It Takes a Village

It is painful to watch. Aunt Clair pushes her walker down the carpeted hallway, ever so slowly. After ten or fifteen steps she pauses to catch her breath. I had not realized that the hallway was so long. Seeing my mother and Aunt Clair move through the world, my perspective on all kinds of things has changed.

The hallway from the elevator to my apartment is not really that long, not for a healthy individual. I have taken my health for granted, but my eyes have been opened. I can stand up quickly from a couch or chair without a second thought. Getting up off the floor is a bit more challenging. I can stand at the stove and cook dinner without needing to take a break. I can go to the supermarket, carry my bags into the house and unpack them – all without stopping to rest. I can take a shower without considering whether I am strong or steady enough to do it safely. My mother and Aunt Clair can’t do any of those things.

I have never been particularly grateful for my body. I usually eye it critically. But, seeing what can happen as you age, I am re-evaluating. While I have achy joints, they all work well. Kein ayin hara (Yiddish for ‘no evil eye,’ or ‘I don’t want to jinx myself’), I can play tennis, go for a hike, ride a bicycle. People my age and younger are not able to do some of those things. I have taken to thanking my legs and arms for functioning so well.

Bearing witness to Mom and Aunt Clair’s experience has made me aware of many things I had not given much thought to previously. The cycle of life is on full display. We start as babies, dependent on others to meet our needs. Many end up back in that position. We don’t want to believe that about ourselves. After living independently for decades, taking care of ourselves, making choices about what we eat, when we eat, when we sleep, where we go, that slowly slips away. The fact that it generally happens slowly, may ease the transition. We adjust to the new realities, we lower our expectations. We draw the circle of our life smaller and smaller. We may make peace with encroaching age and the limitations it brings, but at some point it is demoralizing. I don’t know which is worse – watching someone you love go through it or experiencing it yourself. (I know the answer to that, but it is heartbreaking to observe.)

We may become physically or mentally (or both) incapable of the activities of daily living. We need help.

Who provides that help? In some cultures, the expectation is that family steps up and in. Multigenerational homes are the norm. That may work, up to a point. Sometimes the needs go beyond what can be provided. American culture does not have that expectation of families, but it doesn’t compensate for the lack of it. We value rugged individualism too much and the vulnerable among us pay the price. I don’t know what happens in other countries, particularly those that have the long life span that we enjoy. I should do some research. Insight from readers would be much appreciated – please feel free to comment.

In America, if one is financially able, one can pay for assistance. But even if you have means, and insurance, it isn’t simple. Accessing insurance, researching options online, finding reputable agencies or individuals, getting doctors to write the necessary prescriptions, filling out the paperwork or electronic forms to get reimbursement – is challenging and requires persistence and some skill with technology. You would almost think that the system has been set up to discourage claims or deny payment (sarcasm alert!). It shouldn’t be that complicated! Most of our elders are not equipped to take all of that on. So even if you have money, you still need support.

Not all of us have those financial resources. For whatever reason, not earning enough, not planning ahead or suffering an unexpected financial loss (caused by bad health, an economic downturn, a natural disaster or bad luck), one can reach their seventh or eighth decade without much in the bank. Are government programs sufficient to meet the need? I think it is fair to say they don’t. Some services are available, but there are gaping holes. What are we, as a society, willing to pay to provide for our elders? What level of service, what is the quality of life we want to guarantee?

As we live longer and longer, many outlast spouses and friends. Not everyone has children. This is the situation that Aunt Clair faces. She has been single her entire adult life and she didn’t have a child. She is a very stubborn woman which has been a blessing and curse. She fought pancreatic cancer six years ago, surviving treatment – more than surviving. She bicycled to and from chemo….in Manhattan! From her apartment in Greenwich Village to Sloan Kettering, at Third Avenue and 53^rd Street, she pedaled each way. Sadly, the cancer returned six months ago. She has resumed treatment. Other unrelated health problems have emerged. For a person so independent, who continues to be mentally sharp, the new limitations are a rude surprise, nearly impossible to accept.

Aunt Clair has experienced both the kindness of strangers and the invisibility that comes with being an elderly woman. New York City has a reputation for being a cold place to live, and it can be, but Clair has stories that show another side. One time recently she had an appointment with a doctor she had not seen before and had difficulty finding the office. Turned out she was on the wrong street. After exhausting herself going up and down the block, a younger woman stopped to help. She stayed with her until they sorted it out and found a cab – Clair was in no condition to walk the two blocks. I am grateful to know that there are good Samaritans out there. I know my mom has benefitted from help when she has needed it, too.

What is my role, as a niece and daughter? Clair has other nieces and nephews, each with a full life and responsibilities, their own challenges. Only one lives in Manhattan, albeit not close to Clair’s apartment, the rest of us are scattered around the Northeast. Mom has two other children, a brother and several nieces who have generously stepped in – and yet, there are still needs. It truly takes a village. Personally, I have no idea how to balance it.

When I returned home from New York City, having visited Mom and helped Aunt Clair a bit for a couple of days, I needed to recharge my batteries. I am fortunate to have a loving, supportive partner in Gary. Together we went for a long walk in the woods. My spirit is improved, but I still have no answers.