The Die Is Cast

Last night was it. After an attempt to file but dimly viewed nails, I asked Mr. Z for a pair of his reading glasses. Donning them I saw the world anew. Oh yes, the nails came into sharper focus; it was a delight to see them clearly, and a surprise at just how much I'd not been seeing. What I really saw, however, was my future of increasing disability.

I've been in denial about how difficult it's become to read my iPhone, how often and how much I have to blow up the screen, how very preferable the iPad has become. No more. My near vision sucks. It's going to get worse. I will one day be as my elders are now: happy youngsters will show me blurry screens of what they say are pictures of their cat; I will nod, smile, say yes I see.  The youngsters will know my vision is bad, but they won't know it, not really. I'll know they mean well and want to include me, and that's why I'll smile. That is, if there are any youngsters who come around when I'm elder. I don't kid myself. I don't have kids.  No kidding. The youngsters, if there are any, will be full of well-meant advice, and I will tell them I don't hear that.

We know what's coming, even as we work out at the gym, we aren't stupid. Unless there's an accident or a terrible illness like cancer, death creeps our way slowly. We make jokes about the reading glass harbinger at restaurants with our friends. We ask our partner to crank the volume on Alex Trebek - and wonder why everyone is mumbling. We dutifully remove treacherous throw rugs, install night lights all over the house, grab a cane for outdoor strolls (and then indoor ones too). We put in grab bars, high-seat toilets, convert to walk-in showers with shower chairs, all on the first floor.

We sell the house and move into a two-bedroom one story condo with a patio and outside maintenance provided, become best friends with the nurses at the clinic and the ER and the technicians at Quest, and upgrade to a walker. We become fond of ramps, acquire a handicap parking pass, complain about the lighting and noise in restaurants. (But not at Eat-n-Park, where the coffee is always just right.)  We upgrade to a better walker, add in a transfer chair, and turn in the car keys (some of us more some of us less reluctantly). We depend increasingly upon our children or the kindness of strangers and home health aides to supply us with Turkey Hill Lemonade Tea. Glasses and dishes and silverware grow so heavy, but we don't have much of an appetite anymore anyway. Our pillbox metastasizes from a discreet manageable one-compartment per day to a giant gargoyle garishly color-coded for morning/noon/dinner/night, permanently perched on the kitchen counter, filled (more or less accurately) by the visiting nurse.

We stay home/move in with a child/go to assisted living and we fall and break a bone/we bleed out from coumadin/we get recurrent resistant UTIs and we get pneumonia/have a stroke/become dehydrated and we die.

Mix and match as preferred, feel free to combine as you like, all permutations are allowed. Eventually, all roads this side of the Rubicon will lead to Rome.

The way that you can know all of this, know it casually from reading or intensely from up-close personal experience, and go on living, the reason you don't start haunting the Hemlock Society website, is cognitive dissonance. You think "eh, there's no good way to go, but I can make it another year, plenty of time for that, and maybe I'll go out with a heart attack in the middle of the night when I'm 80 and still kinda strong" and THEN you fall and break your hip.  Now you aren't strong and well enough to do anything about it. Welcome to the rehab hospital. The rehab hospital is where you go to be helped to be a little less debilitated before you die.

A few weeks ago we were visiting one of our elders at a rehab hospital. At one point I took a break to sit outside - there were some lovely rockers on the "porch", the covered front entrance area, and the sun was shining. A woman older than me, younger than rehab, sat in an adjacent rocker. She was visiting with her friend who sat in a wheelchair bemoaning her condition. The visiting woman offered up the following in a very soothing voice: "Well it comes to everyone eventually, though we never think it will, we think we'll always be young and strong, but it comes to all of us, it will come to me too one day. I think 'I'm always going to be just like this' but I won't, it will come to me too." But the older lady in the wheelchair was not much consoled. Because she doesn't have access to the cognitive dissonance anymore.

Of course, there are plenty of examples of people who live into a ripe old age retaining their wits and vigor, caring for themselves at home, until they die peacefully in their sleep. You could be one of them. Or you could be poor, in which case you will probably die sooner and younger, because you won't have access to as much elaborate health care to prop up your failing body.

If you are not poor, if you are blessed with the resources, I suggest using some of them not for elaborate healthcare but to talk with a doctor or someone trained in elder care about end-of-life planning. I mean a serious and sustained conversation, not a brief chat. In another post I will talk about some things you might like to discuss during such a conversation.

Do not despair! You are young and likely don't even need reading glasses yet! Possibly you even hope to have your oceanfront home drowned by the rising oceans before any of this stuff I'm talking about comes to you!

The fear of death and disability, and the fear of talking about them, is not helpful. Not thinking about these things now means it's much more likely that you could end up in a situation you don't want to be in - experiencing poor quality of life that goes on for years long after you can have any real say over what is done to and for you. I do not mean just in the case of being kept alive by machines. This is what I'll talk about in another post.

5 responses so far

  • potty theron says:

    excellent thoughts. As someone who has/ is still caring for my elders, you speak the truth.

  • becca says:

    After this summer, I have vowed to take up skydiving when I'm 65.

  • Pascale says:

    My father and I had a similar conversation last week; you see it happen to your parents, and somehow you think you will never be "like that."

  • BugDoc says:

    Very poignant and true. I'm seeing it happen to my parents and in-laws right now and I think I'm losing the cognitive dissonance. Somehow the internetz with ALL of the info on ALL of the different ways to suffer and die is not helping.

  • quixote says:

    Part of me had a chuckle of recognition with this post. That was pretty much my reaction to needing reading glasses too!

    Part of me said, "But my Gran lived hale and hearty into her 90s."

    And the third part said, "Cognitive dissonance. In full swing."