Multiple Diseases of the Elderly

The cremation place called me this morning…maybe it’s a cremation facility…I’m not sure. Anyway, they called early this morning to let me know that they have my mom and they’re taking care of her. That seems strange because she’s dead so how much are they really taking care of her? I understand that they were telling me that her body is being handled respectfully. I do appreciate that. They also wanted to ask me if I wanted the cause of death on all the death certificates or just some, what about half and half? Of course, I ordered 7 so there you go. We’re getting 4 of one and 3 of the other. I’m not sure which way so it’ll be a surprise. 

Since I had them on the phone…and a side note here, these cremation people are really lovely. They speak softly and calmly…slowly. They are as relaxed as possible, I’m sure because they are dealing with some unstable people…like me. So, since I was talking to them, I asked what my mom’s cause of death was, because no one told me, and I didn’t think to ask. She said, “Multiple diseases of the elderly.” Multiple diseases of the elderly…what the fuck does that mean? I thought they’d say natural causes because being almost 92 is a natural cause of death. Multiple diseases of the elderly make it sound like no one really knows…she was old…elderly…so check the box that covers the most options. Like a big “I’m elderly” blanket. 

I do not agree with their cause of death. My mom did have heart failure and A-Fib. She had a damaged valve in her heart because of rheumatic fever as a child. She had Parkinson’s disease that was progressing. She had a harder time moving her legs to walk and she became so unstable that she had to use a wheelchair. Her hands were shaking worse, and eating was more difficult. She had a hard time keeping food on a spoon or a fork. I know that really frustrated her. I can only imagine. I don’t think any of those multiple diseases were the cause of her death. 

Multiple diseases of the elderly were not the cause of my mother’s death. Not eating, not drinking, and sleeping were her causes of death. Maybe loneliness because she really missed my dad. Maybe that was the heart failure…failing from sadness. The real cause of death was that she wanted to die. So, the official cause of death was a “strong will.”

Now I feel confident in saying that “strong will” is not a choice on a death certificate. That’s too bad because I think it’s one of the most common causes of death for the elderly…strong will. I think that was the same cause of death for my dad. He was ready. She was ready. My mom told me that she wanted to die, and then she’d add, “Not because of you.” I did appreciate the clarification. 

My mom felt like she had lost control over her life and that all her decisions were made for her. That really made her angry. I told her that there were 3 things she controlled: what she ate, what she drank, and whether she took medicine. She controlled those things, and no one was going to make her do anything she didn’t want to. Then I talked to the staff to make sure I wasn’t lying. It was difficult for the nurses and aides who really cared for her to let her go. They wanted to convince her to eat, just a little, or take a sip of water…but they stopped. They honored her wishes, and in that way honored her. 

I do believe my mom willed herself to die. She definitely had a strong enough will to make it happen. She shut everything down and died. Strong will is not a disease but is certainly a cause of death. What are the multiple diseases of the elderly? At first, I was thinking of the obvious…heart failure, cancer, kidney, heart, lung, or liver disease, an aneurism, dementia, a stroke, and the list could certainly go on and on. My Aunt died of COPD, my dads’ parents died young of heart problems, my mom’s mom lived until 96…96 and ½. She’s got the record for sure. Her great grandchildren called her the “energizer bunny” and said that she kept going and going. 

But what are really the multiple diseases of the elderly? A “disease” is defined as an “illness or sickness characterized by specific signs or symptoms.” Seems obvious. But what about the “dis-eases” of the elderly? “Dis” is a Latin prefix meaning, “apart, asunder, or away.” The slang “dis” means “to treat with disrespect or contempt.” “Ease” is the “absence of difficulty or effort, making something less severe, or moving carefully.” Another definition is “to free something that pains, disquiets, or burdens.” 

So…apart, away, disrespect, absence of effort, less severe, free what pains or burdens us….Hmmm. Perhaps the real dis-ease for the elderly in our society is being put away or apart, not being respected as a useful member of society or a family. Maybe it’s that we want to be free from the extra burden of caring for someone in their last years. I guess it’s not that surprising since we do glorify youth in the United States. No one wants gray hair or wrinkles, so people have cosmetic changes made to themselves in hopes of looking forever young. We treat aging as a curse, instead of a natural part of life. I’ve told my wife that I like the lines on her face because I see them as laugh lines, and how could lines from happiness be a bad thing? 

When we moved to Florida with my parents, I had a plan. The plan was that my parents would live with us until their deaths. That way they’d never need a nursing home because we would take care of them for the rest of their lives. Oh, the best laid plans of mice and men…and women. For whatever reason, my mom became adamant that she wanted to be in a nursing home. She wanted to be away from me and away from my dad. She’d tell me that I didn’t want her there and neither did my dad, although that was untrue. 

We both tried to make her happy, but we couldn’t. When her aggressive behavior was too much for me to handle and keep my dad safe, I agreed to find her a nursing home. Getting her into a nursing home was a giant cluster fuck, as I have written about in other blog posts. Once she was in the nursing home she didn’t want to be there. She didn’t want to be at home with my dad and I either…I don’t know exactly what she wanted. I think that maybe she didn’t know either. That was sad.

