Saturday, August 5, 2006

 

My review of What Are Old People For?

    William H. Thomas, M.D., author, describes himself as delighted with the practical, yet this is not a book in which to find practical application. It is a book of whys and wherefores. I found this frustrating at first. Once I realized, though, that he addresses the hows in other books I understood the importance of this one.
    Dr. Thomas argues that industrialized society's fear and loathing of old age are both the cause and the result of our marginalization of old age. He proposes that we have become overrun by the "Cult of Adulthood", which:    I, frankly, like his postulation of the Cult of Adulthood. It explains a lot to me about the fringe character of my own adult life. It offers some well-fitting reasons for why our society is transforming childhood into a mini-adulthood and prefers the institutionalization of elderhood away from both children and adults. It explains well why this institutionalization of elderhood is run the way it currently is by adults, is considered to be well run and why we fear elderhood.
    Dr. Thomas also takes a middling stab at documenting and imagining prehistoric and historic elderhood and comes away with some provocative insights about why Nature favored the evolution of old age in humans. He recognizes that much of what we believe about traditional elderhood may be a construct of both nostalgia and myth but argues persuasively that both of these types of thinking must be founded in truth, a truth which argues that elderhood isn't simply to be indulged and/or appreciated for it's own sake but is a force for the development of a healthy childhood and a productive, sane adulthood, acting like weights balancing a scale. He believes that our marginalization of both childhood and elderhood have dire consequences for humanity's and our environment's survival and are at the root of our current frantic human malaise. Essentially, he says, by stripping childhood and elderhood of their natural power, the Cult of Adulthood has not only become all powerful, it has become dangerously powerful.
    Dr. Thomas proposes that we must reinvent elderhood (and childhood, too, by the way), using what we know historically, what we imagine nostalgically and what we observe with newly opened eyes, of those characteristics of elderhood that we don't notice through our cultish eyes but which struggle to be recognized even as elders are discouraged, incarcerated and drugged out of expressing these natural characteristics.
    Although there is much, much more theory than practicality in this book, I don't consider Dr. Thomas' vision overly romantic. I found his ideal descriptions of elderhood helpful and culled some workable practicalities from them on how to more involve my mother in our life together, including:    I was surprised and pleased to discover that I'm doing a lot "right", at least according to this book. I was equally pleased to discover that my niggling analyses of my mother's experiences with Medicine, Institutionalized Care and Professional Home Care are in agreement with his and that my struggles to keep her as far away from all of these as possible are probably some of the best things I've done for her.
    While I was still reading the book, one of my frequent site visitors expressed interest in what Dr. Thomas might have to say about dementia. Not much, I'm afraid. He does nod toward reinterpreting it as "the power of forgetting", an alternate understanding of and living with Time, etc. He encourages people to reexamine dementia as full of possibility rather than tragedy, but his encouragement lacks specificity or practical suggestion.
    In his attempt to reframe our take on elderhood, his attitude is that it's silly to buck our society's and culture's inability to keep elders in our communities through family care. His primary focus is on the development of intentional, respectful elder care communities that include the residential elders in the initiation, evolution and maintenance of these communities in often surprising ways. His hope is that these communities (some of which are already in existence) can be nudged into the embrace of the larger, highly mobile, adult-led nuclear family community within which the elder communities exist. When he talks about this possibility, he is full of specifics and detailed in his criticism of current nursing home administration. This is the part of the book, in fact, that I found most inspirational in regard to changing a few things that I'm doing with my mother. I should note here that, although I'm confused about whether he is one of the originators of The Eden Alternative and The Green House Project, he has taken on both as primary causes and lends mighty support to their development.
    He also has a fair amount to say about ideal vocational caregiving, based on his scathing appraisal of how institutional caregiving strangles the best intentions of motivated caregivers. He envisions a new type of caregiver, a "Midwife of Elderhood", whom he christens "shahbaz" within the context of a new story he tells about what caregiving is all about. New name or not, despite lack of practical detail of what this midwife does, his vision is not only enchanting but I found it mentally exhilarating. The only aspect of the shahbaz movement that bothers me is that he lists and congratulates, in his Acknowledgments, 37 "first shahbazim": 33 have obvious female names, 2 have obvious male names and 2 have names which are common to both males and females. I guess this is to be expected. After all, we aren't "there" yet.
    This focus on the development of the above mentioned communities is so acute that there is little overt information which would be of use to people like me, who are living with Ancient Ones at home. I've been considering, over the last week or so while I've been reading this book, that what I'm doing is obsolete from the point of view of society (at least the culture within which it is assumed I live). He argues, here and there, that attempting to resurrect what I am doing on a society wide scale is akin to beating a dead horse. I understand what he's talking about. At times I agree with him. It's hard for me to accept, though, that the restructuring of societal thought implied in the development of his ideal elder communities couldn't also accommodate the possibility of bringing our elders into our homes and families felicitously, if that is an individual family's wish, without the adult members of this community having to risk everything, including livelihood, physical health and sanity.
    Still, I'm glad I read the book. It explained some things in concepts that make sense to me. In roundabout ways, I got some ideas from it for improving the level of care to which I treat my mother. I feel a little more optimistic about the possibility of industrialized society one day fully embracing elderhood for what it is, rather than marginalizing it for what it isn't. I'm pleased that his visions for communities with an emphasis on bringing out the value of elderhood and respecting all of elderhood seem to be making inroads in our society, despite heavy opposition. This book reminds me of another inspirational, lightly factual book I read in the late 60's, Education and Ecstasy, by George Leonard. I remember, while reading that book, among others, including one Dr. Thomas cites in his notes, Summerhill by A.S. Neill, how sure I was that education would never be the same again and couldn't possibly get worse. I was wrong. We all were. I hope, forty years from now, someone isn't noting the same about Dr. Thomas' vision.
    Oh, yeah. "What", exactly, "are old people for?" Before I read this book I'd considered this through a differently framed question: Why grow old and why nurture, to the best of our ability, those who grow old, regardless of what this may mean? My answer: Because we can. After reading this book, I think Dr. Thomas would agree with me.

