard-working, tired and anxious.  That vanished in her eighties.

Brooks points to well-researched changes in the brain as the source of this happiness and relaxation: greater focus on the present, less worry about the future.  

He doesn't address worry about death--how and when it will happen, whether it will be painful.

"I'd like to think that people get steadily better at handling life's challenges," Brooks writes.  Really?  That sounds like Emile Coue's mantra,  "Every day in every way I'm getting better and better."  Sheer fantasy--though positive thinking does have beneficial effects.

Brooks lists four changes that really do happen in many older people:

1) Bifocalism--the ability to see a situation from multiple perspectives;
2) Lightness--the ability to be at ease with disappointments and loss, realizing it's not the end of the world;
3) Balance--the ability to meet competing demands in a given situation, such as being honest but kind;
4) Empathy and pattern awareness--what Brooks calls "an intuitive awareness of the landscape of reality."

For each of these changes he cites a book or research study.

I like his discussion of bifocalism, especially the ability to be detached while at the same time compassionate:

"Only with experience can a person learn to see a fraught situation both close up, with emotional intensity, and far away, with detached perspective," he writes.

This dual focus reminds me of T.S. Eliot's poem "Ash Wednesday":  "Teach us to care and not to care."

Persons with dementia may not achieve all these four skills, but they are really good at being "in the moment."  Sometimes the moment is all they have; this was true for many of the residents on the memory-care floor where my mother lived.

I'm pretty content with the possibility of ending my life in a blissful fog while others care for me, making sure I am eating, sleeping, and being diapered. 

My mother did have frustrations and outbreaks such as smashing a glass of water on the dining room table, but five minutes later when I arrived she was cordial and happy to see me.  

As for Ekekiel Emanuel's essay about preferring to die at 75 yrs. rather than waste away later, why bother to make such wishes?  

The bottom line is that we don't get to choose when to clock out... unless we oppose both law and custom.