On the plight of the aged among us and why it matters
by Amy K. Sorrells
We had been turning and cleaning him for days, the incontinence of the old man wearing on our nerves as much as his sore behind. James* was just like most of the other 80-90 year old patients on the hospital floor where I work, brought to the emergency room because of a fall at home. He was lucky he didn’t break any bones, but the bruises combined with his other comorbidities were enough to render him hardly capable of moving, let alone making it to the bathroom. He could talk to us, but we didn’t have much time to listen to his slow and garbled sentences. There are so many patients and only so many hours in a day.
Maybe because I’m a storyteller or maybe because I’m nosey, I’ve made it a point to try to ask my elderly patients about their stories. I had a little extra time this day, so after we finished wiping and fluffing and pulling James up in bed, I stepped closer.
“What kind of work did you do?”
This question surprises most of my elderly patients. So many are quiet, the sort of quiet that implies they have already acquiesced to their inevitable demise, that they long ago gave up on soaking up the marrow of life, because all life had been sucked out of them.
James raised his eyebrows, his rheumy, saggy eyes looking up at me. “Wha?”
He couldn’t hear so well.
“When you were younger. What sort of work did you do?”
He gazed past me out the window for a moment, then looked back at me, his eyes moist with exhaustion. “Why I worked for the auto plant. Fifty-three years.”
“How’d you meet your bride?” I grinned. I might have been mistaken, but I do believe his cheeks pinked up.
“Oh, Margaret. A blind date. Her brother and I were in the war together. She was his wife’s sister.” He looked at his hands, all angled bones and age spots, then raised his head and chuckled. “They divorced. And we’re still married.”
I laughed with him before continuing my interrogation. “So you’re a veteran?”
“I am.” He straightened his shoulders.
“Well, thank you for your service,” I said, squeezing his hand.
He raised his opposite arm and pointed to scars and a hollow place I hadn’t noticed where his tricep muscle should’ve been. “See this?”
“’Bout near lost my arm. Still got shrapnel here.” He pointed to a spot below his elbow. “I was in the unit that liberated Dachau. But I didn’t see that happen. This injury sent me to the hospital. But my unit, that’s what they went on and did.”
James’ incredible story is far from the first I’ve heard in over 20 years of nursing. I’ve heard both gripping and ordinary tales alike from lifelong farmers, from mothers who birthed ten kids at home, from immigrants and concentration camp survivors, from once famous sports players and artists and teachers and preachers who lay unable to feed themselves because of strokes or dementia or Alzheimer’s. Doesn’t matter how confused they are. Every time I make the time to ask, I’m answered with a story, if not from the patient then from their family member.
Statisticians and health care leadership has long warned of the aging population now overflowing our hospitals and nursing homes. The middle-aged sandwich generation struggles to figure out how to care for mom and dad and their own children, too. To date, the main response—and who can blame us?—has been to continue to treat and over-treat, to tie down the confused for fear of falls, and to produce a system which can clean up and put away a generation so effectively, so efficiently, that they and their stories are forgotten. We don’t want to let go—we don’t know how to let go—and so instead of helping the aged live their lives—their stories—well, we focus on trying to make them live forever and end up killing them, at least in spirit, instead.
The situation is prolific, and I dare say dire. The solutions will be debated for decades in conferences and lecture halls. So what can we do in the meantime?
Our response begins with someone like James. It begins with paying attention to the wisdom of Proverbs 16:31 which says, “Gray hair is a crown of splendor; it is attained in the way of righteousness.” We must do better to find the story of a life behind the tattered body. We have a pressing responsibility to educate ourselves about how we can help people be mortal instead of struggling in vain to make them immortal. I’m not talking about euthanasia. I’m talking about rising above our gluttonous, youth-addicted society and embracing the fact that death is as much a part of life as birth. We have the most bountiful health care system on the planet with the capability to do no harm as our storied loved ones fade, but we insist on adding tubes and treatments until all that’s left is pain. As the saying goes, just because we can doesn’t mean we should.
Few have captured this reality as well as Dr. Atul Gawande in his profound book, Being Mortal: Medicine and What Matters in the End:
“A few conclusions become clear when we understand this: that our most cruel failure in how we treat the sick and the aged is the failure to recognize that they have priorities beyond merely being safe and living longer; that the chance to shape one’s story is essential to sustaining meaning in life; that we have the opportunity to refashion our institutions, our culture, and our conversations in ways that transform the possibilities for the last chapters of everyone’s lives.”
We can re-write these stories for ourselves and our loved ones. First, we need to raise awareness of the magnitude of the plight of our aging brothers and sisters and the loved ones close to emotional and physical collapse trying to care for them. Then, we need to listen to their stories, for it is through story—yours, mine, and theirs—that we live.
*Names and circumstances have been changed.
Amy K. Sorrells is the author of the newly released novel, Then Sings My Soul, which features a 94-year-old protagonist named Jakob. Her debut novel, How Sweet the Sound, was the winner of the 2011 Women of Faith writing contest. An RN at a busy hospital, she lives with her husband, three boys and a gaggle of golden retrievers in central Indiana.
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