The care necessities: Dealing with old age

@wwaycorrigan

[Listen to an audio version of this blog entry here.]

For most of us, although tragically not all, dealing with the death of our parents is as unavoidable as our own death.

How we care for our elderly is set to become an even greater issue in the years ahead. (Image from Pexels.)

Same body, different mind

While the actual passing of a mother and/or a father is, I can only imagine at this stage, tough to shoulder, what can be just as difficult is seeing those who reared us deteriorate in health before they breathe their last.

This deterioration, of course, is both physical and mental. On the former, it can be quite a shock to see elderly parents after a protracted period of time, noticing how frailer and slower they've become.

Yet, it is mental loss that is arguably more difficult to come to terms with. This is not to make little of physical decline. If assistance is needed for minor everyday tasks — getting in and out of bed, personal hygiene and suchlike — not only is this sad to see but it requires an amount of time-consuming, potentially costly care and logistics.

However, when the mental degeneration is more than just standard senility, it can be harder to cope with and manage. I mean this in terms of actual interaction with the sufferer. And I'm referring to dementia in its various forms.

'The hope is that we can be as active and "with it" as close to our death as possible.'

We may understand in theory that there's a disease afflicting the mind of our loved one but seeing it played out for real on a regular basis can be taxing and troubling. It can test our own mental strength, our patience.

By all accounts, it's like interacting with a completely different person, a stranger. Yes, it's the body of the one you knew, you loved, you quarrelled with, but the behaviours and utterances are alien. It can break the strongest of bonds.

So it's not surprising that many families prefer to send a loved one with dementia to a care home, even if this is against the wishes of the sufferer and there are sufficient siblings to "burden share". 

While the mental decline is severe, he/she may be in good physical shape. Thus, living with the condition could go on for years.

Describing such a person as a 'burden' might sound heartless but the reality is, in most instances, pretty much that.

Going down with dignity

Coming up to my 38th birthday, I feel that if this debilitating dementia were to be my lot — it is on the maternal side of my family — I'd like to be able to end my existence as soon as it started becoming problematic and my being offered no positive contribution to society (I am contributing positively right now, aren't I?). Of course, it's one thing saying this now, quite another if and when such a scenario arises.

On a broader level, caring for our elderly when such care is required is something that is going to increase in scale across the world in the coming decades.

The hope is that we can be as active and "with it" as close to our death as possible.

For me and my peers, we should already be working towards that aim. 

Yes, there are still many unknowns as to the best way to get there, but we have plenty of pointers to at least be on a more beneficial path.
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'God may be dead, but I want to live (for now)'

[Click here for an audio version of this blog entry.]
'Is it possible that he has nothing but cowardice and fear of death to make him live?' So Sonia Marmeládova asked herself about the one she cared for dearly, the murderer Rodion Raskolnikov, in Fyodor Dostoevsky's classic Crime and Punishment.

Houses of god have been off limits recently due to coronavirus restrictions.

Her great worry had been that the immense mental anguish he was suffering as a result of the crime he committed would lead him to suicide. In the end, it didn't.

In God we trust

The thing is, Rodian was an atheist. Had he believed in a god, an afterlife, and was convinced his actions had been for the good of humankind, perhaps he would have been able to end his existence in this world with less of an internal conflict.

It certainly got me thinking: Is it easier for believers to accept death — be that natural or otherwise — than non-believers?

From a suicide perspective, there have been some recent studies in this regard. While there are a lot of factors at play and it's difficult to get a true picture, there are indications that believers at least think about ending their own lives more so than atheists.

On one level, this makes sense. If you are of the conviction that this life is all we've got and all we'll ever have, there is no second chance, no redemption beyond the here and now, then why would you want to end it prematurely? 

No matter how bad your situation may be, as long as you're still breathing, there's a chance you can turn things around.

'It's difficult to comprehend how utterly miserable somebody must feel to decide to end it all. Experiencing ups and downs on the rollercoaster of life is inevitable. The difficult balancing act is trying not to overly focus on either extreme.'

