Bay Alarm Medical
Sonya Mann

Watching The Second-To-Last Transition

Topic(s) : Caregiver Support, Caring for Parents, Family Caregivers, Grandparenting, Grief and bereavement, Seniors

“How do the trees know what to do?” My grandfather was staring out the window, surveying the woods behind his house. We sat at the breakfast table together. I was drinking coffee and reading; he was contemplating the forest. I put down my phone and looked where he was looking.

sunlit trees in the Virginia forest

The trees waved their masses of new green leaves, some still wet from last night’s torrential rain. Yellow sunlight reached through the branches. My grandparents’ house is located in an upscale part of Virginia, near Washington DC, but the backyard feels like true wilderness instead of affluent suburbia.

“All at the same time,” Grandpa added. He meant that the trees had sprouted their spring foliage simultaneously. We regarded the view together, and Grandpa made soft comments about how many spindly saplings there were versus the few stout century-old trees. We watched the forest silently for a moment.

“I’m turning eighty-five in November,” Grandpa mentioned.

“How do you feel about that?”

Well, he said, he didn’t feel like he was expiring quite yet (although he’s slowed down significantly in the past five years). “I’ve had four instances where I almost died.” Grandpa continued to gaze at the woods.

young buck with antlers

Outside among the trees I saw a deer delicately navigating the tangled forest floor. The animal was a tawny young buck. He was grazing intermittently, cropping mouthfuls of brush, but to my human eyes the deer seemed unfocused, aimless. I didn’t point him out to my grandfather—it seemed wrong to disrupt our quietude.

I don’t know if Grandpa noticed the deer; his eyes may have weakened along with everything else.

The reality of aging involves loss of abilities, both physical and mental. Not everyone undergoes these losses, and certainly not at the same rate, but even people who stay holistically capable until reaching their nineties or hundreds must die eventually.

Death, whether it approaches slowly or arrives all at once, is utterly human. So of course it is uncomfortable and painful! Discomfort and pain are integral to the human experience. Those sensations are not good, and probably not neutral—suffering is arguably bad—but they are unavoidable. I find myself turning to a tautology: it is what it is.

When I visited my grandfather it was obvious that his old age had accelerated. I didn’t feel I could mention it to him, but I discussed it with my parents and a little bit with my grandmother. We all love him, and we all want to ease his transition, but none of us said a thing about it to Grandpa, even though he is still smart and aware.

In fact, he isn’t reluctant to bring up the fact of his waning vitality. For everyone else, broaching the subject of a person’s demise is most difficult when you are talking to that person. And yet those conversations are necessary.

Experts maintain that avoiding the topics of old age and death will harm everyone. In his book Being Mortal, surgeon and author Atul Gawande chronicles American old age both culturally and personally, dwelling on the deaths of many citizens but especially his own father.

Gawande’s analysis-cum-memoir overviews end-of-life care and decision-making in our medical system. He advocates for frankness and early evaluation of familial priorities. What does everyone want? What does the dying person care about most—longer life, less pain, last goodbyes?

Roz Chast's Can't We Talk About Something More Pleasant

Others have addressed the same topic with even more of a personal focus. Acclaimed cartoonist Roz Chast, who has contributed to The New Yorker since the late 1970s, wrote a memoir called Can’t We Talk About Something More Pleasant? The book straightforwardly describes the process of her parents getting old and dying.

Throughout the story Chast is honest, describing the profound irritation and tenderness that are unavoidable emotions when caring for elderly parents. They are anxious; she is anxious. Together, parents and child deal with medical travails and money travails. The whole saga is rendered in Chast’s sketchy style, pen lines and scribbled colors conveying the uncertainty of life’s outlines.

I wish there were an easy fix, a big red button that I could push to eliminate the need for awkward discussions and hard truths. But, as I have already stated, the reality is that death happens. It doesn’t always come rapidly or painlessly—these days it seems like death usually manifests as hospital visits more traumatic than the last and increasingly agonizing months of recovery. We all have to cope with it.

My grandpa’s physical ailments came first, including some scary falls. Now he struggles to stand, walks slowly, and tires quickly. I was shocked by the less-gradual mental changes.

grandpa 11-23-04

My grandfather remains an intelligent man, happy to crack jokes and voice opinions, but he has become anxious.

When we went sightseeing, he worried about how we would get to places and where we would park. On one car trip he asked my grandma several times if there was enough gas in the tank, until she snapped at him. I sympathize with her irritation, but at the same time, I don’t think Grandpa can help it. The world around him has become unmanageable. He must move carefully, which makes fast-paced and unpredictable surroundings difficult.

Sometimes Grandpa has trouble remembering the word he needs to complete a sentence, which bothers him very much. We were sitting in his den, Grandpa in his brown leather recliner, tapping his fingers on the side table, and he told me, “Don’t ever get old, honey.”

I looked up from my laptop, laughed, and answered, “I’ll do my best!”

But of course I will get old, just as he has gotten old. That’s how it works. I can only hope that by then I will have figured out how to talk about it with my loved ones and I especially hope that society will be ready to embrace the last phases of life and the older citizens living them.

Photos by Dejan H, Ashwin Kumar, and Roz Chast/The New Yorker.


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Rethinking Old Age For The New Century

36 Life Hacks for Aging in Place

How To Care For Parents Despite Geographic Distance


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