 

About an hour ago I awoke from a dream...

...yes, I awoke very late, for me, again, but, in my defense, I didn't go to bed until around 0300. As well, the last time I looked at the clock while I was trying to get to sleep (no, I hadn't had caffeine since morning and I wasn't troubled...I just couldn't stop writing the initial draft of the book review in my head) was 0424. From then on I refused to look at the clock.
    Anyway, those of you who know a little about music and/or have ever played the guitar will find aspects of this dream amusing. The person to whom I wrote an e very early this morning may find this dream intriguing, since it contains an element which may have been triggered by my unconscious continuing to write that e (which was finished and sent, in reality).
    The dream took place on Guam outside of our family's home in Oceanview on Karen Drive. I think the significance of the location is that this is where I taught myself to play guitar in real life.
    In the dream I was sitting outside on the back stoop (where I often sat when I practiced guitar) writing a song as I strummed, lyrics and music sort of simultaneously. It was a minor struggle, but not a big deal. My problem was that I was trying to isolate which chord I should play as the second chord in the song.
    A woman approached me. She'd been walking down the street in front of our house and had heard me. She mildly informed me that the song wasn't original, it was written and recorded by her father, whose name didn't come up in the dream but both the song and the artist exist in real life although I don't think the artist has a daughter, or any children, although I'm not sure of this. I'll reveal the artist's name and the song in a minute.
    Anyway, in the dream, this didn't bother me. What then became important was figuring out the chord sequence. The chord that had me stumped was the second accompanying chord in the first line of the verses. The woman, daughter of the musician, wasn't musically oriented but she, literally, leant me her ear while I worked at discovering the missing chord. I finally decided, with her approval, that the chord I was looking for was "S1". I couldn't remember how to finger this chord, though. The woman produced a book with chord fingerings and, as I awoke out of the dream, we'd located "S1" in the book's index and were about to turn to the page with the appropriate fingering chart.
    If you know anything about music, you know that there is no "S1" chord, because there is no note labeled "S" and "1" would be the pure major chord, which doesn't take a numbered designation.
    The artist? Randy Travis. The song? "Forever and Ever, Amen".

 

My better intentions of finishing the book review...

