Whenever I need to get some clarity in life, I have two choices: either visit a therapist or Canada in winter.
Not Vancouver, where I grew up. That's not really Canada-it's just a more polite, slightly less caffeinated Seattle. I'm talking about the real Canada. North. Way up north.
After getting hit in the face by a piece of flying firewood, a character in a Saul Bellow novel learns that truth comes in blows. But in Canada, truth comes in snows. And cold. And more snow. And greater cold. Until you have to go back inside before all that truth kills you.
Why do people live there, under such harsh conditions? Like so many of life's important questions, I've learned there is no answer. They just do. For no reason. Because they can. My wife's parents are perfect examples of otherwise rational folks who seem to take a perverse joy in daily survival on the frozen prairie. You'd think they'd tire of chipping the ice off their contact lenses every time they get the mail, but not so far.
Perhaps believing that time in the world's second largest walk-in freezer would focus my mind and be cheaper than hypnosis, I made a winter sojourn to the colder part of Canada recently. And though I did experience an epiphany there in the frozen north, it wasn't the kind I had hoped for. Instead, in the twilight of a sub-zero winter day, I was visited by the Ghost of My Long-Term Care Future-in the form of an elderly woman on one of those mobility scooters.
She was moving downhill on an icy city sidewalk at a speed that would have been unsafe in a car, much less on her glorified tricycle. No helmet. No goggles. Just a heavy thumb on the throttle, hair and scarf flapping behind like a crop duster pilot, sleet pelting her face, lips scowled tight against the wind. Although clearly frail, she was going where she was going, by herself, and a brutal Canadian winter wasn't going to stop her.
Talk about pure, bullheaded vitality. I've never seen anything quite like it. And I realized I was watching the kind of independent spirit that doesn't and won't fit well into some nursing homes' institutional models of care. Which in turn made me wonder, and this was the scary part, what the future's going to look like for people like me-or more important, for people who actually are me.
I'm no stranger to nursing homes. As an alleged semi-professional long-term care writer and video producer, I'm visiting them frequently. But while many are lovely establishments run by fantastic people, I can never quite imagine myself living there, even when I'll have to. They're just not designed for me and the bad habits, quirks, and foibles I've taken a lifetime to nurture.
For instance, insomnia. I'm cursed with it. Nothing wakes me up like going to bed, and I'm thinking it's unlikely that at age 89, I'll suddenly start sleeping well. So what will I do when I'm lying awake at night in my 36-inch-wide hospital bed in my semi-private room, listening to my roommate snore behind the curtain and caregivers chatter loudly in the hall? Where will I wander to eat a bowl of Frosted Flakes at 3 a.m.? And then where can I lie down on a couch with a quilt and finally fall back to sleep undisturbed watching T.J. Hooker or Walker, Texas Ranger reruns?
Talk about pure, bullheaded vitality. I've never seen anything quite like it. And I realized I was watching the kind of independent spirit that doesn't and won't fit well into some nursing homes' institutional models of care.
And what about my music? Where will I blast The Beatles and Radiohead at deafening decibels as I shuffle about my day? I've been listening to loud music all my life. Why would I want to stop just because I'm old, sick, and hurt a lot? If anything, as my pain increases, I'll probably want to switch to Metallica and turn the volume up to 11. I'm not sure that would be allowed in today's nursing home, as it might drown out the overhead paging system.
I'm heartened by an article I read recently in the New York Times about a facility that permitted an Alzheimer's patient to sleep and eat whenever she wanted, and consume unlimited chocolate. Now that's my definition of homelike, a place where dementia patients are essentially allowed to have anything that makes them comfortable, even including alcohol. “Whatever your vice is, we're your folks,” a facility employee is quoted as saying. That's music to my ears.
Previous generations have probably desired to preserve their fondly held imperfections and quirky daily routines as much as I do, but have tended to suffer loss in smoldering, dignified silence. But I'm a selfish, high-strung Boomer, perhaps the first generation who won't quietly accept having our beloved vices, self-destructive impulses, and time-honored rituals hijacked for the convenience of the system. We'll want to do what we want to do, when we want it, just because we can.
We may not be driving our scooters pell-mell down icy streets, but I promise we'll be wheeled through those nursing home doors with all our bad habits, impulses, and attitudes intact. And I pity the caregiver, administrator, owner, or politician who tries to change them.
So does my wife, by the way. LTL
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Gary Tetz is a legendary long-term care commentator based in Walla Walla, Washington. Long-Term Living 2011 March;60(3):20-21