Supporting someone to the end of life is hard core. You enter into a journey together. If you live through it with them, at some time along the journey, you come to realise, you will emerge at the other side one man down.
My experience is of caring for a relative into very old age. It can be a long process sometimes lasting years or decades. Every time they become ill you wonder, if this will be the end of their life. You don’t want to lose them, you also don’t want them to be in pain or suffer in any way. The longer you have them the less they can do and the more impotent they feel and behave, life becomes sad, recalling their previous abilities and watching their frustration and ultimately resignation. It’s a conundrum. You know you can’t win because at some point, you are inevitably going to lose them, it’s just a matter of when and how.
Age usually brings with it wisdom and a sedate pace we younger generations, cannot yet comprehend. Once I had learned to slow down enough, I learned to love spending time with the very elderly. They have had the time and usually, the patience in life to observe many things. Usually they are experienced in many of life’s challenges, either first hand or through others and are able to share this knowledge, with you.
When I was newly qualified at my job I was fascinated to read articles and research regarding the latest new theory and models. After working in the same job for 10-15 years, I began to notice the same information I had seen years ago, coming round again as new information. Whilst fortunately there is also always totally new research and evidence available, or amendments to previous knowledge, it does make one reflect on learning and work over time. I love chatting to people who have done my job in different areas and fields and for longer periods. They usually have a different take on things and I find it useful to balance and compare my own knowledge, against that of others. We are taught at school and in further education to always research equally, giving evidence toward the positive, together with a negative critique. I enjoy chatting to older generations to gather information and learning, which they have gained over the decades of their life and adding this to my own knowledge. Sometimes the new ways are not always the way to go, sometimes old still works too and may just be forgotten in time.
Old age and increasing frailty forces slowness. When you can no longer get up and do the things you once did, you are forced to plan your day to accommodate your mobility and energy limitations. You can no longer get up to answer the door, make a coffee or pop to the shop. Everything must be planned, according to the available resources, at any one time. You also have to reserve resources, for occasions such as family visiting or going to dentist and GP appointments- woo how exiting!
Old age brings indignity. The young do not look upon the old as valued. I have watched elderly people in shops and around towns. People hurry to get round them so that they are not held back and delayed by them, shop assistants are sometimes very good and will wait for someone to slowly load shopping and find change to pay for their purchases, but others will not and will try to hurry them along, to get them away, to serve the next customer who is waiting impatiently to be served.
I once went into a shop with my Dad aged 99, to complain about an appliance he had bought not working. He had difficulty with mobility and had stains on his clothing, he couldn’t be bothered to change his clothes to go out, as he had usually done years ago. It was too much effort. He asked to see the manager of the shop. The person who came to us was possibly 30 years old and obviously not impressed at being asked to come and speak to such a dishevelled member of the public. My Dad may have looked chaotic and impaired but cognitively he was as bright as a tac. Had he had the same conversation with her 10 years or possibly even 5 previously, he would have absolutely made himself clear at his disapproval of the shoddy performance of her company, but aged 99 and very deaf with stained clothing he looked a shadow of his former self. She had neither the time nor emotional intelligence to be polite and acknowledge his complaint, she merely arrogantly quoted policies and advised that we had been given instruction on delivery which was untrue. We left feeling humiliated, powerless and very angry. Dad’s next action was to request his solicitor act on his behalf- not so dishevelled hey?
The shop episode however was not an isolated incident and I have seen it repeated in many scenarios over the years. The very elderly are not valued. They are perceived as weak and ineffectual, despite the fact that they are a valuable resource whom we should respect and honour. Unfortunately those who do value the very elderly, are outweighed at times by the emotionally immature who do not.
Indignity of age does not stop there. Eventually with age, people become less and less able to carry out daily activity, making food and drinks becomes increasingly difficult as eye sight changes and hand function reduces, energy is less and walking requires equipment. Getting washed and dressed may take so much energy that you can’t do anything else for the rest of the day. When these things happen, you then need someone to help you. Most of us haven’t had someone take our clothes off and wash and dress us since we were about 5. No one has wiped our bottom for us since we were about 3, no one has physically put us on and off a toilet since we were toilet trained, probably before we remember. Carers may do this with patience and dignity. Often carers are highly skilled and adapt their approach to each individual, some laugh and joke in the face of discomfort, others are calmly accepting, others apologise profusely, and others remain mortified for the rest of their lives. It takes getting used to and some accept it well, some can really struggle, it is difficult to accept such intimate help for people who have been fiercely independent all their life and painfully shy, some may have traumatic reasons to fear such intimate care. Not everyone is willing or able to discuss these things.
Watching someone you love, age and ultimately die can be a lonely process. It raises questions for us all about our mortality, our relationships and our willingness to face the deterioration of health and loss, head on. Some people can’t do that, it’s too painful so they visit less and less and move on with their busy lives. Other people can do some things, but others are just too hard.
Dying of old age brings loss in every aspect of life, it’s slow and insidious. It’s unpredictable and can continue for many years. I remember envying people who had relatives who died quickly, their relatives were active and were loved actively by friends and family who busied around to help and support. However it also saddened me, death in old age causes people at times to drop away through lack of contact, lack of communication resources- they can no longer post or write letters, memory becomes affected and they no longer initiate contact, health deteriorates and they move away. Ultimately social contacts die off, either actually or functionally, making loneliness very real.
For those who stay present over the years, there is a closeness which comes, there is time to talk, recall and share, which is not available to others. I have to withdraw my jealousy, I would not change what I had but at the time of supporting my relative, this was hard because it was a double sided gift. I had time to reminisce, but it was never enough, there are always things you want to ask which you never had time to do, there are always things you want to share- first flowers of spring, a birthday or a joke which you never will again. We will never know what our loved one thinks of our life choices once they are gone, they will never see our children age and their successes or failures, they will no longer comment on clothing choices we make or despair at how we drive!
We will however go on with life, as they say ‘life happens despite us’, we will learn to live truly independently of our loved one, we may make decisions on what we think they may prefer but we will never know in this life, and will never know if they were still here, whether they would have changed their minds and learned to love our idiosyncrasies.
Life will never be the same again