I know that the elderly are frequently overlooked in our country. Unlike other cultures, we don’t look to our elders for their wisdom and insights about life. We don’t ask about what life has been like for them. We don’t ask about the things they’ve learned or the experiences they’ve had. My dad could tell you about every place he ate when he was traveling. When we were driving from St. Louis to Florida it was a narration of all the places he drove and where he ate the best something. I told my wife I want to start looking for places to eat when we’re driving cross country…usually I just want to grab something and get right back in the car…but I could change, and it might be fun.

I think the multiple dis-eases of the elderly are loss, sadness, lack of control, and nothing to look forward to. The dis-ease is in watching everyone you love die. You may want to live a long life but along with that comes the loss of many people in your life. My mom said all the time that all of her friends were dead. Then she lost my dad. It’s hard to go from independence to complete dependence. My mom would tell people that I made her sell her car and that she could still drive fine. What she didn’t say was that one whole side of the car was scratched because she hit the side of the garage regularly pulling in. And she was completely blind in one eye. So, she could drive but it was dangerous for her, anyone on the road, and the garage. I understand selling the car represented a huge loss of independence for her.

It’s difficult to move somewhere knowing that you won’t move again. My wife and I talk about Florida as our last move, and we hope to stay where we are. But I’m 63 not 91. I know there’s still life ahead of me and many things I want to do. In a nursing home people only leave when they die. She felt like she was waiting to die. I would try and focus on everything she still had, a big family with grandchildren and great grandchildren, and the fact that she was very loved. I think my mom was sad and felt like I put her away, even though she’s the one who put herself away. It was hard to see her sad and angry.

We have a rapidly growing population of people over 65 in this country…I’m not, but that’s what I hear. We don’t have good answers about caring for an aging population. If you have the money, you can find a beautiful resort style place for independent or assisted living, with increasing levels of care as you need it. If you are not independently wealthy, it’s not as easy. The multiple diseases of the elderly are sadness, isolation, loneliness, loss. Those are the dis-ease’s of the elderly. Those are the causes of death in our elderly. 

I don’t know how to solve the problem except with awareness. We tried to give my mom and dad a full and happy life in Florida, some days were more successful than others. I’m not sure I was always as aware or attentive to my mom’s emotional needs as I could have been. I do know I was doing my best. The only way to discover what needs to be done is to lead with love. If I am leading with love, then I am seeing issues and people through a lens of love. When we love people what are we willing to do for them? If we love our neighbor as ourselves then what actions are we willing to take? Could we befriend a lonely neighbor or just say “hi” to someone? My mom used to love to sit on the patio and watch people walk their dogs. She was thrilled when someone stopped and talked to her. That’s all it took. Less than 5 minutes. Certainly, we all have 5 minutes to give. 

Let’s be real…Everyone wants to matter…to be seen…to be cared about. None of that changes just because you’re 70, 80, or 91. We never reach a place of not needing. We thrive in connection with others…in relationships. We are interdependent beings. We all need love, and we all have a tremendous capacity to love. Sometimes we hoard our love or reserve it for special people in our lives. But love is one of those things that the more you give it away, the more you have to give. 

So, let’s lead with love. If we use love as our guiding force, we will find the people and places that need our love the most. Let’s find them and let’s give all the love we can. We can meet people’s needs to matter and be seen by taking our focus off of ourselves and turning it towards others. We can find ways to be loving all day every day. Let’s do that. Because in the end all that matters is how we love people. Let’s love freely and generously. Our actions can ensure that love wins. Love must always win. 

Floating and Falling

The Grammy Awards were last Sunday. I love Billie Eilish and that night she won “Song of the Year” for, “What Was I Made For?” If you haven’t heard it, you should change that…now. It’s an amazing song…in my opinion. She wrote it for the movie “Barbie” which I have not seen yet. Anyway, the beginning of the song says, “I used to float, now I just fall down. I used to know, but I’m not sure now….” As I’ve gotten older there are so many more things, I’m not sure of. Everything was so clear when I was in my 20’s…so simple…so black and white…so rigid.

When I was younger, I was an athlete. I played basketball, softball, and I swam…all competitively. I was coordinated. I could stumble and catch myself easily before I’d ever fall. I could run forward and backward…I thank basketball for that. When I went to college, the basketball coach was interested in me for the team. It was a very small school but still that was a dream come true. I ended up having knee surgery instead of trying out for the team (thank you field hockey…I should have never trusted a sport that makes you wear a skirt) and that was a big loss for me. Being an athlete was a huge part of my identity then. I think it was my identify. Everything in my life was connected to sports, all my friends played, and we spent our time together on and off the court. I had a basketball with me all the time and got really good at spinning it on my finger…I could even switch fingers and hands (my grandkids used to think that was very cool when they were little).

