What do we do with the old folks?

This piece was published on June 8, 1999 in the Chicago Tribune and in a small local paper, the Elkhart Truth. Later that year the National Examiner (yes, the tabloid) referred to it under the inch-and-a-half headline: "Gray Rage!" in their September 19, 2000 issue. Their title was taken from the phrase that appears below. The News-Herald, a paper based in Cleveland, Ohio also drew from this piece in a more serious treatment of the issue on the front page of their November 26, 2000 Sunday edition. But, like the Enquirer, they couldn't resist using the same bullet in their headline, also in huge, bold font...

Georgette Smith died last week. She was paralyzed from the neck down, unable to breath without mechanical assistance, to move, feed or care for herself in any way. Completely dependent, but alert and competent, she decided to stop the medical support that was keeping her alive, and died less than one hour after her breathing machine was disconnected. One can’t help but note the sad irony in the circumstances surrounding Georgette’s disability. Last March, she was shot in the neck by her mother, Shirley, who was nearly-blind, chronically ill and irate over the prospect of being sent off to a nursing home by her family. With little hesitation, Georgette decided against the dependent, institutionalized life she had wanted for her mother. And in her ardent desire to avoid the restrictions of life in a nursing home, the mother is now facing jail time, confinement of a far different sort.

Shirley could be the poster child for almost 3 million people in the US today: the disabled elderly, dependent on a range of social services, confined to long-term care facilities, and often lacking the companionship and affection of their families. Don’t get me wrong. Sweeping generalizations in these matters are always inappropriate, and there can be objective circumstances that compel the most conscientious son or daughter to choose extended care for their parent. Nursing home placement is almost always a wrenching decision for all involved, and it’s not difficult to acknowledge the gray rage experienced by some institutionalized elderly over their lost independence.

The fact is however, that some old folks can be a handful: forgetful, wheezy, distracted, stiff, slow, cranky. Not very attractive traits in a culture that values youthful vitality, witty one-upsmanship and chummy smiles as the paradigm of human virtue. At times, our culture seems to lack sympathy for those who suffer. They are "in the way", not part of the way. We need to recognize that people like Shirley have their own unique contribution to make to family life, not just by transmitting traditions and life experiences to our children, but by helping them become more sensitive to the needs of the weak and those who suffer. This "role", if you will, of the elderly and disabled in the family is valuable because it effectively teaches children how to be human, to be generous with their time and talents, to never be indifferent to the needs and frailties of others. So it is that, with their quirkiness and infirmity, warts and all, Shirley and those like her can help civilize a society that each day seems less and less human.

What about Georgette? Could anyone find fault with her decision to let go? Advocates for the disabled, quadriplegics among them, on hearing that she was appealing to the courts for termination of life support encouraged her to go slow, to wait before making an irrevocable decision. They chose life -- clearly a most challenging, difficult life -- and invited Georgette to do the same. They cited a large body of scientific literature -- and undoubtedly a lot of hard personal experience -- showing that, while many patients with spinal cord injury initially feel overwhelmed by their abrupt, severe, usually permanent limitations, the majority recover their sense of purpose and go on to live a full life accompanied by family, friends and all manner of sophisticated gadgetry designed for their independence and productivity. They encouraged her to hope, to see that every problem has a solution, not the other way around. A courageous attitude to say the least, and one that does not escape the criticism of some in our society who can’t understand that happiness is elusive without sacrifice.
In time, doctors and scientists, working with the disabled and elderly, may solve many of the difficult problems they and their families face.

For now, the Shirleys and Georgettes of this world should know that their presence in our society is valuable and esteemed. And since this family calamity is now a part of the public forum, like dirty laundry hung out to dry, we should in justice recognize that some good has come of it all. Shirley expressed her deep remorse for her actions, and Georgette publicly forgave her mother before she died. In this they can both find some consolation.

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