A Slippery Slope
My Father was just a few months shy of his 97th birthday when he took a nasty fall in his kitchen and landed in the hospital. The head injury which prompted a 911 call proved to be - despite profuse bleeding - superficial. Nevertheless, because of his advanced age and obvious fragility, his attending physicians thought a more thorough medical assessment was advisable.
Blood tests, urinalysis, and an MRI exposed a number of underlying problems, including a persistent urinary tract infection, scarring on the frontal lobe indicating a series of small strokes, and a festering sore on the patient’s back, likely caused by prolonged sitting and poor hygiene. And, after a cognitive evaluation, Dad was said to “lack capacity” due to the numerous deficits the testing had revealed.
When the hospital psychologist called to apprise me of this finding, I had to ask what the the term “lacks capacity” signified. “It means that you need to think seriously about establishing a guardianship for your father,” he replied. Following that conversation I embarked on an internet search and discovered that “lacks capacity”,
…is a clinical diagnosis which connotes an impairment in the functioning of the brain or mind which results in the inability to understand, retain, use, or weigh information relevant to a decision or to communicate a choice.
That seemed clear enough, so after getting the go-ahead from my mother, I engaged a well-qualified elder law attorney who began laying the groundwork for a court appearance at which our petition for guardianship would be considered. The process was unfolding smoothly when my father, whose condition was not thought to be life-threatening, expired in his sleep. The issue was now moot.
But that innocent sounding phrase - lacks capacity - got me to thinking. For mental health professionals it has a precise clinical meaning. But more generally, it can describe what all of us experience in the inexorable process of aging. For example, it was determined that my father “lacked capacity” in a different sense several years earlier. After he performed poorly on a series of exercises that would determine his ability to operate a motor vehicle safely, the DMV pulled his license.
The hard truth of the matter is, our capacity to perform certain tasks, pursue certain interests, embark on certain adventures, begins to diminish no matter how many supplements we swallow or hours we spend at the gym. It’s not a matter of if this will happen, only when.
It is hard not to notice the increasing limitations aging places upon us, but it’s also easy for us to ignore them. A few years ago the legendary Green Bay Packer wide receiver Max McGee died after a fall from his roof. Apparently this former pro athlete was still climbing ladders to clean debris from the gutters at age seventy-five, even though he had the money to farm the job out. As for me, I stopped using our extension ladder to paint the peaks on our house several years ago after noticing that I was a little wobbly on the upper rungs. For certain maintenance chores, I now “lack capacity.”
The same is true in the mental sphere. My learning curve is steeper these days, and adjusting to the frequent software updates from Apple takes more time. I tend to stick with the familiar because adapting to a new system requires extra effort and often leaves me frustrated. For my son, who is half his mother’s and my age, this is hardly the case and, in fact, he welcomes the challenge. In this respect, his capacity far exceeds my own.
Diminished capacity can actually begin at a fairly young age. Trina and I were watching the movie “Proof” the other evening, a story set in Chicago about a celebrated mathematician beset with dementia and his brilliant daughter. At one point, a young protege of the older man remarks that mathematicians do their best and more creative work before the age of twenty-three; after that, it’s all down hill. Whether that assessment is accurate, it has also been applied to a wide range of physical pursuits that require speed and agility.
This is not to say that loss of capacity is all we have to look forward to as we age. There are, in fact, compensatory rewards. My perspective is more nuanced than it was when I was younger, and the “crystallized intelligence” that some neuropsychologists associate with the older brain is a phenomenon I can now relate to. And…an old dog can still learn a few new tricks - this website, for instance, which I set up and launched partly for the challenge and partly for the pleasure of doing so. If it contains something that others consider worth reading, so much the better.
In the end, though, the diminishment of our capabilities feels like a rocky road on which we try our best not to stumble but sometimes do. If we are wise, we will recognize that it may be time to pick a smoother path. Or, as the sagacious Edward Hoagland, employing a different metaphor, wrote recently in The American Scholar:
Aging is a skid, and as in driving, when you turn in the direction of the slide, don’t wrench the wheel toward being a youngster again.
