by Peter Topolewski
Biohackers pour in effort to extend it, the ultrarich pour in money to make it eternal. Life, that is. But death does not discriminate. It takes us all.
We know this, and yet a death rarely fails to shake us out of our routines.
Death likes to creep up at inopportune times. While people are skipping rope or cutting a rug on the dancefloor. Riding a scooter without a helmet or chopping down a tree. Number crunchers can narrow the likelihood of death’s arrival by parsing the demographics: income, gender, whether we brought a gun into the house and where that house is located. Avoiding such places and activities doesn’t change the outcome. Death finds you, somehow to your surprise.
Tornadoes, earthquakes, high rise fires, war—death works in bulk at these events. We know this. Yet we so often tsk tsk the final body count.
Murderers—the solo and the state variety—try to put death in their service, but that only lasts so long, and it never wins them a free pass. Death comes for them, too.
We don’t like to think about death, the yarn goes. That’s why it catches us off guard. Maybe. But we’re also getting used to the idea that it operates way out there, in the foggy future. Because while death still operates in the freak accident genre, among others, in much of the world its work has gotten increasingly predictable. It sidesteps the young and thrives among the elderly.
Improved nutrition, basic hygiene, proliferating lawfulness, and widening food supplies—banal hallmarks of civilization—have all helped push lifespans higher. They’re about 80 in the U.S., 80-plus in Canada, China, Japan, Australia, and throughout Europe. Globally, they average 73 years.
If death doesn’t nab you when you’re spry, and chances are decreasing it will, it awaits at the end of your shuffle through dotage. The Baby Boomers and Gen Xers discover they can keep dancing to songs of their twenties and replaying the movies that set their imaginations on fire. Time to get a tattoo and a new hobby, buy that dream hot-rod and take that trip to their cultural Mecca, wherever in the world that might be. They’ve evaded death this long, and aging too, that it feels—oddly, irrationally—that it can come for everyone else, but not me.
It’s coming, as sure as Christmas. But first it’s old age.
Desires for money and sex and drugs and all the other good stuff you couldn’t imagine living without—they wane. Preferences become must-haves, ignorance calcifies. Mobility decreases, fragility increases. Tastes narrow. Hearing fades, eyesight darkens. Muscles dissolve, joints creak, bowels loosen. But death is for someone else, you insist, even as you can recall all the things you used to be capable of and list the new things in life you hate: the loss of your independence and even your control.
It’s unevenly distributed, but more often than not the elderly get a semblance of the care they need. In hospitals and care facilities. At home. It’s a big job providing so much help to them. In the U.S., there are more than 65 million people over the age of 65. The U.S. Bureau of Labor Statistics reported that in 2021, 37 million people provided unpaid elder care. That’s generally at-home care for friends, siblings, partners, aunts and uncles, and most often for one or more parents. That unpaid work usually falls to daughters but also sons and in-laws.
It is not easy. It is stressful and unappreciated. It is never enough. It is a mountain of prescriptions, cooking meals that don’t get eaten. It is the Groundhog Day trips to labs for tests and doctors’ offices for appointments. Guilt for falls you did not prevent and the colds you did not keep at bay. It is bathing and clothing, bathroom and diaper duty and the rest of the personal hygiene regimen (hello toenails). It is lonely and overwhelming and it is full-time. It costs you time with your own kids and spouse and friends. It is time subtracted from your life.
Sound familiar? Caring for an elderly mom or dad is like raising a child. Twins even. It is, for many, being a parent to your own parent.
It has its rewards, and they can be priceless.
But unlike kids, the helplessness that aging adults grow into is not cute. It’s messy and tiring. And the chores associated with it do not hold out the promise of progress and personal or spiritual or professional blossoming and maturity. It promises dissolution.
If your parent was an asshole or hateful or generally unpleasant in their prime, chances are they will be an asshole or hateful or unpleasant in old age. Caring for them will be hell. If they were a joy, you will cherish moments of chit-chat and of silence and of reminiscing. But you will catch hold of those in a slow storm of mourning as your parent shuffles away from who they were, from who you knew, to unbecoming that person. A person who is weak and needy and no longer the rock you can lean on.
Maybe your mom or dad made a plan somewhere along the way to one day move into a facility. Maybe you can’t look after them anymore, maybe there was never a chance you’d spend a single night caring for their needs. So, you take them to the elder care facility and you drive away. Even if you don’t say it, you know what the end looks like for them.
Elder care has turned into big business, and in big business there are snakes of every stripe. And there is, as under our own roofs, elder abuse in these places. But far outnumbering the abusers are the heroes. Doing all you would do for your mom or dad, but for strangers. Nursing home employees in the U.S. earned about $18 an hour in 2022. For home healthcare aides, the number was less than $15. In 2023, 1.4 million people in America worked in nursing homes. So let’s be straight about it. Dreadfully underpaid folks, many of them immigrants, each day show compassion and bring comfort to the aged, whether they are sweet, mute, in pain, miserable, or awful. They care for, and often come to care about, fragile old people.
