Off North Road

Aging becomes us

By Russell Hoxsie - November 16, 2006

What do you get when you put three couples (people) around a table with coffee amid the aroma of fresh breads from the warming oven and plates of browned croissants, muffins, and tarts? Conversation is apt to go like this: "I can never get out of the way in Cronig's check-out," says the first woman. "My fingers don't work on sheets of paper and dollar bills anymore; I can't get one by the single; have trouble giving up change from my pocket book. The clerk looks unkindly when I put down two nickels thinking they are quarters." Another of the men says, "I have that problem too but mine's worse; I can't slide my hands out of my change pocket, then the coins go all which-way."

"Does anyone have the problem I have?" I ask the group. "It takes at least three return trips to the back door before I can get my wallet, my keys, sun glasses, and grocery list all together to start the car, let alone drive out of the driveway. The alarm bell in the car drives me crazy. I can never remember to hitch the safety belt." Everyone laughed, good belly laughs that seemed to me that my question was common to the whole group. I even started to open the wrong car door at the market's parking lot until I noticed a Lambert's Cove beach sticker which I did not own in the rear window and my dog Ticker was looking at me with cocked head in the vehicle, another pick-up but older than mine. When the dog starts to question your actions you must be in bad shape, I thought.

By this time, our six-some was on the verge of giggles. We shared one problem after another. "I never thought when I was younger what lay ahead," one of the men spoke up. He shook his head in consternation and disbelief. "I can't even call my neighbor by his first name unless I go through the alphabet and all kinds of other tricks just to get a mumble out which may or may not hit the correct name. I don't say it too loud; he might not hear a mistake."

Some of us hadn't seen each other in several years, some were new acquaintances but we were all so close to eighty years I would have thought the humor in our conversation would have had a trace of bitterness since we were disclosing our failings of age, not a new gift of light heartedness. On further thought, we were probably projecting some of the sadness and anxiety of our elder status away from our core feelings and beginning to accept with good-natured laughter tales of our aging lives. We were not without serious problems. One had been widowed a few months earlier; several of us had survived serious illness with partial on-going disability; two of us could no longer drive our cars at night; one was disabled to the point of marked limitation in her ambulation and ability to perform usual household chores. Yet, we all looked fit and as robust as most at our age and it's fair to say that our getting together this particular day represented an episode of joy in a spontaneous sharing of ourselves with each other.

A few evenings before this gathering, I was a presenter at one of a series of my church's adult education conversations, including the topic of "The Physician's Role and Responsibilities for End of Life Issues," no light-hearted discussion. A woman asked the first question: "Would you aid a patient who comes to you asking for help in assisting her suicide?" Of course, I felt on the spot but that was my function for the two-hour session. For many years I have thought about the problem and had decided with some ambivalence against participating in the purposeful assistance in a patient's intentional suicide. I know it is a controversial decision and my questioner, I thought, was disappointed.

"Would you accept the patient into your office or hospital and discuss the question with her, perhaps counsel her in her present state?" the same woman continued. That, of course, would be another question altogether. I have done that many times with patients. When pain and suffering of an incurable terminal illness becomes unbearable, appropriate treatment can ease one's death. In this instance, the caregiver must be able to treat the dying, not only the terminal illness itself. Treatment of the dying process may in fact abandon some or all of the treatment modalities for the disease. My experience with Hospice, for example, has confirmed my belief that an easier death with proper management is possible. Drugs can be administered without concern for addiction, concern, only for the comfort and ease of the afflicted. Anti-depressants can be administered for the relief of another component besides pain of the dying process. This management of such a patient comes with a cost to caregivers, cost in terms of giving of oneself in a type of love between caregiver and the dying patient. Death, after all, is the normal process that we all must go through. The catch is to begin preparation for it as a lifetime work for all of us including the caregivers for the work they will share as the time approaches. Likewise there is a reward for the caretaker, not a failure of treatment for the terminal illness but success in the easing of the pain, the isolation and the despair of dying.

I would assume that our happy gathering around the breakfast table with coffee and refreshment, our spontaneous coming together in some comfort with old age and the joy and laughter of sharing common problems will serve those who were there in better stead than if we had not been able to participate so freely. I believe that we also were working on end-of-life issues in as constructive and maturing a fashion as others worked earlier in the week participating in the more formal church discussion.