On the other hand, I can only imagine, for those who truly believe in an afterlife or reincarnation or whatever, when things reach a terrible low, opting to roll the die (there's just one!), so to put it, might seem like a viable alternative than struggling on with the status quo. (Of course, against this, suicide is a sin in many religions. Yet so are lots of other things that followers let slide.)

Personally, as somebody indoctrinated into Catholicism at birth and who was an active, enthusiastic participant in it well into my mid-teens, I have often visualised my own death. 

This is not so much in a suicidal way. It is, somewhat narcissistic you could say, more about what my funeral would be like, especially if I were to die relatively young.

A lot of this is probably due to the send-offs we tend to give our dead in Ireland — or how we did pre-covid in any case. 

The deceased takes centre stage for a couple of days, so I'm, um, looking forward — paradoxically considering I don't really believe I'll be able to experience it — to my moment in the spotlight.

To die for

As for taking my own life, well I've never given it any serious thought. (Some may argue that a number of my life choices have been akin to toying with death, but I just call this living within my means.)

A corollary question is, do I fear death? In fairness, it's a concept rather difficult to envisage until one is actually confronted with it. 

What's more, considering all the unknowns surrounding it, most of us probably want to go as swiftly as possible when our number's up or when some illness like dementia takes over our minds. That way, we wouldn't be a burden on either the active living or ourselves.

Outside of that, for one who otherwise would have years to run, it's difficult to comprehend how utterly miserable he/she must feel to decide to end it all. Experiencing ups and downs on the rollercoaster of life is inevitable. The difficult balancing act is trying not to overly focus on either extreme.

Appreciate the mundane, the middle ground, the steady ship. The highs don't last. Reflecting on them too much very often just heralds in the lows. Next thing you know, death comes a-calling, by whatever means.
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Easy empathy from the comfort of home

There really is no greater an emotive topic than death and the pain and suffering one's passing inflicts on those left behind. (OK, romance heartbreak might come close at the actual moment of hurt but this generally diminishes with time.)

We never really come to terms with the loss of a loved one, we just learn to adapt to the "new normal" it creates. As with most things, the passing years make it more bearable.

Downwardly mobile: Are people really willing to downscale for the good of humankind?

Of course, some deaths are more acceptable than others. The death of a person who's lived a long life and feels ready to "move on" is a little easier to deal with and understand than that of someone in his/her prime or, worse still, a youth who is only really starting out in life.

From a personal perspective, my paternal grandmother breathing her last when she was well into her 90s is a case of the former. My eldest sister's passing at the age of 47, leaving behind three young sons, is very much in the latter category.

Your number's up

Right now, as always, millions of people across the world are dealing with death. For some, as we are all well aware, this has been brought about by the novel coronavirus and the infection it causes, covid-19, an illness that we're still learning about and still unsure as to how deadly it is for society as a whole.

A more positive view of the figures and profiles of the majority of those who have succumbed to it thus far leads one to assume that it's not particularly lethal for large swathes of the population.

This, I stress, is not to belittle the suffering of those who are dealing with it.

'Will the comfortable classes opt for more modest lives, start some serious downscaling to reduce their overall consumption?'

Informing somebody who has just lost a family member or friend to complications arising from covid-19 that, all things considered, it's not too deadly for humankind as a whole is scant consolation. It's like telling people burying plane-crash victims that air travel is statistically the safest way to commute. 'Great, thanks.'

Nonetheless, in these highly emotive and uncertain times where many people are genuinely filled with fear, keeping a little bit of perspective on things is, I believe, a worthwhile exercise.

Just because one talks about numbers and stats it doesn't naturally follow that one is heartless, that one doesn't care about the people who have been tragically affected by covid-19.

Deadly decisions

This coronavirus is, in any case, and understandably so because of its novelty, dominating the public discourse.

Within that, there has been some discussion, which I touched on previously, about the unintended consequences of the measures countries around the world have introduced in a bid to control the spread of the virus.

There's the issue of the elderly and vulnerable locked up in their houses and frightened to step outside in the current environment. How many are shunning seeking regular check-ups, potentially allowing other deadly diseases and illnesses to develop that otherwise might have been nipped in the bud?

There's also the risk that outwardly healthy folk, who in normal times might have sought medical attention for something they think is minor yet is actually malignant, are not being seen to.

