Nana turns 90 this December. She's lived alone in the same house my dad was raised in since her husband died over fifteen years ago. She prides herself on her independence; not only is she able to drive and take care of herself, she's still what she calls a "productive member of society," baking cookies and coffee cake for her friends and neighbors (and granddaughter), stuffing envelopes for her church.
This week she visited a friend of hers in Kentucky, "Sally," who now resides in one of those "assisted living" places. Here's Sally's typical day, according to Nana: in the morning she gets up and dressed, eats breakfast, plays cards, and returns to her room to freshen up; in the afternoon she has lunch, rests for a bit in the room, and then has cocktails (Sally likes cosmopolitans); finally she eats dinner, plays cards, then returns to the room to go to sleep. By "room" I mean something resembling an apartment, complete with a tiny kitchen, living room area, and separate bedroom. Nana says that someone comes in to clean and change the sheets: there's nothing left for Sally to do.
My grandmother could not live in one of these places. She tells me, "Don't let me go there - I'd die of a broken heart!"
We read an article in class about "slow medicine," the idea that instead of providing elderly (those 80 and older) with drastic, expensive, and invasive treatment, doctors and their patients should have a conversation much earlier about what kinds of life-saving action, if any, they want taken. The article compares quantity of life to quality of life but also makes the point that tests and life-saving measures in older patients often make things worse. I recently heard this referred to as extending death, rather than prolonging life.
Anyway, I love visiting her on Sundays. When my brothers and I were little, we spent the whole weekend there. Saturday evenings, we'd get our hair washed in the sink, we'd watch Lawrence Welk in the family room, and we'd sleep between our grandparents in their pushed-together full beds. Sunday mornings, we'd all go to their church (where I'd try to count past one-thousand without having to start over) and then our parents would come and we'd all eat brunch. I can't imagine visiting her for hours on Sundays at a nursing home. When she was in the hospital and then recovering at a nursing home, she was so feeble and depressed. She couldn't do anything for herself or for others, feeling at best useless and at worse a burden.
I have no insight or grand conclusions. This stuff is complicated and uncomfortable. But I told her that I wouldn't let her go into one of those homes if she doesn't want to go. Hopefully we never reach the point where that seems like the only option.
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Edited to change "quantify" to "quantity." It's never too late to proofread!
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