Uneven Aging: A letter to my older self
My parents were straightforward about the inevitable exigencies of aging. "One day", Dad said from time to time, "the axe drops". He saw it with patients, with colleagues, friends. I am witnessing that now, from minor but limiting incidents like a sprained ankle to the big, life-threatening diseases.
Sometimes there's a precipitous event, but for many older persons, a natural deceleration occurs—the popular expression is, your tread gets thin. The culture promotes denial; we are enjoined to fiercely ignore the inevitable shift.
To counter that in myself, I have written a letter to my future self, issuing instructions in the case of a period of decline. The letter assumes I will have the mental capacity to understand it, and the good sense to follow my instructions.
Though family would confront my obstinacy, why not hold myself responsible? If you can be your own worst enemy, why not flip that and be your own best advocate?
There are three main orders:
1. Don't be a stubborn fool. I'm telling myself to move to an assisted living residence or other supportive housing if I can't manage to eat three square meals a day (an ice cream sandwich does not count); if I need help with personal care, taking medication, or getting around; if I need more social interaction. Some I know plan to live with their children, but it's not something I expect.
2. Should Le Duc be around, he might be in better shape than me. If so, I remind myself, Make sure he does not shoulder all aspects of your care. We often discuss the financial implications of the coming years, but this is a different matter: the endless work would affect his own well-being. He is perfectly capable of being a stubborn fool too, so I ought to point out examples of successful support and tell him it's time.
3. One critical point precedes the first two: If you sense that your health is declining, do not deny it, because that self-deception will make the situation worse for everyone.
The press features persons who are driving themselves across the country in their nineties, or playing tennis every day as they nudge the century mark. These are super-elders, one end of the ability continuum. (The other extreme are those who see their imminent demise in every twinge.) I figure the normal curve has served all these years, so I should prepare for some time spend being somewhat diminished.
I saw the price of denial close up over the past several years. (Names are pseudonyms.) Judy knew that her beloved husband, Hal, had symptoms of cognitive decline, but every time he was evaluated, he summoned some superpower and passed the tests. Not only was he mentally competent, but charming and friendly to boot. On each occasion she was told, "He's fine. You can take him home."
For several years, he pulled off this feat multiple times, but she and their children, trying to live with a definitely ill person, were exhausted and frustrated. Judy, one of the funniest and most vibrant women I know, was sinking into grief. Because Hal lacked a diagnosis, they were ineligible for home care.
Hal declined further early this year and was diagnosed with an advanced form of dementia. He now lives close to home in an extended-care facility and is doing better now that he receives treatment. The family can now access benefits included in his union's health plan, such as counselling for Judy, which in turn helps her to care for him.
I suppose you're thinking, Hmm, Duchesse's letter assumes a lot of control. As I wrote, I thought of the Yiddish proverb, "We plan; God laughs." I do not believe that a Supreme Being directs individual affairs; should that turn out otherwise, I have only written a letter. If that letter is ignored by human or divine readers, I tried.
It is not the only such letter I have written; I recently re-read the first, from me in my thirties for use twenty-plus years later: Don't criticize your adult children, their partners or grandchildren unless it's a life-threatening situation; don't force your stuff on them; remember how busy and tired parents of young children are; cheer on their milestones; appreciate their attention." There must have been some dust-up at the time because I also wrote: "Be careful about day drinking with Mom."
At age 40, I ended the letter with just two words, "Love them", and the same holds true for what I expect to be my last letter to self.