...and getting back to everyone who has commented on my posts and written me over the past days and catching up with all your journals have, yet again, drowned in my mother's birthday celebrations and hangover, and a personal suggestion to which I felt an urgent need to respond. Just want everyone to know, I'm still headed in the direction of catching up. I'm sure I will. I just need to stop trying to predict when that will happen.
    Thank you, each of you, for continuing to comment and write. I will get back to each of you and catch up on reading where each of you is at. I consider it a sacred duty. I'm just having a little trouble stretching time, lately, to encompass everything. It seems that my mother has urgently needed me to keep to the straight and narrow time zone, lately. So, forgive this blanket response, know that personal responses will follow, as will personal catching up, and the book review (I'll address that first).
    With profound apologies and gratitude...
    ...in the immortal words of Arnold Schwarzenegger, "I'll be back"...
    ...later.

Friday, August 4, 2006

 

Dark moments of the soul, I guess.

    The evening went so well that just a few minutes ago, before Mom retired (her light is still on, though...she was fairly jazzed, even when she went to bed; my guess is that it'll be on for another half hour or so) she said, "So. What're we gonna do tomorrow?"
    "Good question, Mom. What do you want to do? Should we do some window shopping and hit one of those courtyard restaurants for lunch?"
    "Hmmm...well, we'll see."
    "Do you have any suggestions?"
    "Let me think about it. I'll tell you in the morning."
    Tomorrow, though, promises rain. Every day, lately, has promised rain but it hasn't occurred. Tomorrow, though, it looks likely, especially since the clouds are hanging low tonight and it's significantly warmer than it has been the last few nights. If the weather is heavy, even if we, in this specific area, don't get rain, I doubt that she'll want to go out.

    Anyway, although the restaurant was loud for the first half hour after we arrived, which bothered Mom because it confuses her tired ears, although it was crowded, although it was difficult for her to get to our booth because the only one left was next to a large family partying up two birthdays and their chairs sprawled into the already narrow aisle, although for the first 15 minutes Mom was a little miffed and mentioned that "this wasn't the way [she] remembered it," once we were settled she was in her element.
    In the booth next to us was a sweet, small girl who stood on the seat, next to her mother, facing us, and chatted us up: Marley, two, "soon" to be three, showing off her bracelet, talking about food, waving her unusually long fingers because I'd commented that she had "beautiful hands", offering us an unintelligible song she'd recently learned. Once their food arrived and her mother turned her to eating, my mother noticed that the party next to us had turned a dour shade of drunk, which delighted her, as this made for an excellent guess-gossip topic.
    It took her awhile to decide what she wanted. She chose a full rack of ribs, even though the waitress and I suggested the half rack. I'll be damned if she didn't put away every last bit of food, including the beans, the fries, the cole slaw and her root beer. When we'd finished eating and the restaurant had emptied and quieted, I indulged her love of "just sitting", looking around, observing people, commenting on the activity and environment, it was a pleasant evening. Except...
    ...weirdest thing. I was about halfway through my "Mexican Fiesta Salad", which wasn't Mexican and certainly not festive but it was the only hefty dinner salad that looked like it would go well with a chopped chicken breast and included a variety of vegetables (I'm not a fan of Applebee's food). Mom decided she needed several more wet wipes, since she was using them as napkins instead of using the pile of napkins she'd been provided and saving her two wet wipes until after dinner. I signaled the waitress, who arrived within seconds, asking, "What can I do for you ladies?"
    I looked up at her and without warning my eyes welled with tears, trust me, they were not tears of joy, which immediately gushed down my cheeks. The waitress stepped back and stared at me. I shrugged my shoulders, held up my index finger in a silent request that she wait for a second while I controlled my out-of-order self, brushed away those tears that hadn't dripped off my face, smiled crookedly to show her that I was as surprised by my behavior as she, then choked out my mother's request. Both the waitress and I looked furtively at my mother. She was lost in her ribs and didn't notice, thank the gods. The waitress returned with several wet wipes and held them above the table, waiting for me to take them from her hand. I felt a piece of paper beneath, on which she had written, "Is there anything I can do to help?"
    A laugh warped by yet another surge of tears erupted from my throat. I nodded my head, grabbed a pen from my purse and scribbled on the other side of the paper, "Yes. You can trade lives with me tonight and take care of my mother while I cover your shift."
    She read it, looked at me and the two of us burst out laughing. She offered me a high five, which I enthusiastically returned, grasped my shoulder, leaned into me and said, "I gotcha covered, girl."
    My mother noticed the merriment, of course. She sat, holding a half scoured rib above her plate, staring at me as the waitress moved to her next table. "What was that about?" she asked.
    "Oh, nothing. Inside joke," I said.
    "Really! Have you been a waitress? I have, too," she said, coaxing me to explain the incident to her.
    "No," then, as an out-of-time video of everything I've ever done for my mother charged through my head and another rush of tears threatened, I corrected, "well, yes, I have."
    My mother returned to her ribs, nodding.
    When we left I tipped the waitress all the extra cash I had, which added up to almost 100% of the cost of our dinner.
    For the rest of the night I was fine, except...
    ...weirdest thing. We were home and settled. Mom was watching the first of two abridged episodes of Sex and the City showing on the channel on which she'd just watched the news. I'd finished the evening chores and stretched on the sofa like a Roman after a banquet, scanning the screen to catch up. It happened again. The last of the night's spontaneous torrent of tears. I let them flow. They lasted for maybe a minute. Before they stopped, though, The Little Girl, the oldest of my beloved cats, moved in front of my face from her position above my head, examined my cheeks, then licked off the tears. I hadn't been sobbing, but my malaise must have been tangible. Although she's seen me cry, many times, her reaction tonight was a first. She worked over my face until it was clean.
    Cats don't accept tips. They only accept devotion. Mine to her redoubled tonight.
    Later.