On the somewhat positive side, lives are being saved from the non-occurrence of fatal accidents that would have happened in "ordinary" times. Considering the more indiscriminate nature of such deaths compared to coronavirus-related ones, an upshot of this, we can assume, will be the human population maintaining a greater number of those of child-bearing age than would normally have been the case.

That, of course, might end up being more of a hindrance than a help to our collective future in the mid-to-long term.

Linked to this, as we're emitting less carbon into the atmosphere during this crisis, the resultant better air quality should, quite literally, give more breathing space to live for those with respiratory morbidity.

A long way down

With all the talk of the new modus operandi to come, brought about by the way we've been forced to change our lives due to coronavirus, it will be interesting to see how those currently taking the moral high ground in the comfortable classes will operate in the months and years to come.

Will they take serious steps to reduce their carbon footprint rather than just paying this lip service as they have generally tended to do? Will they opt for more modest lives, start some serious downscaling to reduce their overall consumption?

It's rather easy, working from home in one's plush surroundings, to follow the herd (although not herd immunity) and join in the outpouring of emotion during this coronavirus crisis, castigating those who "coldly" point to overall deaths and a world population that continues to grow steadily.

It's much harder to take steps that actually reduce one's living standards, steps that could help save the lives of our planet's most vulnerable. The big tests are yet to come.
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Wake up to Pinker's wonderful world

"The world has never been better and very few of us know it." That was the hook for a talk given by the 'celebrity' cognitive psychologist Steven Pinker in Bogotá recently. It's also the thrust of his latest book, Enlightenment Now.

No one can really argue with the various statistics that he rhymes off as to why the human race has never had it so good. 

We're living longer, peace rather than war is the norm, global poverty levels have dramatically fallen while the world's calorie intake has increased. What's more, it's not that it's just that oft-vilified top one per cent reaping the benefits. Everyone is.

Steven Pinker in Bogotá: 'Never mind the future, things are bright now.'

So, compared to the not-too-distant past, current challenges notwithstanding and acknowledged (climate change, populism and suchlike), it's all positive, it's progress.

Malignant media

To be honest, it surprises me somewhat that very few people, according to Pinker anyway, know this. These health & safety and material advancements are obvious, aren't they?

Of course, from a news media perspective, one could be forgiven for thinking the opposite was true. Pinker, with good reason, does lay an amount of the blame at the media's door for all the negativity swirling around the planet.

"That we are statistically on Easy Street these days matters little at the individual level."

Indeed, I recall my late sister and her husband taking a decision a few years back not to read, watch or listen to the news because it just depressed them. We can easily lose sight of the good when we're consuming a large, unhealthy dose of the bad.

So we're agreed, at a macro level, there's never been a better time to be alive.

Yet, that's the crux of it for me — the macro level. From the individual viewpoint, this zoomed-out approach very often doesn't hit home, quite literally. While we're more connected than ever and can converse and share experiences with people on the other side of the planet in an instant, virtually albeit, we still have to live out our lives, tackle the trials and tribulations that we personally face, on a daily basis.

The fact that we are statistically on Easy Street compared to our ancestors matters little in the here and now. It's all relative.

What's it all about?

As that other celebrity Canadian speaker and psychologist, Jordan Peterson, puts it, "Life is suffering."

For the majority of our species born just 100 years ago or so — or even more recently — the initial challenge was simply to stay alive. If they dodged an infant death, managed to find some sort of income or whatever was needed to get sufficient food and shelter, the next goal was to reproduce. After that, exiting stage left was usually the least-worst option. In such a scenario, it was all purely about survival.

These days, for those of us lucky enough to beat the exceptionally long odds of actually being born, the chances of us then living to an age of 60 plus are very high, as the statistically astute Pinker is well aware. Therefore, basic life and death issues don't tend to constantly come into play.

"In the secular world, finding meaning becomes our 'cross to bear'."

For many, these are replaced by questions of "What's it all about?" and the like. Deeper concerns about meaning, or what some might term spirituality, are what fill this space.

Added to this is the fact that we're now smarter. Not only have global literacy levels increased but so have our IQs, as highlighted by Pinker.

