Wednesday, August 21, 2013

What Are Old People For?

"What Are Old People For?" is actually the title of a book, which in full reads: "What Are Old People For? How Elders Will Save the World" by William H. Thomas M.D. Dr. Bill Thomas is one of those people who could be referred to as Elder Heroes. Not that he is particularly old, but as a geriatrician himself, he is promoting a new way of revisioning old age, or perhaps a remembering of the possibilities of aging that we have culturally always known, but that have succumbed to our fast-paced dementia.

Dr. Thomas describes in terms of biology and evolution, that aging and elders, have made humans what they are, and culture possible. He promotes and advocates for a view of elder care which is radically different than the Long Term Care, what some have come to refer to as the "Nursing Home Industrial Complex" that has come to be. Here we have it, in our fast- paced- youth-obsessed-global society, we are obsessed with the new, the instant, the quick gratification, and spurn whatever takes time, or is slow, or requires long attention. The elderly are like a kind of illegal alien on the borders of our mainstream, that are segregated into nursing home ghettos, separated from nature, plant life, and animals, and all the diversity of the generations including childhood - like prisoners who don't belong and whom we don't want to see. Infirmity, the awareness of time passing, illness, and even death are to be banished in our society to somewhere out of sight and out of mind. Even in our political culture, while rarely referring to the elders themselves, the debate rages of how Medicaid is unsustainable, and behind this how the undeserving old are sapping the vitality of our nation.

Dr. Thomas' vision which appears new, but is actually age-old itself, is that elders deserve a different kind of re-spect (looking again,) and a caregiving different than society currently provides. In many traditional societies, the old have been revered. Particularly in Asia, and in those societies that practiced Ancestor worship, the edlerly were viewed and honored as being close to becoming the ancestors themselves, who were revered in death as lifetime guardians/protectors of the living. Even in Vietnam, a country torn by violence, north divided by south, when both sides often practiced involuntary inscription to the army, exemptions were allowed during that conflict for those who were at home caring for an elderly parent.

Mr. Thomas is not proposing going back or idealizing the past, but considering these outlooks to develop a manner of caring for the old that could only be relevant and possible for current times. He reviews the research that describes in evolutionary, biological terms, how the phenomenon of old age in the human species nurtured what we consider the best to be of human qualities, (such as curiosity, play, and kindness) and allowed for the development of such human societal attributes such as culture and civilization. The special link between the very young and the very old, and the nurturing that takes place between them is something unique among the species. The phenomenon of human longevity made possible a kind of nurturing not possible in the same way to other creatures. Grandparents and particularly grandmothers, having a special role, freed from the competitiveness and responsibilities of adulthood, are able to transmit a caring and a kind of attention to the young, that adults caught in the struggle to survive and prosper are unable to do. From the sheer perspective of time spent, the availability of grandparents as a branch of the family, allowed many other human pursuits, which were not possible in the strict pursuit and business of staying alive. Grandmothers in particular on the most concrete level supported the family by providing food and nurture to the very young.

Most animals don't have an old age, life is short, and our longevity has been made possible by some qualities that other species may share, but have been allowed to develop in us, in distinctly human ways. Others before Mr. Thomas have recognized this, the mythologist Joseph Campbell used to write how the old were the storytellers, the initiators, and transmitter of wisdom to the young. A psychologist Erick Erickson developed the idea of "generativity", as both a quality and as task applicable to adulthood and older adulthood. By fostering a sense of meaning though nurturing cultivating and honoring the young and culture, adults and elders promote the feeling "that it is worth it," that life is worth living, and pass it on, to other generations to come.

Dr. Thomas describes animal studies in which a behavior called "gentling" provides insight into evolution and the significance of aging for humans. Research has shown that infants and young that are handled by older individuals or grandparents are given a kind of tenderness and attention that is qualitatively different than can be provided by the adults. They are "gentled" and the studies have shown that individuals who are given this care prove to be better adapted, more flexible, and less prone to reactiveness and aggression than other animals. This kind of caregiving which has developed in a distinctly human manner, creates many other possibilities.

It is ironic that the stage of life which in many ways has contributed to distinct institution of human caring, creates and even demands such an opportunity for caregiving in its own right. But perhaps this is only fitting and part of the natural cycle. What Dr. Thomas offers is that what we provide now to the elderly falls so far short, that we are harming ourselves, and society. Segregated into Nursing Homes, which are environments that embody some of the worst aspect of our culture - busyness, isolation, depersonalization, lack of privacy, vacuity, and the incessant loud droning of roomfuls of televisions. Dr. Thomas calls himself a nursing home abolitionist, and is in the process of creating and advocating for care-giving institutions, such his "The Green House Project" that offer a radical alternative. He believes that elders should be honored and cared for in a way that views old age as another stage of life where growth is possible rather than a development to be despised.

That the old have both fostered and evoke a specific compassion in humanity is a quality that has been observed as among the most distinct and valued human achievements. Compassion in the Buddhist outlook is a prerequisite and very close to the attainment of enlightenment. The Dalai Lama speaks of a Tibetan meditation to foster compassion in which you would imagine that every person whom you encounter had been your mother in another life, who provided endless hours of nurturing and support for you when you were small and vulnerable and helpless. Perhaps with Dr. Thomas' insight we can extend this metaphor to imagine that every person has been your grandmother! As our elders reach the end of life, the observation of Dr. Elizabeth Kubler Ross on palliative care also seems pertinent. Working with many families supporting elderly parents through hospice, she often would advise, that the work was a great gift, an opportunity to give back to parents all the caregiving that had been bestowed on us as children, when we likewise were helpless and vulnerable.

Dr. Thomas in his book retells a parable from the Hasidic tradition which is both humorous and and worth pondering. There was an old man who lived in a house with his adult son, who had survived to very old age, and was very successful and prosperous. Throughout the house, in many places, he had hidden many bundles of gold. One day the son became concerned that his father was finally losing it. He was observed to carry a sack of the gold to the river, and to dump the contents into the dark swirling depths. Days went by, and day after day the son witnessed the father perform the same ritual, a walk to the river, and a toss of a sack of riches, sinking to the bottom. Concerned that the old man was crazy, and wasting his inheritance, the son went to the rabbi for support and advice. After describing to him the situation, the Rabbi pondered for a moment and asked: "Those sacks of gold must be very heavy for an old man, Yes? " and added:

"You are going to have to help him carry them."

1 comment:

  1. This is an interesting article. I personally think senior citizens should be taken care of more. There should be more assisted living situations for cheaper prices. My sister and I decided to look at NJ senior care when our parents got to the age and were so happy we did. They had a lot of great services that fit our parents perfect. They get help with the things they need.