Seeing the big picture with aging Americans

Johnny Carson gave us the funny "Aunt Blabby" character. Ed McMahon introduced her as "deer, sweet, lovable, old," remember?

Hospitals are places of miracle and hope today. Certainly it's different from an earlier time, when medicine didn't have the tools to extend life so much.

I remember George Will writing that in 1946, the No. 1 expense for many hospitals was "clean linens." Science has brought us light years along.

But all good things are accompanied by challenges. As we find cures for the big things that can take one's life, we set people up for a lot of little problems and hindrances that come with age.

God's plan for us was to get steadily more brittle and vulnerable, beginning at about age 75. Society hasn't yet gotten a true wakeup call on what this will mean. No true clarion call. It's only "hints," as with these feel-good programs where a college student might volunteer to be a "buddy" to a senior citizen for part of a day.
It's very well-intentioned but hardly adequate.

An aging person who really needs this sort of thing is going to need it on a more continuous basis.

Often the most difficult step is to give up driving. How many boomers lay awake nights wondering if their parents are making the proper adjustments? If they're human, they are more distracted by this than they're willing to admit. We like to keep these little anxieties private. The barrier is pride.

Even though it's obvious God created us to lose our independence after about age 75, we don't like to admit it. In America, personal independence is an ideal. It's why we seem to revile "European style socialism." Actually I think it's just a few loud voices from the right trumpeting that.

A lot of older people are going to need considerable help as time goes on. We hear hints of this from the media occasionally. The true wakeup call hasn't seemed to arrive yet.

The concept of "assisted care" has been bandied about. It sounds like such an easy solution: "assisted care." Not messy and sad like "nursing home."

Boomers like me don't like associating themselves with things that are messy and sad. We grew up quite hedonistic and haven't entirely thrown off that inclination.

People of my vintage, 1973 high school grad, are at a point where our parents have passed on or are likely quite dependent. Old friends come back to town for funerals.

A classmate of mine who I don't see often approached me at a restaurant recently. His father had recently passed. I expressed sympathy. Without missing a beat he said "it was a blessing." The deceased had suffered from Alzheimer's.

Yes, medical science is a miracle. It prolongs life, for which we all cheer, but God has decided the end must come. An individual gets cured of something - thank the Lord - but aging then brings on other maladies. Gradually our independence must be relinquished.

We are restrained in discussing this with others. But most assuredly there are private little conversations going on all over the place. Even with the best-planned transition, older people get more vulnerable. God has simply decided this.

A recent page 1 headline tells us Minnesota is tightening elder neglect/abuse laws. We might wonder why the nursing home establishment has shown reservations about this, actually opposing to an extent. Shouldn't they be out front pushing for the best care? Of course it's not that simple.

Older people have challenges they wouldn't have dreamt of when younger. Aging is slow so we might overlook some of these changes. Older people can be in denial about their limitations. They might argue with their children over giving up driving.

There's a huge risk of falling, yet they don't seem aware of all the precautions they might take. Elder neglect laws may fly in the face of the kind of frailty that even the most conscientious caregivers, whether family members or an institution, can't fully provide insulation from.

I'm reminded of an impassioned letter to the editor in the Star Tribune from someone imploring us on how many suggested cases of "elder abuse" have shades of gray. In other words, "two sides to the story." You have to have been there, taking care of a brittle older adult.

There are truly egregious cases of neglect. The law tries to focus on these but it can be fungible. If the laws become too strict, maybe no one will want to take the risk of caring for, or keeping an eye on, very aged people. I imagine institutions will have to increase their costs. Yeah, like we're all ready to accept that.

Well we may have to.

The perfect is the enemy of the good.

A spouse of a high school classmate of mine once said to me "eventually the Federal government is just going to take care of everybody." If our laws increasingly demand perfection and if that perfection has a prohibitive pricetag, the government will have to step in.

European style socialism? It will be the American brand. It will progress along quietly beneath all the conservative rhetoric. We talk about self-reliance but in fact we need help.

The Federal government can print money. Of course, that way lies madness too, or collapse. The doomsayers seem to be increasing in number.

Maybe the best thing would be for families to be forced together to take care of their own. America has been alone in discouraging multi-generation families. Through history, multi-generation families have been quite common.

The economy has been forcing some re-thinking in America. Still, we get news media commentators who insist on talking in a snarky way about this sort of thing.

Just as the automobile liberated us in the 20th Century, we came to feel we could all live like islands. It might be healthy for us to retreat a little. It might be nice for us to be collectively slapped in the face, and be told that cross-generational caring has been the norm through world history.

There are limits to how well institutions can perform.

I read a book from our Morris Public Library that cautioned on the concept of "assisted care." Let's emphasize it's a concept. The author noted how fashionable it is for middle-age people - boomers, you know who you are - to reason "I won't need a nursing home, I'll just use assisted care."
It's a delusion.

"Assisted care" sounds so much more palatable. But the author stressed: "Assisted care is more a philosophy than an established body of practice."

I would suggest that many people who begin considering assisted care never make it. Once you consider any sort of special help, it's likely you'll need it on a pretty intensive basis. We don't turn to this until we truly need it. And then we might be on the verge of a true "long-term care facility." OK, a nursing home.

The miracle of medical science extends life to where many people descend to where quality of life seems questionable. Surely we want to extend life. But we must accept the responsibility we have to older people, facilitating their adjustments as independence fades.
This begins when they're still living at home. We all need to slow down and think more about the people whose productive years are behind them. We're all headed there.

I often take an evening walk past Summit Cemetery. As I note the names on the monuments, I wonder how many of these people of an earlier time died at mid-life. The grieving for such people would have been intense.

If you were to talk with a funeral director today, you'd probably hear that the percentage of "low-grief" funerals is increasing. These are for people who have lived beyond where they could be reasonably said to have quality of life. As my high school friend stated regarding his father: "It was a blessing" (when death came).

It's horrible on the face of it to say that. But let's be honest: Such examples are likely to become more, not less, common.

God's will is that we become frail. He guides us to death, I guess. We want to delay that process.

Surely God would smile on our efforts to cure physical maladies. But we cannot defy our mortality.

The Fred Gwynn character in "Pet Sematary" said "sometimes dead is better." None of us wants to say that. But we all think it sometimes.

- Brian Williams - morris mn minnesota - bwilly73@yahoo.com