Thus, it can be argued, in our search for more concrete truths about existence as a greater number of us leave behind old 'comforting' beliefs in this secular liberal democratic world to which both Pinker and I espouse, the meaning of life becomes our 'cross to bear' so to put it. We're here, going through the motions, 'working for the system' or what have you, for what?

You would be right in thinking that I'm writing this from the point of view of a single, childless man who isn't exactly 'loving' his principal job right now. I'm not alone. And it would appear we're on the rise, thanks in no small part to a lack of wars to check our numbers.

It's not just men who are at risk from this, although we are more likely to end things prematurely compared to women. 

Listening to Pinker in relation to technological advancements and artificial intelligence, I couldn't help but think of an episode of The Simpsons where Homer gets a new well-paid job and moves with the family to an ultra-modern house, replete with all sorts of gadgets to do the housework. With very little to do, wife Marge takes to the wine. There's always alcohol to fill the void, isn't there?

Believe in better

Of course, this isn't to say that technology and the accompanied 'softer living' are killing us, um, softly (although, in some spheres, this might very well be the case). That same human ingenuity that has made our lives easier can also come good to ensure we remain strong and feel fulfilled.

That being said, that our lives in this world have never been better could be put into the 'lies, damned lies and statistics' category. 

One way to view it is like a football team that has had the lion's share of possession, the most shots on target, the most corners, etc. and goes on to win the game as expected. However, for the players, it seems like a defeat. It should have been much better. They think more about what they did poorly rather than what they did well.

That's human nature really. It's what keeps us striving for better and it is where we can find meaning. This is where Pinker and I agree, the ability of mankind (can I use that word in these politically correct days?), collectively, to keep on improving. The problem is that some don't feel part of the game at all. Or at least they feel like they only have a very minor, insignificant part in it.

So yes, the world has never been better for the masses when we crunch all the numbers. Yet, we can't experience the lives of those in the past to appreciate just how good we have it now. 

Also, the stats usually count for very little. Pinker can publish all the graphs he wants to show how such a wonderful world it currently is. It's how we perceive things to be going, though, this is what generally matters most.
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An uncomfortable undertaking

It was Benjamin Franklin who said that nothing in this world is certain except death and taxes. Some people, however, manage to find ways around the latter one. As of yet, though, no one has managed to get the better of the former.

Death: The unwanted but unavoidable guest. (Image: villains.wikia.com)

For something so inevitable, that many of us give very little, if any, considered thought in planning for our own demise could be viewed in a puzzling light.

OK, you can make the argument that we're too busy living to be thinking about such morbid things. 

Plus, the younger you are and/or feel, taking time out to organise both how you want your body disposed of when you breathe your last and where and to whom you'd like your earthly belongings left may seem an unnecessary distraction. 'I've plenty of time for that, sure.'

That may just be the case, but the thing is we never know exactly when we'll depart this world we currently inhabit. Throw in the fact that the older you get or if faced with a potentially terminal illness, you may not want to think about death; imagining it might just bring it on more quickly.

Taking all these points together, then we'll never feel predisposed to preparing the legal and practical necessities for when we die. You could say it's a selfish approach: 'Let those I leave behind deal with all that pernickety stuff.'

Yet, dealing with death is seldom easy, so we can all play our part in removing at least some of the potential trauma ahead of our own passing. 

And seeing how I generally go along with the not-thinking-about-it approach when you're battling a severe illness, especially in relation to younger adults, the best time to think about and plan for your death is when you feel in rude health.

There are the rather straightforward things such as: electing for either burial or cremation; the type of coffin you'd like (and perhaps where you'd like it purchased — there are other options than just relying on a costly undertaker to source it for you); the clothes you want on your dead body; how you'd like your funeral arranged, for example where you'd like your body to spend its last hours before burial/cremation, an open or closed coffin, etc.; and yes or no to your organs' being donated.

Having arrangements made, in a legally binding way, for how any savings and/or assets you have are distributed is, to state the obvious, a very prudent move. 

If you have sufficient funds to pay for your own funeral, these should be made available to cover it as soon as legally possible. If you're an expatriate, as is currently the case for me, expecting other family members to shoulder the cost of having your body repatriated isn't the nicest parting gift (I might be just left where I am!).