Thursday, August 3, 2006

 

"Mmmm...hamwhatam!"

    Mom awoke yesterday only a few minutes after I peaked in on her at 1430. I questioned her about the dream I noticed she'd been having just before she awoke but, whatever its contents, her memory of it was gone. She insisted that she hadn't been dreaming.
    I explained her obvious, organizational choices for the day: Despite the lateness of her arising, if she wanted to have her restaurant birthday meal, we'd gear our day toward doing that, as what would work into our day as a late luncheon. Or, if she didn't feel up to going out preparations, there was always the ham and, being her birthday, she could have as much of it as she wanted, in whatever way she wanted. This was when she voiced her choice in the above quote. It's been years since I've heard her say this (and, for me, she's the originator of it, although she may have gotten it from her own born into family).
    My immediate oblique response was, "Or, is that, 'A ham is what I am'?" and reminded her of the Famous Family Story of the time she demonstrated for one of her sister's dates that she could place an entire unpeeled orange in her mouth.
    "Oh, my," she said, "I'd forgotten about that!"
    Even though she awoke later than usual, she had a lively day. She insisted on having her ham choices prepared in front of her. We watched the mysterious, intriguing Miyazaki animated film Nausicaa, which we both enjoyed. She didn't nap. She spent a long time picking out and working on writing a thank you card to MFS (who's phone number we don't have) for the flowers. The card isn't completely finished. Most of that time was spent looking out the window and at the bouquet while determining what to say. My guess is that she was thinking, in depth, about MFS and her family. At one point I mentioned that I discovered, some time ago, that if I spend too much time trying to figure out something to say in a thank you note, I noticed the thank you note never got sent.
    "Well," she said, "that's not my problem."
    So, I left her to her Reverie of Gratitude. I'm assuming that the note will be completed sometime...she remembered it today (I left it on the TV table to the side of her rocker) but insisted that she needed more time to "think about it".
    Today is Restaurant Birthday Dinner Day. I left the choice of restaurant up to her. It was an interesting challenge to determine the name of her choice. She had the place clearly in mind...was able to describe it perfectly from some of her memories and some prompt-filled leading questions. Finally, I figured out it was Applebee's, so that's where we're going. The things she remembered on her own without prompting are interesting: That it was "heading out of town" (which indicated to me she knows, for the time being, what town we live in); it was "up on a hill"; she could sit in a booth there (it is one of the few restaurants with booths where she doesn't end up with her chin on the table when she sits in a booth); lots of windows; lots of people (it is a great people watching restaurant). These bits, however, didn't narrow it down for me until she mentioned that we'd been there "only once". There's only one restaurant "heading out of town" to which we've been only once. That "once" was almost two years ago, during the month we were selling the house in Mesa. I recall, now, that she was so pleased with our experience there that she mentioned we'd have to go there regularly. Maybe that's a possibility, now, even though we have yet to go back for that Denny's dinner to which she was looking forward.
    Yes, I've finished the book and started the review but I only got a couple of sentences written before Mom awoke. I'm hoping to work on it this evening when Mom retires.
    Time to awaken her and get her ready for An Evening Out.
    Later.

