Dying by pieces

How can we face a long decline?

Death isn’t polite conversation, but neither are the ravages of aging - dementia or immobility or pain. These are the deaths before we die.

We can talk about these happening to others, we can talk academically or antiseptically, but our minds cannot imagine ourselves in such bodies. If we can, it’s in terms of access to care - be it insurance or children or institutions.

So let’s talk about it

I’ve written before about intimations of such ravages of aging - here and here.

Yesterday someone asked me, “… but what’s your plan, not for aging but for being old and needing care?” So here are the ingredients of my plan, partially baked.

Insurance

I didn’t buy long term care insurance. I said it was because I thought insurance companies might fail before I do. Instead, I became a squirrel-er. My savings are in my house, with 2 ground floor rentals, and in a rental house nearby. These are assets that bring in current income and can be sold or borrowed against if I need to pay for care. My savings are also in a large garden and a big cistern to store water from the roof.

I have a feral part of my psyche that doesn’t trust man-made systems and would, were I an animal, gnaw my leg off if stuck in a trap. I won’t list everything this part of me has had me do - but skills and practical tools, a packed to the gills van and a keen mind are part of my insurance. What if you lose your mind, Vicki? I simply do not know. On to item two.

Tenants

When/if needed, I intend to trade for care the two studio apartments on the ground floor of my house. For now I have great tenants from whom I expect nothing but rent. When I need tangible help with yard work and some cleaning, I’ll start the trading system. Then shopping and cooking. Then helping me up each day and getting me into a chair in front of my huge picture window overlooking the mountains and water. Or maybe I’ll rent one to another person in need and we split the cost of care. Or my house becomes a Golden Girls house.

Neighbors

No, I don’t expect the people in my subdivision to turn themselves into caregivers for me. Especially because I live in a NORC, a naturally occurring retirement community and there’s a possibility that many of us will need care at the same time. What will I do then? I hope we have built strong enough relationships to at least bring by hot dishes or do some light maintenance.

We have several home-grown organizations designed to help older people age in place i.e. in their homes. South Whidbey at Home and Hearts and Hammers. Good Cheer provides food for whoever needs it (and a thrift store where I’ve gotten my whole wardrobe). So far, the cycles of life are working in that people who were volunteers are now being served. There are agencies. I’m on the Board of one of the biggest one, Island Senior Resources. We serve the whole county with meals on wheels, a medical equipment lending library, rides to appointments, many fun and useful programs, and a rich “switchboard” hub that helps people navigate how and where to fill their needs.

I know some have formed mutual aid circles, but I’m not in one of those. I could form one using this homegrown resource by Cynthia Trenshaw. I also know that churches do a lot to care for their elderly, but my Sunday morning church is called Prayerbody - 50 or so beautiful dancers, with live musicians.

Unbelievable that the Trump administration has not reauthorized the money that pays for meals on wheels! I think we are a tight enough community to fill in the gaps, but he is taking food from the mouths of the elderly and disabled. And putting it into military equipment - a military on the verge of turning on our citizens. OK, that’s an aside but it must be said. And it’s relevant in that no one can plan for aging in a dying empire that seems like it may pass through violence before it fully breaks apart.

Another aside: The current administration is making it harder to hang together as things fall apart. To our credit, and I think other rural communities would say this as well, we aren’t taking the threats to funding lying down. Mutual aid is in the bones of communities that have had to survive together, our island being one of them. The Board of ISR is treating the de-funding as a creative opportunity for civic revival. The parts and pieces of thriving together are here, from land to people to institutions or governance. Some day ask me about all the cockamamie ideas I’ve had for mutual aid in collapse. We had a dress rehearsal fifteen years ago with Transition Whidbey.

Friends

Blessedly, a couple I’ve loved since they first stepped on the Island has decided to include me in their circle of elder care. That doesn’t mean diaper changing but it does mean they will manage the systems of care and maintenance of my material world. It’s reciprocity. I’ve helped them with their farms.

Family

My brother and sister are both older and my sister is already in a nursing home. My brother has a large family, but I don’t assume they will be involved with any decrepitude that befalls me. I love them, but they have busy lives far far away.

Care Facilities

Insurance will not cover costs if I need to go into a care facility, perish the thought. But I hope I can liquidate my assets to pay for care. We have several long term care facilities on the island. I hear they aren’t bad once you realize that you - yes you - need to live there. We have a decent rural hospital that hasn’t been bought up by United HealthCare or some equally sleazeball corporation - yet. Our local drug store bit the dust and so we’re stuck with Rite Aid that is going under. All that said, I intend to do my best to die at home here in my community.

Mexico and beyond

I know people who are moving to countries where you can be in a home with meals and care for a tenth of what it costs here; so little that their social security can cover it. I know someone who went there to die and ended up falling in love with his caregiver, what a happy ending.

Dying before any of this becomes an issue

People in my family have died of heart disease. That seems a lovely way to go. I used to say I want to die in my boots, mid-stride, but now I’m less florid. I do hope to be engaged in some small ways in daily life, and then a few days or weeks of decline and off I go. A women in my local circles did just that a few weeks ago.

Yet the women in my mother’s family have lived into their 90s before their hearts fail. They’ve been upright and able, but still, care might become an issue, so I’m not sanguine.

Every loss a liberation

It takes fortitude to sail into the “no go zone” of direct headwinds. You have to tack, catch the wind at an angle, to move forward. And then tack again. The pace of friends passing has accelerated. Each little personal death - of expectations or relationships or capacity - along this way gives us fortitude to face the final death squarely as it comes near. At least, I hope that the inner work of coming of aging will serve me in end. TBD.

Surrender

I don’t know what even today might hold or me. I don’t know who or what will leave my community before I do. Even with good friends all around now, I don’t know if I’ll die among strangers - or alone.

There’s an old teaching story.

A river was rising and water poured into the streets. When it rose up to preacher’s veranda, a man in a rowboat comes by and says, ‘Get in, preacher, the flood is coming.” The preacher said, “No, son, God will save me.” Then the water rose higher. The preacher was now by his second floor window, looking serene. A parishioner came by with a motor boat. “Hop in preacher.” “No, no, God will save me.” Then the water was up to the roof line. The preacher stood up at the peak. A helicopter comes by, a ladder drops down and they shout, “Preacher, grab on, climb!” The preacher says, “No God will save me.” Well, of course, the preacher drowns and when he gets to heaven he complains to God, “I was faithful and you let me drown” to which God says, “I sent you two boats and a helicopter.”

Our carefully wrought plans for deep old age are useful but we can’t control the future, especially with the head winds of systems in greater chaos. We can, however, notice all the boats and helicopters that come our way, and hop on board. We can trust in allah… and tie up our camel, as The Prophet taught. Prepare, and let go.

Surrender is the greatest teaching. We do what we can, and then trust in God/Life/Allah - not to save us but to put everything we need in our path, even the hard stuff, to grow wiser as we grow older and face the end with equanimity. We hope.