A number of thoughts about what I might write have come to mind. Linking the personal with the political seems key. I imagine that an older person’s ruminations might serve a function rather similar to that of ‘elders’ in traditional societies (whatever those are)—which might have some ‘socially redeeming value’. I am a 65 year old, female anthropologist whose life has been lived in the US, Turkey, Iran, Indonesia; and whose travels have spanned the globe. Two years ago, I moved back to the US, to the tiny hamlet of Etna, New York (near Ithaca and Cornell University).
I begin these ruminations, rather randomly, with the sense that we will need some major governmental restructuring to deal with the aging of America. I have been preoccupied of late (as have many others I know) with the link between generations, particularly with the ascending generation. Those of us in our mid-60s are confronted with a largely welcome, but also difficult, series of responsibilities relating to our own elders, many of whom are living much longer than has been typical throughout human history. Like those who have gone before, we are learning about the needs of the elderly as they lose their various faculties, whether physical or cognitive–and this multi-generational learning process is occurring on a much grander scale than previously. We can also expect to be watching parental deterioration for much longer periods of time than have previous generations.
The mobility of Americans has lent still another dimension. Many of us have moved far from our parents. We have kept in touch by phone, email, post, occasional visits; yet as our parents age, they need more direct, daily, face-to-face help.
The constant change of circumstances, as they age, means a continuing need for difficult (and often expensive) decisions.
- When should they give up driving? And when that time comes, how is the decision made, by whom? What alternatives are there for transport?
- How much household help is needed to keep the house clean, to cook the meals, wash the dishes and the clothing, look after the yard? How can it be obtained? How much will it cost? Who can and should pay for this care?
- As parents’ conditions deteriorate, how are health care decisions made? How much intervention makes sense? When should people stop living independent, or semi-independent, lives and move in with children or into assisted living?
- How does one determine when to stop trying to save a life, and accept the nearness of death?
These questions plague us, as we try to treat our parents with dignity, trying to help them maintain their own sense of self and satisfaction with their lives—lives in which serious, painful loss becomes a regular occurrence. As I look to the future, I wonder how one maintains a positive, optimistic outlook in the face of such recurrent loss. Yet my own mother, and a number of other older relatives, have shown their ability to do so.
These issues that I recount have been problems for me and my friends. Yet, we are more likely than average to have sufficient resources to deal with these eventualities, difficult though they are. My worry is more severe for those whose financial resources are minimal. The cost of care is astronomical, and care at home becomes virtually impossible, as elderly vulnerability increases. There needs to be a more effective safety net for those who are unable to pay; and the cost of medical care needs to go down.
How do we make this happen?