Categorized | Columnists, In My Mind's I

The difficult decisions to make in old age

Posted on 07 September 2018 by admin

I recently received a difficult but thoughtful post from a dear old friend in Chicago. It poses the kind of important decision all of us must face from time to time; hers has come at the time of the approaching New Year.
When I say “dear,” I mean we have been friends for 62-plus years. When I say “old,” I mean on the cusp of 90. Now, she is in an assisted living facility in that same city, fighting kidney disease. In her case, the body is weak, but the mind is strong. Very strong. And that’s her dilemma for Rosh Hashanah.
Friend Bobbie has two daughters — one in Pennsylvania, the other quite close to her in Chicago. The nearby one has Parkinson’s. She would now like to relocate to be closer to her sister and three nieces in the same area; she has a good husband and one daughter (but she is away at college) and is anticipating need for support for herself as her disease progresses. She herself has been her mother’s primary support for a long, long time, and she wants to take her mother along with her.
Bobbie is nothing if not a realist. “I’m really not wanting to move,” she writes, “and they all know that. My friends are all gone now. My daughter and son-in-law are all the family I have here, and I’m not strong enough to live without them nearby…too many runs to the ER. And it’s a toss of the coin now when I will go into end-stage 5 kidney failure.”
Dialysis would be the only thing to keep Bobbie alive at this point, and she doesn’t know yet if that’s even a possibility — or if she would even want it if it is. In a few days, the vascular surgeon will determine if her veins are strong enough to handle a fistula — and that would take up to three months of healing before it’s ready for use. “They could make an entry into my stomach,” she writes. “Then I could do my own dialysis at home every evening. But it may mean there’s already too much calcification for anything to be done. If so, I’ll be gone within a month.”
Her mind is still 100 percent, which she now calls both a strength and a curse. She hasn’t even said she’d want dialysis, given the advanced gravity of her disease. “I have to educate myself more on the subject to make an informed decision,” she says. “On the positive side, I still have some time ahead of me. But I’m physically feeling my age, and I’m fighting a kind of depression: I’d like not to have to think about this all the time, but that’s impossible, since everything I do is a constant reminder…”
My old friend Bobbie has never been a quitter. She’s faced some very difficult life situations — a sad divorce; an addicted son she’s had to cut entirely out of her life to ensure her own peace and safety. This current dilemma shows she isn’t quitting now. She’d like to live, but she doesn’t yet know if there’s much time left for living, or if the strain of a major move might take the greater part or all of it. That’s her reality.
The one thing she has never mentioned is wanting to die. Some in her position might wish for death, might even think suicide. Not Bobbie. But “This live-or-die stuff is getting to me,” she says. “It’s as though the Sword of Damocles is hanging over my head…” Yet her sign-off tells me she’s getting ready to go to her living facility’s Labor Day party!
What’s the best response to a post like that? “Shanah Tovah” certainly can’t be right. But I’ll send her what support I can over the miles as she makes the (perhaps final) decision(s) of her life. So I ask: Please add my friend to your own prayer lists. Debbie Friedman’s prescient words, “for renewal of (body and) spirit,” invoke the only thing possible now.

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