Carol A. Hand
“Honour the Aged; in honouring them you honour life and wisdom” (Basil Johnston, 1976, p. 93)
I remember Clara. I was just a young teenager when we first met. At the time, I lived with my family on the upper floor of a three-story brick building, once a fancy upscale home in a small county seat in northwestern Pennsylvania. By the time my family moved there, it had been turned into a nursing home with 20 elders who needed varying degrees of 24 hour care. My mother purchased the business and assumed the role of administrator. (Thanks to the generosity of a wealthy resort owner on the Ojibwe reservation where my mother was born and raised, my mother was able to attend Loyola University and received her degree as a registered nurse.) I was twelve when we moved and not happy about leaving all of my friends in a more cosmopolitan setting with a far better educational system.
Spending time with elders was far more enjoyable than handing out with my new peers, so my mother gave me a “volunteer” job as a nurses’ aide. Clara arrived a short time later. She was a tall, thin, lovely woman with wavy silver hair. I can still remember her sitting in the rocking chair in the corner room that she shared with two other elders on the second floor, right below our upstairs apartment. Neither of her roommates was mobile or able to speak. Clara could speak, but she seemed to prefer to scream instead, nonstop, unless someone with a calming presence was with her. She taught me how to be that presence, how to use body language, facial expressions, and my voice to help her feel more at peace.
I don’t know much about her life before she moved to the nursing home. I was told that she had once been a gifted and beloved teacher. One winter day, she slipped on an icy sidewalk and the head injury she sustained left her as she was when we met, unable to care for herself or communicate with others. Although she couldn’t pay the full cost of her care, and Medicaid and Medicare didn’t yet exist, my mother agreed to give her a room at whatever price she could afford. There were no other humane options for someone with her level of needs.
Photo Credit: Antique Rocking Chair
As two outcasts, we found a sense of peace and belonging in each other’s company. The first thing I did when I got home from school many days was to stop by to visit Clara. When I appeared in her doorway, she would often be seated in her rocker, screaming. She would stop screaming as I said hello. Then she would smile and reach out her arms to welcome me. The worries and insults of my day would vanish as we sat together and I told her stories in my gentle lilting musical voice. She helped me discover that voice, that compassion, and that depth. It was her kind and accepting presence that helped me survive tumultuous teenage years. My grandmother’s often repeated messages that I was ugly, my father’s escalating physical and emotional abuse, my homogenous peers with whom I had little in common added to the angst of transformative years.
Spending time with Clara became my sanctuary. I was powerless to prevent her worsening physical health, and finally, my mother was forced to send her to a facility that could provide the level of care Clara needed. I realize now that don’t know how she fared in her new home, or if she lived long after her move. I do know her absence left me adrift for a while.
I hope she was treated with kindness and respect in her last moments. Yet, I have witnessed too many institutions where people have not been treated with kindness. It’s odd to realize how powerful the underlying belief has continued to be in the dominant Euro-American culture that people are only worthy of respect if they contribute something that is viewed as worthwhile from a narrow economic perspective. Self-reliance and the Protestant work ethic…
Many years after my peaceful days with Clara, I returned to the university to finish a social work degree that I hoped would enable me to develop state policies in partnership with elders – policies that were founded on the recognition of their dignity. Of course I encountered faculty examples of what I didn’t want to become when I grew up. “Older people are like children,” said one faculty member interrupting my class presentation. “I don’t know why you want to study elder abuse policy in this class. Older people are so useless and troublesome to deal with. Their abuse is understandable,” said another, interrupting yet another presentation. But I was fortunate to have other faculty who taught me important lessons about the plasticity of brain development and adaption, the wisdom factor, and ecosystems theory. I learned that we’re never too old to keep learning and contributing. And the challenges that make living independently difficult come largely from our socially constructed environment and institutions. When an elder who has lived in a two-story house for decades develops arthritis in her knees and can no longer climb stairs, her ability to live independently is threatened because of how we build houses, cabinets, and bathrooms. It’s because of where we locate stores and service agencies, how we provide (or fail to provide) affordable transportation, the proximity to family and informal support, and the income people have once they retire.