I wrote about my accidental fall, surgery, and ongoing recovery a couple weeks ago. I wasn’t really planning on writing anymore about it because it was done. Right? Then I was walking my dog and I tripped on my crutch and that whole accident came crashing down on me. I was back on the beach as if it was happening again right then. I saw myself fall. I heard and felt the crunch and snap of my arm breaking. My heart started racing and I felt the warmth of tears welling up in my eyes. I felt overwhelming fear and sadness, even though I was fine in that moment. I did not fall. I did not even come close to falling. I just tripped. I was so afraid.

I used to float…I’m not sure I ever floated but I didn’t fall. I wasn’t clumsy. I was coordinated. Now I just fall down, randomly and for no reason or that’s how it feels to me. And worst of all, I don’t know how to stop it. Missteps that I could have easily corrected in the past, knock me to the ground now. And I am afraid. Afraid to live in my body. Afraid to feel in my body. Afraid to fall in my body. How can I mentally feel like I’m 40 and physically move like I’m 90? That’s fucked up. I feel like everyone treats me like I’m fragile and about to break. But I’m not…okay I did break but I’ve been put back together with metal and cadaver bones. Just missing duct tape.

“I don’t know how to feel but I wanna try.” Feelings are hard for me. As a child, I was encouraged not to have them. Feelings are messy. No one wanted to know how I felt. How do I know this? No one ever asked. No one cared how I felt. If I was angry, I got in trouble, even though anger seemed like the go to emotion for my parents. And if I was sad or cried, I was teased or taunted. I felt humiliated. I decided emotions were way too much trouble for me.

Let me be real… I don’t know how to feel because I’m having difficulty being in my body right now. I was learning to be present in my body and feel my feelings and then I fell…my catastrophic fall. I feel fragile and I am not a fragile person…so that pisses me off…which I’m sure is helpful. I am not fragile. I’m fucking Superwoman. I deal with, manage, and take care of tons of shit every day. I am not fragile. Fragile feels bad to me, weak. I am not weak. I can’t be weak.

I don’t know how to feel…that’s true two ways. The “I don’t know” as in I don’t recognize the feeling, and/or the “I don’t know” as in I can’t decide, too many choices. I’m with number 2. I can identify feelings, I’m better at it with other people’s feelings but I can get to mine…it may take a minute. I have a master’s degree in counseling…I know lots of feelings…a grade 18th’s worth. But it’s not so much that I don’t know how to feel as I don’t how I can manage all these feelings. I have a fucking tsunami of feelings.

You see, it turns out I have all the feelings. So many feelings. I have spent years learning to feel my feelings…years. And convincing myself to stay present in my body, even when my body hurts. To stay with the physical pain and any feelings that arise from it. I feel afraid of all the feelings inside me. Afraid of being devoured by them. I’m afraid and sad. I feel diminished by falling. I became a fragile and weak person in other people’s eyes, and they question my capabilities…and their doubts eat away at me…and so do mine.

Now let’s be real…I might have some PTSD, just a tiny bit. I’m afraid. I’m afraid of being me and living in this body. I feel fragile and vulnerable in a predatory way…like my body is out to get me. I don’t know how to be in my body right now, it feels complicated. I’m afraid of my body, as if it’s separate from me, and can damage me on its own. I feel breakable in a new way since I fell. And it’s not so helpful that my mom tells me I need to stop falling because I’ll end up in “bad shape,” basically dead is what she means. If it was as simple as deciding not to fall, then it would never happen again. It’s not that simple. I’m careful and I fell. I’m careful and I’m afraid. 

It feels strange to say that I am scared of myself. Makes me feel a little bit like I have multiple personalities and I’m afraid of one of them…the one making me fall. I don’t know exactly what to do. I can pretend that there was no impact on me from the fall but the the slightest misstep or stumble and my insides collapse. Physically being put back together didn’t fix my fears. My bones have healed but not my heart.

 Let’s be real…I can’t outrun my feelings. I actually can’t outrun anyone, except maybe my English Bulldog. And neither of us believe in running. What’s the worst thing that can happen if I stay with my feelings? Allow myself to sit with my fear and sadness? I suppose I’ll feel way more than I want to but what else? What’s the worse thing that can happen if I feel…feel it all? And what’s the best thing that could happen if I allow myself to feel that whole tsunami of feelings? They are messy and I am messy, but would I learn to believe? Believe in myself. Believe in my ability to handle anything that comes up for me. Believe I can feel a tsunami and survive. Believe I am bigger and stronger and smarter than my fear. Believe in myself and my potential just like I promised myself I would. Perhaps practice what I preached just a month ago…there’s a whole lot of believing that’s ready to go on here…and all I have to do is stay, relax, and feel. So simple and so scary. Until you do it…until I do it.

Post traumatic stress disorder is a big topic so next week I’ll talk more about PTSD and the fear and sadness that can accompany it. In the meantime, I’m gonna practice what I preach and I’m going to love. I’m going to love myself and the people around me. I’m going to practice a loving attitude toward the world. Love will keep me a glass half full kind of person. It’s all in my perspective…so I’m keeping mine focused on love, because in the end all that matters is how we love people…including ourselves.