Wednesday, August 2, 2006

 

Ai! Well, she's snoring...

...which is unusual for her, and I can tell by her eye movement that she's dreaming. I know she's sound (pun not intended but appropriate) into whatever she's "doing" because, as I was studying her the doorbell rang, announcing yet another gorgeous delivery of birthday flowers (the first arrived day before yesterday) from MFS. When she's sleeping lightly this usually awakens her because the bell box is attached to the wall right outside her bedroom door. Today it didn't even disturb the rhythm of her very audible breathing. She's probably dreaming about birthdays which I would consider past but in which she is fully engaged, at the moment, eating cake, as it were, a respectable and expected birthday pursuit. Thus, I haven't the heart to disturb her.
    Dream on, my dear. I'll be here, with ham, when you return.

 

"The past is a foreign country. They do things differently there."

    The above quote comprises the first two sentences of L.P. Hartley's novel, The Go-Between. I was reminded of it this morning while reading through a caregiver journal to which I was just introduced, Fading from Memory, which I've also just added to my outgoing links section to the right. I was reminded of this quote as I began digesting a complete reading of Mike's journal. The initial impression with which I was left is that Ancienthood, whether one is experiencing it directly or as a caregiver, is also a foreign country...in which one, as either caregiver or Ancient One, has no choice but to learn to do things differently. Learning a new language, a new culture, new habits of community, or having to invent all these (which is often the case, at the moment, since it is becoming apparent that this foreign country is also a new frontier), I think, may be the fundamental emphasis of becoming Ancient and caring for the Ancient. It is certainly obvious in Mike's journal.
    I want to mention, as well, since I notice I didn't last night (the effect of exhaustion, I guess) that Mom was so thrilled with the at-home-birthday-ham dinner we decided on and I prepared that, while I was working on finishing What Are Old People For she was up three different times reminiscing about this latest celebratory ham dinner, past dinners and, finally, on the third awakening, urgently suggesting that it's been a long time since we've hosted a family Christmas...perhaps we should this year. At the moment I'm leaning toward this possibility, even though, in recent years, I've rejected it. Maybe, with a few new rules, this possibility wouldn't seem so overwhelming to me; the chief rule being, no one spends the night with us. I'm considering it, now.
    Since there is no reliable 12-hour mark today, I've been tiptoeing into Mom's bedroom every half hour since noon and gently rousing her every hour (noon, 1300, 1400) to see if she's ready to arise. So far, she hasn't been. I'm getting a little nervous so I'll probably insist on her arousing at 1430. It's becoming doubtful to me that her restaurant birthday dinner will take place today. She may be too interested in the ham (which I expect we'll have for breakfast and, probably, for dinner, if we eat here) to want to do that tonight. If so, well, that's fine. Our family seems to have a predilection for celebrating singular birthdays over and over...a fine tradition which began with Mom and Dad and continues in the incarnation of their latest great-granchild.
    Better get this posted and face whatever type of arousing is in the cards for me today. Speaking of cards, just a reminder to myself. More later on that, maybe, if I remember. Something to do with playing a computer card-game called "Montana".
    No, I haven't quite completed the book, but only the Appendix and notes remain unread.
    Later.

 

I'm still reading.

