02 July 2011

Old Age and Death and Dying

Ready for an uplifting post?  Then don't read this one ; )

"A test of a people is how it behaves toward the old.  It is easy to love children.  Even tyrants and dictators make a point of being fond of children.  But the affection and care for the old, the incurable, the helpless are the true gold mines of a culture." 
~Abraham J. Heschel~

We've been dealing with some aging parent issues around my home. My mother-in-law will be 91 next month, and my father-in-law just turned 87.  My father in law has been having some dementia issues for a few years now, moodiness, anger issues, confusion. He's been in and out of hospital's and nursing homes, and it seems like it may finally be time for him to permanently leave his home. 

I have dealt with this before. Three of my grandparents ended up in nursing homes before they died. My maternal grandmother, (Nanny) had breast cancer that metastasized to her bones. She got to the point where she just couldn't be cared for in her home anymore. She went down hill pretty quickly after being moved into the nursing home. I suppose you lose your will to live a lot quicker when you realize you no longer have anything to live for. She was trapped in a bed, away from her family. We visited her, but how often can you really spend at the nursing home when you have a job and your own life to live? (and being 21, I felt my life was very important).  My mom was an only child and had big issues with her mom. My parents were on vacation in Florida when my grandmother died and my mom refused to come home. She said the service could wait until after her vacation. So my sister and I made all the arrangements. I had just turned 22 four days after her death, and my sister was 26. We arranged for her cremation, and arranged a service with the cemetery and the priest. Thankfully my grandmother already had a burial spot bought and paid for. But we still had to wait two weeks to have her service, because that is when my parents would be home.  Nanny died February 15, 1990.

My grandmother left behind her husband Harry, my step-grandfather, but really the only grandfather I had ever known. He fared pretty well for awhile, but then he too needed to go into a nursing home because he just couldn't live on his own anymore. My mom certainly wasn't going to move him in with her, she already had my paternal grandfather, Pa, living with her and my dad.  He had moved in when I was a sophomore in high school.  

In 1991, a year after my grandmother died, my parents moved from IL to TN. My mother decided she was not going to take my grandfathers with her, so they were both left behind, in IL, in nursing homes.  And then my mom pretty much never looked back. My dad was complicit in this too, he was just usually in the background of everything my mom did, which is why I keep putting this on her.

So it fell upon my sister and I to visit our grandfathers and make sure they had the things they needed. I tried to get out to see them weekly. The nursing home was about 1/2 an hour from me, but it was over an hour for my sister. It was rough going to the home every week. I was in my early twenties, when it seems you are the most alive. And every week I had to go and sit with those on deaths door. Pa was never overly happy to see us. I sensed he realized it was out of a sense of duty, not that we really wanted to be there. He was a pretty angry man, had a rough life and carried that with him.  I can't recall him ever being really happy.  But my sister and I would go anyway, we would sit with him and watch TV, or while he ate his lunch. Make sure he was being treated well, and then we'd leave. It was always so depressing. A lot of the people there never had anyone visit. They were just left there. My sister and I would talk to some of these other residents if we were in the community room. They seemed to appreciate having someone other than nurses aides to talk with.

A few times Pa needed to go to the hospital for a feeding tube because he started having trouble eating. The nursing home would transport him there and then call my sister to let her know. ( She being the oldest was the one left in charge).  They were never able to keep the tube in him, he always managed to pull it out. He had a DNR (Do Not Resuscitate) on his chart, but a feeding tube isn't the same as not resuscitating. My mother also had a signed living will from Pa, and she had his medical power of attorney, so eventually she decided to just stop all means of nourishment. She was still in TN by the way, calling the shots. So even though my sister and I were there, actually caring for him, my mom got to have the final say in how he should die. 

Harry (my maternal step-grandfather) managed to hang on until 1995. He lived in that nursing home for 4 years. The first few years he did pretty well. He had a TV, he could watch the baseball games. He was asked to be on a major league team right after high school, but his father wouldn't let him go.  Harry never had any kids of his own, his only other relatives were his sister who was older than him and still lived back east. My Nanny was Harry's life. When my parents were transferred to IL with my dads job, Nanny and Harry moved out a year later. So our family was all Harry had. But Harry wasn't my moms real dad, and she didn't particularly care about him once she moved to TN. Harry had done a lot for me growing up. I was only 10 years old when Nanny and Harry moved to IL. He drove me places, I used to hang out at their apartment, and he taught me to drive. So I felt I owed it to Harry to visit him as much as I could. He died 3 weeks after my eldest daughter was born in 1995. My parents came back to IL and we had a small service for him at the cemetery and a small luncheon afterwards. All of that was at the insistence of my sister and I. Harry had a burial plot next to my grandmother (they both wanted to be cremated) and if it had been up to my mom, we would have just passed his ashes off to the cemetery and had him buried. But I remember that service and the luncheon. And I am glad we paid him the respect he deserved. My mom had a marker placed on her mothers grave after she died, but she never got one for Harry. She kept telling me she didn't have the money. In 1997 I received a settlement for a back injury. One of the first things I spent money on was a marker for Harry's grave.

So why I am writing all this down? Well, for one, grandchildren shouldn't have to deal with taking care of their grandparents when able bodied children are alive. My parents both completely shirked their duties as children. I realize both had crappy childhoods and had serious issues with their parents.  But they were never not on speaking terms with them, we always had them in our lives.  You just don't abandon your parents in the end.  It was really stressful for my sister and I to have to make sure our grandfathers were taken care of. We were just starting our own lives, by the time Harry died we both had small children.  It was a heavy burden. I don't regret all that we did , but I still think the responsibility should have been on my parents.

Back when all this was going on I often thought how it would be for my parents. Would I have to put them in a nursing home and watch them deteriorate too? As fate would have it, my dad died at 56 of pancreatic cancer and my mom would die 6 years later of internal bleeding at 62. Has it spared me the pain my husband now has to go through? I don't know. Death is death no matter when it happens. I was devastated when my mom died, it was quick and unexpected. I had 6 months from diagnosis to death with my dad. A little time to prepare and say goodbye, but it was still very, very hard. But my parents will be forever young in my memory. I didn't have to watch them lose their faculties and their minds. I didn't have to worry about the care they might be receiving by others in a home. Death is death, whether young or old and it is painful for children to watch their parents die.

I have a fear of death. I know I shouldn't as a Christian, but I do. So I want to live as long as possible. And I kind of hope my mind has gone when I go, so I am not aware of my death. But I certainly do not want to put the burden of my elderly care on my daughters. So it is a dilemma. Obviously I really have no say when I die. But if I had to choose early death to spare my children the pain of my care, or living to a ripe old age to hang on as long as possible, I choose the ripe old age. I just don't want to die, ever (yes, denial!)  I hope to make sure my old age needs are taken care of before I get there (if I get there) so that those decisions don't have to be made by my daughters. I'll also make sure they know that they don't have to come and sit by my bedside and entertain me. I'll have lived my life, and they should be living theirs. Not worrying about old mom in the home.

Life sucks and then you die.  Or your parents die, or are dying, or are losing their minds.  None of us expect or want this in our lives.  But it will come for all of us eventually.  C'est la Vie.  

“Parents, however old they and we may grow to be, serve among other things to shield us from a sense of our doom. As long as they are around, we can avoid the fact of our mortality; we can still be innocent children.” 

~Jane Howard~

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