The New Territory of Old Age

Until I was 12 years old, I was lucky enough to have my great grandmother living right across the street.  My Gramma always seemed very old in my estimation, although in actuality she was only in her mid 70’s when she moved in with my aunt and uncle, and 85 when she died.   But we spent lots of time together, watching her favorite stories on TV (General Hospital and Lawerence Welk), drinking Cokes and eating Fritos, and piecing quilt squares together.  In addition to having this wise and wonderful old lady across the way, my maternal grandparents lived with us.  So, I grew up with the elderly and I became quite familiar with the aging process.

I only recall my Gramma becoming weaker and less energetic that last year of her life.  She was often in bed when I’d dash over after school, and sometimes I would just sit in the chair beside her bed and read quietly while she slept.  One day I came home to the news that she had fallen and broken a hip.  Surgery was performed, but within a couple of days she developed pneumonia and died in her sleep.

“She was ready to go,” I remember my mom saying through her tears.  “Bless her heart, she was just all tired out from living.”

Today, people who are “all tired out from living” have spawned their own cottage industry.  Assisted living, memory loss neighborhoods, respite care, nursing homes – all euphemisms for warehousing the aged.  My mother in law “lives” in such a place, and I place quotation marks around the word “lives” because I’m not sure that what she does qualifies as living, at least not the way I define it.  She doesn’t remember that she was married, that she raised a child, that she worked in a productive, responsible job.  She recalls her mother- whose photograph she will bring to her lips and kiss – but she doesn’t recall her own name, or her only son’s, or her husband’s, or mine.  She’s been “banned” from participating in the one activity she might enjoy (playing Bingo) because she becomes “adversarial” if she doesn’t win.

Sigh.

I’ve just been conversing with my mother in law’s physician (a young woman who sounds as if she’s about 15 years old) and she tells me that recent test results indicate her creatinine levels are “alarmingly high,” and her potassium levels are also “quite high.”

“Normally a physician would be very concerned about this because it signals kidney failure,” Dr. C. says.  “I’m only telling you because I need to know how you’d like to proceed.  With creatinine levels this high, we might start talking about dialysis.  But considering her age and mental status, I’m not sure this is the direction you’d want to take.  And the elevated potassium, if left unchecked, could lead to atrial fibrillation and heart failure.”

(At this point, I press my finger to the ear opposite my cell phone because there’s a cacophony of background noise on her end.  Did I hear someone say “do you want fries with that?”)

“Well,” I say, taking a deep breath and looking over at my husband who is sitting at our dining room table on a business conference call of his own, “at this point we really aren’t pursuing any course that will prolong her life.  We basically just want to keep her as comfortable and pain free as possible.”

Do you realize what I just said?  I’m standing in my kitchen on a sunny spring morning, coffee cup in hand.  My dogs are sniffing around the back yard.   And I’ve virtually just pronounced a death sentence on my mother in law.

“I understand that,” Dr. C. tells me.  “I can document that you want me to check her potassium levels in three to six months and then go from there.  If I check the potassium and it’s dangerously elevated, we can do something as simple as providing medication to counteract it.  Or you can decide to let nature takes it course.  It’s completely up to you.”

Oh god.  I speak enough “doctor” to know that she’s asking me whether we should check her potassium levels at all or let her die a (semi) natural death.

At this point, I’m longing for the ease of a broken hip and pneumonia.  How easy that would be.

Of course, it isn’t really my decision to make.  This is my husband’s mother, every difficult, stubborn, pessimistic bone of her 90 pound body.   She doesn’t really belong to me – she never has.  The two of us have absolutely nothing in common save our relationship with this man sitting at my dining room table talking to a fellow engineer about heat calculations.

“I need to talk to my husband about this,” I tell the good doctor. 

“Of course,” she says again.  “Just let me know how you’d like to proceed.”

So here I am, plopped squarely in this brave new world of old age.  It isn’t anything like the old age of generations gone by, where the elderly tended to be cared for by one family member or another until they died.  Oh no, it’s much more complicated than that.  Now we have “living wills” and “do not resuscitate orders” and hospice.  We have to make “decisions about how we want to proceed.”

My oh my, how life (and death) have changed in the last 40 years.

Of course, I’m not the only one in this predicament.  It would take all my fingers and toes to count the number of people within my circle of acquaintance’s who are currently dealing with similar problems. 

Sometimes,  I  imagine myself in this situation at some point in the (hopefully) very distant future, when my son and daughter in law might have to make these same decisions.  My worst fear is the loss of my mind, my ability to read, write, think, know what is going on in the world around me.   Would I want to continue living in some institutional type environment, sucking up time and money to prolong my existence?  Or would I advise them to “let me go” as peacefully and painlessly as possible? 