This never-ending body of work is a massive and ongoing display of patience and warmth. It shows regular people are still doing not just something, but many things, right in this world.
#####
There’s a bit of wiggle room on the timing, but when it comes to whether it happens or not your death is as non-negotiable as your birth. We’re innocent bystanders in our birth. Dying, however, we can prepare for. How do you get ready for the end? By living well, could be the facile answer. But how do you prep for your actual final breath, especially if it comes after a meander through your golden and not-so-golden years? We’re admonished by bankers and insurers and wealth managers to prepare financially. Tech writers tell us we now have digital legacies to see to, online accounts to deal with. Some people write their own eulogies.
Many people who find themselves providing in-home care say their parents didn’t have a plan for living on and on with diminished capabilities. And their families didn’t have a plan for their parents. The kids, like the parents, never wanted to think about it, even though the day was coming as sure as rain. Unless instigated by a major event like a stroke or a bad fall, parent care usually doesn’t arrive like a tsunami. It’s more like a drip here and a drop there, until the parent’s needs are a flood.
When many adult children who care for their parents have a second to catch their breathes, they fear, of course, the day their parent dies. But there’s another common sentiment, shared by all those who see their parents steadily slowing down and losing their faculties, no matter where they are. These caregivers don’t fear for their own deaths so much as becoming, like their parents, an adult child to their own children. A helpless old person who needs a stranger to feed them. It’s this fear of lingering and of being a burden that partly explains the appeal of another kind of plan.
Assisted suicide, or medical assistance in dying (MAID) as it’s called in Canada, is one route that sound adults can take to avoid such a future. It is a way to take control over who you are when you die because you can say when life ends. Not alone, not without dignity, not relying on others to care for you.
Many families consider opting for assisted suicide the selfish choice and an affront to God. Perhaps they don’t think about the often unspoken sacrifices expected of them from a parent who chooses more life, life diminished but life that goes on and on. In other circles, choosing suicide is the single greatest act of independence a person can wield.
It can also be a blessing.
#####
There are many points along the path of life where that option is closed to you. One is when dementia sets in, if you should be so unlucky. “Dementia,” Lee-Ann Olwage writes in National Geographic, “is the catch-all term for a range of slow-burning brain diseases that have similar symptoms: the incremental fading of a person’s memories and their ability to think and reason; changes in personality or behavior; and sometimes a loss of language or analytical skills.”
The onset of dementia in a loved one can be like losing them twice. Bodily death is ahead, but in increments before your eyes your mom or dad or friend or spouse disappears. Memories come and go, and often even when memory remains your mom or dad can’t share it because language betrays them. They lose track of the day, where they are, who you are. Rightfully, they at times become scared and angry, demanding answers and safety. We can never know what another person is thinking, but when a person with dementia loses their grip on the things we can agree on—our names, our location, the date, our shared times together—they become distant. Dementia progresses, a weird word for something getting worse, and they become a person you don’t know. A stranger.
We can’t always presume the worst. Even when a mom or dad with dementia is confused, contentment can be a part of their life. They might get stuck in a loop of a conversation that happened five minutes ago, and be fine with that. They could wake up excited to go on their first date, oblivious to the decades of marriage and career and kids they’ve lived through. In both cases and in all streams between, they might be living their best life.
For the forgotten, this is painful. It’s painful to watch and to imagine what life is like inside your mom’s or your dad’s head. It’s painful to have so many of your ties to your parent severed. Is your mom gone, her deteriorating mind breaking apart her consciousness and her soul, too? Or is the physical breakdown of her brain rather crippling her soul, inhibiting it, not allowing that soul to get out and express itself? Do her bursts of memory and lucidity prove that her brain does not host her soul or does it show how poorly we understand our brain’s functions, how it holds memories, how it formulates time and an I that persists, for most of our lives, through time. Until I don’t.
Then what?
#####
How interesting that it is has been the job of the village—the school, the sports team, the house of worship, the politicians, and (God help us) more recently, the Internet—to support parents as they attempt to raise their children with a fundamentally good sense of moral agency. Parents take the lead, but it’s all of us together that guide children from unknowing and innocence to knowing and responsibility. There’s no line they step over when they’re ready, it’s never clear when exactly it happens, but we send them out on a foundation from which they can encounter the world and judge on their own right from wrong. We hope from that foundation they can make decisions and take actions, and remain open-minded enough to forever learn. To recognize those who need help or leadership or an example.
What could be a more noble cause?
Your parents and your village, let us hope, raised you with a strong current of decency running through your moral agency. If they did, there’s a chance you will find yourself one day minding your mom or dad or partner or spouse, now caught in a helplessness of dementia that obviates their responsibility. Indeed, it leaves them a moral patient, a person who deserves assistance and protection.
More often than not we collectively show we are capable of what is right. We take care of our old. At times we— individually and as a state—care for them as poorly or worse than our young. We can’t not demand better of ourselves and each other, of the villages we’ve made. But we can still see what we’re doing now—the care we provide—as goodness, as a sign of… what?
Of living well. Right to the end.
***
Enjoying the content on 3QD? Help keep us going by donating now.