Like most folks, I did not think much about the end of my life,
but if I had there are big issues that I’m not sure I could have finessed. The main one it’s hard to escape is the second childhood.
The fact is you experience helplessness again and you become more and more dependent on others as you age. The myth is that your volition is gone and it’s inevitable that you will be the done to rather than the doer. That’s not the law and that is not the fact as long as you can stand up for yourself.
In recent years, I’ve been watching the process in my family as I begin to experience it myself. My wife’s mother was stalked by cancer, a terrible disease that came after her body as dementia came after her mind. My mother just made the hospice decision after cancer returned for the third time, the same cancer her mother had and I have.
My peers have made exits more in the manner I pictured for myself. They simply drop from a heart attack or a stroke or have a short battle with cancer. Beyond that, there is a body count that surprises me from gun violence and suicide. That body count may be surprising but it is still sudden.
Three young men had an earnest and serious discussion about starting a law firm together in the hardest place in Texas to start a law firm, the People’s Republic of Austin. That running joke (“People’s Republic”) started on the Left Coast in the San Francisco Bay Area, and Berkeley probably got there first.
The reality it represents is democracy ascendant or running amok — depending on your point of view — in cities where great universities have outsized political influence: California at Berkeley, Texas at Austin, Ann Arbor, Madison. People come to these cities to acquire education and then fall in love with the location.
Those who want to stay after graduation fall into competition with many others who have the same idea. When I was in law school, more than one professor told us to adjust our salary expectations radically downward if we wanted to stay in Austin and understand if hanging out your own shingle the competition will be fierce.
The three of us were about the same age, between 25 and 30, and we were under no illusions about the size of the challenge. As it happened, we took separate paths to staying in Austin, but that was not because we thought we could not work together. Our career orbits could have rejoined later.
I am the only survivor of the three. Peter keeled over in his forties from a sudden heart attack. Michael had a painful exit with early onset dementia.
The lawyers in the firm that gave me my first job were more fortunate as a group. There were five partners and two associates. One partner died young of a sudden heart attack and another made a slower exit from cancer. The rest of us survive.
As our peers fall away by means expected and unexpected, the aging in our families present entirely different problems. Most of those problems, I am convinced, stem from the summing up of your life you are moved to do at the end of it. Cancer caused me to switch into that mode after I lived my allotted three score and ten.
My wife’s final reckoning with her mother was rocky at first. I witnessed it up close and personal because she was living with us. They settled matters between them before the dementia set in.
My mother is different because she did not raise me. She had four sons. I am the eldest, raised by her parents, and all the others are half-siblings to me. The second eldest only became known to me in 2011, when my mother spilled the beans. He was given up in an open adoption, so I was able to track him down via the Internet and drive her to Florida to meet him. She raised the two youngest.
Son number four is a drug addict who may or may not be currently among the living. When last seen, he was freshly out of prison and motivated to make up for lost time getting high.
Son number three is an alcoholic who has a record of misjudging the character of the women he married. He has strong opinions imported from the minds of others because his education has been limited to the technical stuff he needed for work. He is a hard worker and competent when sober and he usually appears so because his alcohol tolerance is very high. I am one of those elitists he despises and we barely speak.
When our mother became infirm, I was the only one able and willing to take her in. She was living with my wife and I when she shocked me by handing me her car key and telling me to sell the vehicle because she felt unsafe to drive. My son Paul had driven her from Texas to Bloomington, Indiana, where I was teaching.
I was able to sell her car after serial comedy routines that came from my ignorance of the fact that many of the generation I was teaching did not know what a “stick shift” is, much less how to drive one. After half a dozen comical encounters, I tired of the sport and reworded my ad on Craigslist to explain that not all transmissions are automatic.
After I got the car sold, she asked me to get her into a nursing home. This surprised me, because I did not think she was that far along. I had to help her get in the shower. Her bladder was leaking and her attempts to blame the puddles on the dogs were wearing thin, but we were all getting along and I didn’t see any health problems likely to kill her soon.
A couple of days driving around Bloomington and consulting a social worker convinced her that a nursing home was going to be a problem because she had no money. Unlike most of her generation, she switched employers regularly and so had no retirement income other than Social Security. The lump sum she acquired by having me sell her car gave her too much money to qualify for Medicaid.
While she was spending down that asset, my body was beginning to give out. I could no longer stay on my feet for a fifty minute lecture. My wife and I determined to retire back in Texas to be close to kids and grandkids. We quickly found that Austin was priced beyond our reach, so we wound up in a suburban community just north of Austin.
We got my mother on the waiting list for subsidized housing, which was doable because she had lived in Texas most of her life. Her rent subsidized apartment worked well for her until she started falling. She was seldom seriously injured, but the ambulance rides were a thousand dollars a pop.