And does one person really have the right to decide for another just when life is no longer worth living?  But what do you do, how do you “proceed” when the person in question cannot decide for themselves?

When I talk to my husband about this, his reaction is basically what I’ve come to expect in regard to dealing with his mother.  “I really can’t handle this right now,” he says, staring at me glassy eyed, the look that means “don’t push me too far or I’ll break.”

Sigh. (again)

I’m traveling through uncharted territory here, folks. 

Wish me luck.

  

 

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11 thoughts on “The New Territory of Old Age

  1. Last week I started counting how many people I know who are dealing with aging parents – not just getting older, but getting sick and “senile” too. I lost count. It’s not only uncharted territory, but scary as well. We worry about making the “best” decision, whether to treat a condition, when to move them for better care, what degree of help they need. When they’re difficult people it’s all that much more frustrating.

    I’m wishing you luck and as much peace as can wrap itself around you both.

  2. Oh Becca, these stories are so sad, and unfortunately, all too common. Who’s to say what the best course is. When Shaynee went to do her therapy work at a memory loss center, we could see eyes light up and for that moment there was a person there…but then they go away again. I have no answer for you, but my thoughts will be with you…

  3. I can see the added layer of delicacy you face in that you are dealing with someone who is not your own parent. Many times I wished that I didn’t know the “medicalese” because it often revealed more than I wanted to know, and then I was faced with “do I share this or keep it to myself?”

    I think you’ve done an admirable job in guiding your MIL’s care in your husband’s place. And I, too, wonder if it wouldn’t have been more a blessing not to have all the choices that modern medicine provides.

    I’m here supporting you in whatever way I can. You and your family are in my thoughts and prayers.

  4. My husband & his brother have both passed away, and so I “inherited” my mother-in-law. My new husband and I have had her living with us for 6 weeks because she is no longer able to care for herself, but did not want to accept moving into an assisted living. She has recently gone into a beautiful place, but I still find myself doubting the care, as well as myself for the decisions I am making on her behalf. There are no easy answers Becca, we just have to do the best we can for them. I just spent the evening worrying about what it will be like for ME-and then I read your blog. Isn’t life ironic :)
    Hang in there, you are not alone.

  5. We are going through this with my father-in-law now, too. So very hard. Wishing both you and your husband peace and courage and much patience with yourselves as you navigate these difficult waters.

  6. With my mother now 8 years in a nursing-home, those questions aren’t far away for my family, I fear, and like you, I have no idea what the “right” way to proceed is. I wish you more than luck, but also peace of mind with the choices you and your husband make. You raise questions that are real and present for so many of us now.

  7. Oh, God. I have been there before, Becca, and fear I will be there again someday in the near future. I’ve tried to lift this responsibility from my son by telling him to do nothing to prolong my life in order to live out my days in a nursing home. Medical wonders have forced inhuman decisions upon the children of the elderly. There’s a truth that resides within you, Becca. Find a quiet place, and allow yourself to be guided by it. You are in my prayers.

  8. Big hug Becca! This will be tough for you both. Maybe you could question staff and quietly spend a day observing her routine to get a handle on her quality of life. Knowing her before she was this bad and you not being her child may help you guide your husband.

    I’m hoping as the elderly population grows there will be more dialog for their wishes before the children must be forced to decide.

  9. ((((Becca)))) — these are the questions of this “new age” and ones we hope all the way along we will not have to make. In that way I know I’ve been “blessed” with losing my mother suddenly, my sister the same way. My mother in law at nearly 92 is “healthy” and what I pray is that she will just go peacefully into the night. My father in law had a stroke that required a decision on dnr which I had to make as neither my mother in law nor my husband was prepared to do that. Not easy. Not something I ever wanted to do, but in some situations it falls to the person best equipped to make decisions and it was easier for me since this wasn’t “my” father. It wasn’t easy — but I looked at the state he was in, and what it would mean to prolong that and would he really want that and went from there.

    Sending you my hugs, blessings and love.

  10. My mother lived to be 94 and her worst fear was that her mind would fail. We were lucky that it remained very good except for the times that medications caused temporary confusion problems. She spent her last five years in a healthcare center and we went almost every day. I much prefer the old ways where younger family members took care of the older ones, but she needed more care than I was able to give.

    You have a hard situation to face. I think it may all come down to what her quality of life will be. Some Alzheimer’s patients lead very happy lives in their own little worlds. Others don’t. I’m sorry you and your husband are having to go through this.

  11. Becca
    You should be a writer who informs the oublic about aging issues. I have been working with ALzheimer’s clients for over 13 years and one thing that I have learned is that we need to “live in their lives”. It is sad that she doesn’t remember you or the wonderful memories that you and your husband have had with her, she still has memories and will probably live with them. If she’s kissing a picture of her mother, I am sure in her own way she kissing you and your husband.

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