Photo Credit: Tools of the Trade (by Artist Caren Caraway)
Instead of building housing and communities that support aging in place, we force people to move to “handicapped accessible buildings,” often huge institutional looking structures. In smaller communities, homes like the one I spent my teenage years in are retrofitted as housing for older people. When I worked as the state aging network supervisor, one of the areas I focused on was housing. I took the time to travel the state with the state staff who licensed facilities that received state funding – “the good, the bad, and the ugly,” as the inspectors dubbed the wide variety of facilities we visited. I also had the opportunity to be part of a team of ten state professionals in a week-long program that applied a 50-category assessment tool to evaluate the degree to which social service agencies, like residential facilities for elders, were founded on the recognition of dignity. Imagine your first impression when the administrator of the participating facility greeted the team with the following introduction. “Let’s meet in the dining room for our orientation.” We all followed her lead. “The table is round, you see. Old people like to sit in circles. You know, the people here are all waiting to die. We do our best to keep them comfortable in the meantime.” Sometimes, I have the wisdom to be patient. I merely listened and observed. I knew there would be time to meet with the elders who lived there later, and time to talk privately with the rest of the team.
The experience turned out to be valuable, but heartbreaking. Elders from 60 to 95 were categorized as “waiting to die” – waiting with untreated injuries, hearing loss, and serious depression, sitting alone in their rooms. They clutched at my hands begging me to stay after we spoke, even though the rest of the team was waiting somewhat impatiently. The experience actually taught me about the many ways we fail to acknowledge dignity. I remember the many facilities I visited with names like “Shady Acres,” the long drive to the outskirts of town with a road sign signaling what we would find, DEAD END. As we entered facilities, we sometimes found elders who appeared to be overly medicated parked on couches and wheelchairs facing the blaring TV.
Photo Credit: Elder’s Building – Spring 2012
How I wish I could say that things have improved over the years since those days. I’m sad to say they have not. In my visits to friends in the apartment complex across the street, I am reminded of the many ways elders may be safely housed without being accorded respect or opportunities to share their wisdom of develop new skills. I voiced some of my observations in recent comments to an earlier post.
To Rowena at Beyond the Flow, I replied – Recently, I have been observing the many ways in which everyday actions that are based on lack of compassion affect people’s lives. Actions that may appear insignificant on the surface have profound consequences for the quality of life of many people through ripple effects. The elders’ apartment complex across the street is an example. Elders who love to garden are denied access to garden plots because those in charge of maintenance prefer easy-to-mow lawns. Denying this simple request has profound consequences on the health and well-being of residents on many levels. Many residents have accepted this limitation after voicing their desires repeatedly and simply adjusted their lives to give up something they love, something that feeds their spirits and brings beauty into the world. They could join together and become “guerilla gardeners.” I would welcome the chance to help them dig up the lawn at night and help them build gardens that are high enough to accommodate varying degrees of limited mobility. But that is their decision…
To Debra at My Land Restoration Project, my reply was – It’s so easy to cultivate fear and shame, to destroy confidence and hope, and so challenging to rekindle a sense of real possibilities. In fact, it’s how I met my neighbors across the street. When I moved to this neighborhood a little over three years ago, the yard was filled with piles of tree limbs and brush. I began the long process of bringing in soil and compost, and building gardens. It was difficult manual labor and I wondered if it made any difference at all to anyone else. Then, this past year, two of the women who live in the elder’s high rise stopped to talk when I was working in the front yard. Now we meet for monthly tea and share stories. Neither one is able to have one of the coveted garden plots in the small space allotted for residents, so they come and sit with me sometimes when I’m working, sharing stories about the gardens they’ve had and advising me on what to plant. One is eagerly waiting for the tulips and daffodils I planted this fall as she watched. (The garden is too low for someone who needs a cane to walk because of knee problems.) It’s a small thing, but it gives me hope and allows my neighbors to spend time in a place they see as a sanctuary. But ever a rebel who automatically wants to challenge oppression, I hope they choose to organize creative resistance and create a midnight garden by digging up the lawn. I can bring my shovel and do the heavy work to help…
My neighbors have raised children, survived abuse and many losses, and they’ve become adeptly ingenious at living on less than poverty incomes. I have learned so much from them and eagerly anticipate our monthly “Tea for Three” discussions. I wish more residents would join us, but my life is blessed by the presence of these two lovely women. I wish the administrators of the facility where they live would treat my friends and all of the residents with the respect they deserve – the “dignity of risk” and the “right to folly” – “respecting each individual’s autonomy and self-determination (or “dignity”) to make choices for himself or herself.” It was something my mother made possible for Clara as long as possible.
Photo Credit: Public Domain Pictures
Work Cited: Basil Johnston (1976) Ojibway Heritage. Lincoln, NE: University of Nebraska Press.
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