I took on the nightmarish Medicaid application and it was approved on the second try. We got her into the same nursing home as my wife’s mother and even, briefly, in the same room.
It was pretty impressive, I thought, that those two ladies were in the same room getting the same care while one was there courtesy of Medicaid and the other was private pay. Everything was hunky-dory for a couple of weeks.
Then the invisible people who had been visiting Tracy’s mother off and on started showing up when we were in the room. As best I could tell, these visitors were, in addition to being invisible, dead.
Not to be outdone, my mother — who had shown no prior symptoms of dementia — -was getting exercised about the little men who came out of the air conditioning vents every night and stole blood from her roommate.
She also developed a sudden worry that the nursing home was maintaining a dormitory for undocumented workers on the third floor and the people who worked there were rotating between trips back to Mexico and living in the dorm. The first thing that struck me was that she had lived in the borderlands longer than me and I had never heard her make a fuss about anyone’s papers. The other thing was that the building had no third floor.
The only life experience I had to help me deal with this was back in the LSD days, helping people who were having bum trips. The differences were that the trippers were usually younger than me and I knew they would come back down within a reasonable time and all I had to do was keep them safe until that happened.
This did not adequately prepare me for my elderly relatives adopting permanent fantasies. I measured the vent in my mother’s presence and reported numbers that made repeated visits by vampires impossible. She responded that they were really small.
Just briefly, I flashed on the Cherokee Little People. There are lots of stories about the Little People, but I know of none involving vampirism.
Why did her roommate not react to the blood loss every night? The little vampires were very quiet and they only took a little.
I put her in a wheelchair and took her outside to show her that the building had no third floor. She was not convinced — the footprint of the third floor could be so small we could not see it from the sidewalk. Pushing her around inside looking in vain for a stair was not convincing to her either.
Then my wife’s mother fired another salvo when she alleged my mother had a gun and intended to kill her. I said that if she had a gun she would be more likely to shoot the vampires. What vampires, my mother-in-law asked? I told her the story and she said it was ridiculous. I did not disagree. Management searched the room in her presence. No gun.
She said my mother was really clever in hiding the gun. I mumbled something about the gun being hidden on the third floor, but she heard me and asked, “What third floor?”
The facility separated the mothers and the outrageousness dialed back. My mother’s mail comes to my house, and it was at the height of this craziness when I got a purge notice regarding my mother’s voter registration. Failure to respond to these Republican love letters gets you kicked off the voter rolls.
My experience with dementia was, as I explained, limited. I thought it was a one way slide into fantasy. It was that for my mother-in-law, but my mother found the off ramp in time for the 2016 elections. She always wanted to vote for the first woman president.
Hillary Clinton’s loss was a much bigger “oops,” but the oops in my face first came when my mother asked about her voter registration card.
What followed was a weeks long fight with the Republican voter suppression laws that they deny are for the purpose of voter suppression. I was trying to get a woman back on the rolls who had been registered to vote in Texas most of her life. But her last driver license was in Indiana and an expired license would not do anyway. There was no way to get a birth certificate from Oklahoma in time.
How I did it is a story for another time, but for present purposes I want to state for the record that I kicked myself many times for allowing her to get purged in the first place.
While my mother was incompetent, I used the medical power of attorney I had for years. When her faculties returned, I expected her to make her own medical decisions. Her care providers did not, and I was continually being harassed to make decisions for her that I no longer had authority to make on the face of the power of attorney. The nadir of that issue was when a nurse asked me to sign a consent to treatment for my mother in my mother’s presence.
When she finished expressing her outrage, I didn’t have a word to add other than to remind her that I did not want her telling people her son is a judge, particularly in the context of demanding something….even though, in this case, what she was demanding was everybody’s entitlement. Nobody can make medical decisions for another who is competent to make his or her own decisions.
Another common legal abuse is that too many people do not understand the difference between a medical power of attorney and a general power of attorney. I did not have the latter, but it did not matter because I am co-owner of all of her accounts for the same reason my wife and I own everything as joint tenants with right of survivorship. There is nothing quite like presiding in probate court to motivate you to never have to fool with probate.
The bottom line for those of us getting old is that persons in caretaking roles conspire to infantilize us. It’s already beginning to happen to me, but all of my kids are well aware of how I feel about being cut out of the loop when decisions are made about my life.
It may sound obvious, but you must not only understand you do not get to choose the time and manner of your death but you must also conduct yourself consistent with that understanding. And make sure all of your family knows your wishes just in case you really are unable to communicate them yourself.
This post was previously published on Medium and is republished here with permission from the author.
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