    Used to be that I could read a book like this in one day "off" (work), even if I was highlighting and notating in the margins (or, as I sometimes used to do if I found myself having a lot to say to the book, notating in notebooks). After I'd stopped working in order to be available to Mom, while her ability to manage her life was needing incrementally more and more assistance but her health was not yet being challenged, I remember reading similar books in two days. I'm heading into my fourth day with this book and I still haven't completed it, despite the fact that I'm spending all my spare time on it, thus, I'm learning how little "spare time" I actually have. I just discovered that in the now necessary practice of picking the book up, reading some, then putting it down I skipped two chapters. I have yet to read the appendix and notes. Now you know why I don't read much any more, unless it's short, sweet, to the point and probably on the internet. You also know why my posts, long or short, often appear to be unedited (they often are unedited when I publish them). You also know, if you subscribe to any sort of service that pings you when I publish, why maybe a quarter of those publications are republications of posts that I happen to notice, upon later scanning, need to be edited.
    Reading, for me, used to be pure joy. Some of that joy remains but a great deal of frustration now accompanies the act of reading for me because I do not feel I can protect myself from interruptions, anymore...the interruptions are much too important. Even reading aloud with my mother is vaguely frustrating because, of course, it is impossible for me to read as fast or as far as I'd like in a single session.
    It is becoming apparent to me that I need to change my attitude about and my preferences in regard to reading if I want to continue to read books, at least some of the time. Not reading has been my chosen option for a couple of years but it's been just as frustrating (note the books I continue to purchase lining our hearth and obscuring our fireplace even as I know I probably won't read them until after my mother dies) as reading under the life circumstances to which I am devoted, at the moment. Changing my attitude and preferences presents added difficulties, too, as, two of the salutary aspects of not reading are:
  1. I've noticed that I've rediscovered my enjoyment of information that comes to me through my other senses, and;
  2. although I've always listened to myself studiously and written a lot of what I hear myself thinking (as well as listening to others aside from reading people's writing and writing a lot of what I hear other people express), I'm doing a lot more listening to myself and writing what I'm hearing myself think than I can remember ever doing. This pleases me so much that I tend to think I might like to continue these in-lieu-of-reading activities for a while longer.
    There are times, now, when I reverently imagine living in a strictly oral culture. Can't remember ever fantasizing about this before. It is an extremely pleasant fantasy.
    Nonetheless, this book is having a surprising impact on me. Despite the fact that it is primarily philosophical, rather than practical, it has already moved me to change one practice in my caregiving and, earlier last evening (or was it this morning), sparked another idea that will further redirect my caregiving of my mother, if it's possible.
    One thing reading this book has done is rendered me much more sensitive to the use of the word "decline" when talking about Ancient Ones.
    One more awareness, not related to the book but it hit me while I was reading the book: I use the word "now" a lot. Must think about that. Now, now...
    Time to hit the sack, though. More on all that...
    ...later.

Sunday, July 30, 2006

 

Fully absorbed, I think.

    It didn't take much time for me to absorb the shell I needed to create for a little while and look outward, again. Since sometime yesterday afternoon I've been feeling much more available. I haven't gotten back here, though, for a couple of reasons. First, my mother has revived as I have. Today, in fact, although she retired at her usual time with her light going at at 0100 this morning, she was up and ready to begin her day at 0900. As well, I received, Friday evening, a book I'd ordered: What Are Old People For? by William H. Thomas, M.D. I'd heard about the book maybe a year ago; mixed reviews, depending on who reviewed it and to what purpose, which is typical with "trade" books. I'd avoided finding a copy of it simply because I wasn't sure I'd ever find the time to read it. Because, though, lately, I've been thinking about why I insist on devoting the resource of myself to my mother's life even though society seems to agree that what I'm doing is one of those activities to which only fools rush, and have been considering, too, what the value of lives such as my mother's is, despite the fact that, superficially, her life appears to be of little value, I decided to order the book and work on reading it in the hopes it would push me beyond some of the confusion I'm having with these topics.
    I'm a little over a third of the way through it so I haven't developed an overall impression, yet. My mother, though, noticed it while she was watching, hmmm...something on television yesterday, can't remember what, and I was reading, expressed interest in it and I decided to also read it aloud with her. She and I are into it by 18 pages. I will continue to read ahead.
    At the moment, though, everything else is being put aside as we finish her hair (she just arose from her nap) in preparation for watching Bette Davis in Jezebel on TCM.
    Looks like today is going to be a well engaged day. Wanted to check in, though, and leave evidence that I'm doing better. I'll be back, of course...
    ...later.

All material copyright at time of posting by Gail Rae Hudson

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