walkitout (walkitout) wrote,
walkitout
walkitout

It's All Cultural, or, more from the New Old Age blog at NYT

I cannot get over how amazing this blog is. The entries are good, but the comment threads are unreal.

http://newoldage.blogs.nytimes.com/2008/07/24/love-in-unexpected-places/

The author describes her experiences with a particular nursing home for her mother, and a particularly wonderful person who works there. A lot of the comments are from people who similarly had loved ones in _that particular nursing home_, which all by itself is really kinda cool (more cool if I were shopping for a nursing home for someone in the NYC area, but this is all very theoretical for me anyway) since there's reason to believe you're really looking at apples-to-apples. Some of the comments are about parallel experiences (good, bad and indifferent) in other locations. But there's some fantastic analysis embedded in these personal, detailed stories.

I suppose the first thing that jumps out is the repeated recommendation to hire a private aide for your loved one. There's dispute about the relative merits of private vs. semi-private rooms, but no one is arguing against having a private aide. There's a parallel here in my world: the recommendation to hire a doula, because the nurses aren't there to help you or be with you -- they are hired to supply particular medical procedures and that's it. Same thing in nursing homes, apparently.

The next thing that jumps out is that virtually everyone in an nursing home has some fairly significant cognitive impairment -- and they don't wind up in the Special Wing until they're way, way far gone. Not necessarily Alzheimer's, but someone who put someone in a nursing home for Lyme Disease recovery with the expectation of them coming back out were quite horrified about how nursing homes weren't really set up for anything _but_ end-of-life and end-of-life with a lot of cognitive impairment at that.

It had been increasingly clear that everyone was keeping their loved ones in assisted living as long as possible before being forced to switch to nursing homes, and the One Thing that forced the change was advanced dementia of one form or another resulting in them being more or less evicted from assisted living. Makes sense that the result would be that nursing homes would ONLY have that group after a while.

The other thing that jumps out -- I make have remarked on this before -- is how how many people basically shudder and go, I'd rather _die_ than have that happen to me (especially if they've watched one or more relatives go down in a nursing home), and here's _my_ plan for making sure I get to exit ahead of time.

Comment #14 is an interesting variant of the usual:

"one does not need to hoard pills to use all at once. If one can restrict one’s eating…to essentially starve oneself, that is a quick low pain way to go. My mother had investigated it when she was in her 80s…and the knowledge brought her relief that she would be able to take matters into her own hands if need be. Sadly, 2 months later a stroke did it for her, before she wanted to die."

While of course I am sad to hear that this woman's mother didn't get to pick her way out, and sad for the daughter because it's gotta be tough to lose someone you love, I just have to marvel at the idea that it could be considered sad to die of a stroke (and apparently not a lingering one, which _would_ have been pretty awful) while in one's 80s, _after_ planning one's death, but before being able to implement it. Parallels here in the world of childbirth as well, in that I find myself completely unable to empathize with some tales-of-woe (the one in _The Mask of Motherhood_ springs to mind, IIRC), when at least all the details supplied would have qualified as a fantastic birth experience from my perspective. Similarly, done in by a quick stroke at that age? Woo fucking hoo! I would consider that hitting that jackpot.

There's another story in the comments raging about neglect of a loved one in the nursing home, someone on dialysis who died of an undiagnosed infection. _Again_, if you're on _dialysis_ in a _nursing home_, given your options, this might be one of the better ways out. Please don't misunderstand me. I'm _sorry_ about people who lose a loved one. I'm _sorry_ that people die. And if the comments are just ordinary grief and loss that have been redirected to the technical details, I guess I can shrug and say, that's just human. But if this kind of thinking is setting policy somewhere, I'm a bit concerned.

ETA: Given the vast quantities of money being spent on care for the people in nursing homes, and given that there's quite a lot of consensus (other than the I'm-gonna-die-before-I-land-there crowd) that we should spend money to make it a better experience all 'round, I think we should, collectively, quit wondering about several otherwise inexplicable things in other times and places: (a) the Pyramids, (b) Stonehenge and (c) Buddhist Funerals in Japan. There are some other examples, closer to home, that would probably be a bit touchy to mention. We all engage in ancestor worship, one way or another. After a while, you don't need to understand why; you just need to recognize it in action.

ETA2: Looks like George is treating the comments section as an opportunity for some hooking up. *Highly* entertaining.

ETA3: Comment #30 by "Sere" indicates I am not alone in reading and enjoying this blog for somewhat unusual reasons (altho I do not share Sere's particular explanation). After noting she is not old, and is an orphan with no parents to worry about, Sere says:

"I read this blog for the strange pleasure of a rare thing: reading healthy people’s fantasies of death...Children wishes for their parents’ demise, and dreaming of a swift and easy death for themselves."

Sere isn't being sarcastic or mean (as near as I can tell), but utterly sincere and I really love that. I've been trying to figure out why _I'm_ so taken by this blog. Obviously, when people are telling a lot of details about a subject little spoken of but close to the heart, what's not to love? But I think it's more. I've always thought a lot about the future and a lot about death. My planning for the future (which coexisted, bizarrely, with long-standing suicidal ideation) has projected forward-from-now until fairly recently. But lately, I've been thinking a lot more in terms of go-to-the-end-and-work-backwards. I think it's because I've gone, in the last few years, from thinking in terms of, if stagflation happens, the money might run out to, hey, we're dealing with a really dodgy economic environment, I should pay a lot more attention to the consequences to my family. And I know from nothing, personally, about nursing homes, since my grandparents all died at home, one way or the other, and my other relatives who have died have not spent more than a few months in nursing care, if that.
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