For the record, to put it publicly here — subject to future changes — I'll go for cremation (that was the result of a coin toss), a reasonably priced wicker coffin (if people would like to see my dead body before it's disposed of, fair enough), my last night at my parental home, I'm easy on the clothes as long as they're mine, and if my organs after my death can be of use to other people, then go for them.

On the money front, whatever bits I have in accounts in Colombia, the Republic of Ireland and the UK should be used to pay for funeral costs. If there's anything left over (unlikely at this remove), distribute it among my parents and siblings (or siblings' children).

There you go. 

Of course, I fully hope that the provisions in my death plan change many times before they're actually needed, but putting off making one at all isn't best practice. 

Death is the one thing that awaits us all.
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Indomitable spirit, indestructible energy

The Wrong Way approach to spirituality and suchlike has very much been in the contemporary science sphere. The closest thing to the belief that we have an immortal, incorporeal soul is the idea that the energy running through our living bodies continues in some shape or form after we breathe our last.

Double rainbow: An impressive message.

That those who leave this life can make strong, real contact with us in the shape of the persona they once were is something I've never really given much credence to. Nonetheless, over the last few weeks, there have been a number of incidents that have been curious if nothing else in relation to this.

Now, before we look at those, it must be stated that when you have just lost a loved one — as our family has — you are more likely to be open to the notion that the deceased is still very much with you. Happenings that otherwise you might completely dismiss or give no notice to at all can take on other meanings in such emotionally distraught times.

Perhaps the strangest occurrence had to do with white feathers. 

My brother-in-law, looking for a sign from his late wife, my sister Lynda, that everything would be OK and that he and his three boys would cope without her asked her to send a feather. Moments later, looking out his kitchen window a single white feather was stuck to the leg of a deck chair. On closer inspection, the feather was held in place with a long human hair, which my brother-in-law attributes to Lynda.

I had been sitting on the same chair just a short time beforehand and had the feather been anywhere else I probably would have hit it and removed it. But no; it stayed in place for my brother-in-law to see.

No doubt earthly, mundane explanations can be given for this and it was purely coincidental, yet it is thought-provoking all the same. It's not like there are feathers floating about the area in question all the time, let alone strategically stuck to the legs of chairs.

Outside of that, a couple of days after Lynda's passing my brother-in-law heard for the first time the song Wasn't Expecting That by Jamie Lawson. 

As he says, he could have written it himself considering how the lyrics mirror his own situation. Fair enough, the timing of the song becoming a massive hit in the UK is probably just random, but you could, as we have, ask 'Why now?'; a song, tailor-made for the situation as it is, becoming hugely popular at this moment.

A sign from another dimension?

Then you had the quite spectacular double rainbow that arced itself behind my sister's house a few days after she died. In some Eastern cultures, aligning with my sister's strong spirituality, double rainbows carry profound meaning, symbolising transformation. The material world is represented by the first arc, while the second one is the spiritual realm.

For the Chinese, the red of a rainbow is symbolic of the feet and violet represents the head. So a primary rainbow appears to illustrate a human descending from heaven. Since the secondary arc has reversed colours, with red on the bottom and violet on top, it is said to represent ascending from the material Earth to heaven.

Another sign or message or coincidence, whatever you want to call it, was in a local supermarket where my brother-in-law spotted the book My Lynda — the less common Lynda with a 'y' that is, as my sister spelt it — written by a British man who recently lost his celebrity wife Lynda to cancer. Needless to say, it struck a chord. And again, the timing of its release was very appropriate.

There have been other, let's call them perplexing coincidences, but I won't go into them all here. They all beg the question, is Lynda still communicating with us from some other place? My heart would like to say 'yes' but my head says 'no'.

What I will say, though, is that for somebody who displayed enormous strength in the face of what turned out to be an unwinnable battle for her mortal body, Lynda's energy, positivity and spirit can not have just vanished. Science tells us as much. Her energy has not died.

She may be physically gone (and free from the terrible pain she endured in her last weeks) but she continues to exert a strong, positive influence. 

For those of us mourning her loss, we can take comfort and strength from this. Rest well Lynda, you deserve it.
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