A Gift to the Very Old
Some thirty years ago I stumbled upon a book that has informed my relationships with the aged more than any other. Its author, Wendy Lustbader, is a mental health counselor, social worker, and instructor at the University of Washington. Her first book, “Counting on Kindness,” made a profound impression on me for several reasons: it contained insights into the psychology of aging that, at the time, were unusually cogent; it included pointers that were easy to put into practice; and, the content was engaging because, unlike most works in this genre, it had a literary flavor (Lustbader sprinkled quotes from William James, Virginia Woolf, Hannah Arendt, E.B. White, and many others throughout the manuscript).
Although I hadn’t thought about it much since retiring, the book’s lessons took on new life as my nonagenarian mother began to show obvious signs of mental decline. She recently stopped cooking and baking for herself, partly because of the physical effort required, but also because she was finding it difficult to follow a recipe. These days, simple financial statements confuse her, as do instructions from her physicians. I’ve needed to create charts so that she can keep track of her medications and take them as prescribed. Although in conversation my mother can still be quite lucid, she becomes easily befuddled by the functions on her cell phone or billing statements from the cable company.
Like many others of her vintage, she is determined to maintain as much independence as possible and abhors becoming beholden to others. The thought of assisted living, much less a nursing home placement, frightens her. She needs help, but she also resists and, to some extent, resents being helped. Lustbader enables me to put all of this in perspective with citations from her own elderly clients. “Saying thank-you all the time makes you feel bad,” one woman acknowledged. “I can’t keep asking for favors, day in and day out,” said another. “They’ll get sick of me.” A telling quote from the Roman writer Tacitus completes the picture: “Services are welcome as long as it seems possible to repay them, but when they greatly exceed that point they produce not gratitude but hatred.”
That may be putting it as bit strongly, but in my experience it’s not that wide of the mark. My own mother’s increasing ambivalence about my involvement in her affairs is all too apparent. However, I have found at least one way in which I can help her to feel like a giver and not just a taker; a person who still has something meaningful to offer someone twenty-six years her junior.
In his 1999 book “The Force of Character and the Lasting Life,” the noted Jungian therapist and author James Hillman expands upon one of Lustbader’s insights - that elders can feel they are “giving back” when they are afforded the opportunity to share their personal stories with an attentive and nonjudgemental listener. For younger adults this requires intentionality and a clearer understanding of what really matters to those approaching the end of life.
To the casual observer, what no longer seem to matter to the geriatric adult are the routine tasks we all perform to realize short-term goals: working a TV remote or a dishwasher, taking medications on schedule, balancing the checkbook. If such things were still important, why don’t they just concentrate and try harder, we wonder? But with the progressive deterioration of short-term memory, what was once easily managed becomes much more challenging, and thus a source of frustration to those for whom they are still elementary. People who have assumed the role of caregiver may evince impatience, and infantilize the afflicted party with constant corrections, curt instructions, and over-protectiveness. But while assistance may be necessary, without a compensatory strategy it only succeeds in further depressing an elder who is already burdened by feelings of worthlessness.
At the same time as their ability to manage daily affairs declines, Hillman points out, old people’s focus turns to persons and events from the distant past. These memories increase in significance even as what transpired a day or an hour earlier recedes in importance. We may pity the individual for whom the past is more “real” than the present, but a truly humane approach would be to participate in that reality when in their presence.
According to Hillman, what we fail to appreciate is that all this rummaging through life’s deepest storage vaults is extraordinarily meaningful to the individual doing the digging. It’s part of a process he calls “life review,” and we can give an elder an emotional lift by showing interest in the stories they’ve excavated. For me, this has meant sitting with my mother as she sifts through boxes of old photographs, describing the people in them and the context in which they were taken. She not only enjoys the attention, but feels validated when I comment approvingly on the details she is revealing.
Has ours been a “life well lived?” It’s a question we all must answer for ourselves, but a little outside validation doesn’t hurt either.
