Readers sometimes send me interesting questions about getting old (as if you think I actually have answers). When they are specific and about topics on which there is a body of knowledge and consensus from experts, I can act as researcher when I have time.
Lynne's question, which has been sitting on my blog to-do list for longer than I realized, is about her 89-year-old mother's apparent ennui.
Here are the most salient bits of Lynne's email:
”What do I say to my mother, who is asking, 'What's the point?'
“Mom is sharp and healthy, although discomfited by damage from a broken femur of 3 years ago. She lives in a 55+ community, where she participates, but she's older than almost everyone, and can't keep up with the younger peeps of 75 or so.
“Still, she does crafts, drives, has community and church activities, but says she feels like she's swimming through Jello. She laments the slowness, forgetfulness, dependency, and general fearfulness. She deals with grief, over and over again, when another friend or sibling dies.
“Not that she doesn't have joy! But sometimes she feels like she's just going through the motions...At 60, I don't know what to say to help her. She lives 4 blocks away and we include her in 90% of our activities, including those with great-grandchildren, which she enjoys.”
With mood or mental changes, it is good to check for physical reasons and my first thought was medical: is Lynne's mother takng a large number of medications – including over-the-counter drugs? This is officially called polypharmacy or overmedication and is a common problem in old age because it can lead to dangerous drug interactions, and is a serious issue because it is easily overlooked.
Dr. Mehrdad Ayati lists potentional side effects of overmedication in the book I told you about on Wednesday, Paths to Healthy Old Age, and they are many:
”...heart failure, seizures, disorientation, confusion, weakness, sedation, falls, fractures, hypotention, incontinence, electrolytic disorders, anxiety, delirium, mental decline, blurred vision, constipation, GI bleeding and loss of appetite.”
Because elders are often treated for several diseases and conditions at once, each with its own specialist physician, it is easy for a variety of drugs to cause negative interactions. If you use the same pharmacists for all prescriptions, those professionals are a good backstop for negative interactions.
You should keep an up-to-date list of all drugs with you always, including over-the-counter medications, supplements, etc. to give your doctor so he or she can check new prescriptions against the list.
If the problem is not an excess of drugs and Lynne's mother is not clinically depressed, then what?
Part of Lynne's message about her mother is a good description of old age in general: our bodies slow down, we become forgetful, dependent and our personal worlds contract, if we live long enough, as our friends and relatives die and the number of people who share our world view declines year by year.
These are the burdens specific to old age and they are not easy – particularly, I think, with grief because in the U.S., we do not grant ourselves much time for bereavement; we expect people to be “back to normal” in a couple of days.
On this, let me quote a bit from Sogyal Rinpoche's brilliant and wise Buddhist spiritual classic, The Tibetan Book of Living and Dying. He speaks of how we can help the bereaved who, he writes, may be
”...shattered by the array of disturbing feelings, of intense sadness, anger, denial, withdrawal, and guilt that they suddenly find are playing havoc inside them.
“Helping those who have just gone through the loss of someone close to them will call for all your patience and sensitivity. You will need to spend time with them and to let them talk, to listen silently without judgment as they recall their most private memories, or go over again and again the details of the death.
“Above all, you will need simply to be there with them as they experience what is probably the fiercest sadness and pain of their entire lives. Make sure you make yourself available to them at all times, even when they don't seem to need it.
It takes a long time to grieve a loved one's death, time we don't readily acknowledge in our culture and in old age not only is time necessary, the deaths keep coming one after another; there are so many to mourn.
There is another factor that affects those who are very old. In all that I've read over 20 years of studying aging I have never come across a reference to it (that I recall). I have only personal experience.
My great Aunt Edith was my favorite relative. For most of her old age, she lived on the west coast and I on the east but we wrote letters (remember those?) and we spoke on the telephone about once a week for an hour or so.
Aunt Edith read widely – books and magazines. She mailed me articles that interested her – political, social, weird news, etc. - and she also liked to send cartoons from The New Yorker.
She had a good sense of humor – about life and about herself especially, as they occurred, her diminishing physical capacities. She was well into her eighties when she told me that after scrubbing the kitchen floor on her hands and knees, no matter how hard she pushed, she couldn't stand up.
She had to crawl into the living room and pull herself up with the help of chair.
Aunt Edith laughed throughout the entire story (which she dragged out because she was a good storyteller). And we laughed some more when I told her that they'd invented this amazing new cleaning tool she might want to look into – it's called a mop and has a long handle.
It was about this time that I first noticed other kinds of changes in Aunt Edith.
Her letters didn't arrive as often and when they did, there were not as many cartoons and other clippings. She stopped sending her cooking-for-one recipes (she had never married and had a large collection). More frequently than in the past, I did the telephoning as if, perhaps, she had forgotten. Or was distracted. Or something.
None of this was sudden and it took awhile for me to notice. Gradually, over a period of two or three or four years, I came to see that she was withdrawing from life. She had less interest in news and politics. She wasn't reading as many books. Her stories were fewer. She wasn't as generally curious anymore. Our conversations became shorter.
There was nothing wrong with her mind. She just became less and less involved with the world and its activities.
Aunt Edith died in 1985 just a couple of months short of her 90th birthday. Since then, I have given a great deal of thought to her steady disengagement from life.
In doing so, I have come to believe that if you do not die suddenly or linger in great pain from disease or injury, a period of letting go makes great sense. It feels "meet and right" to make time as the end appears to grow near, perhaps over a few years even, to look inward, to make private peace, accommodation and to find some harmony perhaps within the mystery of being.
As it did with Aunt Edith, I suspect this goes on without need of discussion about it with other people, friends or relatives.
I have no basis in fact for any of this although I have noticed its possibility in three or four other people, including my mother who knew she was dying, that it would be soon and who, as she grew weaker, had less and less to say.
Does any of this have anything to do with Lynne's mother? I have no idea. In the (embarrassingly long) time since Lynne first emailed (January), I've poked through my library of books on aging, consulted Dr. Google and can't find anything that directly applies.
Her question, “What's the point?” already comes to my mind now and then and I'm 16 years younger than Lynne's mother. I'm not sure it needs to be answered or that there are any answers. Not to be too flip, but it occurs to me that you first have to figure out if it is meant cosmically or just about whether to replace a shabby chair.
What I hope is that my rumination has given us all a few things to think about and I'm looking forward to see what you, dear readers, might say. Remember, it's the internet and there is no space limitation – just please, please use paragraphs (hit enter twice) if your comment is long.