The Unfortunate Segment of Our Aging Population
Every time I passed this woman sitting in her wheelchair outside of
her room, she gave me a very odd, piercing look that seemed to reek
of hatred. It briefly stressed me out just to see her. She was one of
many wheelchair-bound residents of a combination
nursing/palliative/hospice care facility that I was visiting on a regular
basis for personal reasons.
Visiting this facility was an almost daily (sometimes multiple times
per day) occurrence for me over a period of two weeks. I came to a
point where I tried to avoid looking at and interacting with anyone
other than the person I was visiting and the facility’s caregivers. On
any typical day, the mostly head-hanging, wheelchair-bound
residents were strewn all over the hallways and elsewhere in the
building and outside spread out across the fenced-in patio, seemingly
waiting to die. Hardly any of them even talked to each other.
Some were terminally ill. Some had all of their mental awareness and
intelligence intact. Some were unable to talk. Some had Alzheimer’s
or various levels of dementia. In general, this facility was a
microcosm of that very unfortunate segment of our aging population
who could no longer live independently and had no other options
I frequently saw a good number of residents who desperately tried to
maneuver their wheel chairs with tiny shuffle steps instead of waiting
for some assistance, which often came very late because of a small
staff incapable of helping everyone in a timely manner. Most,
however, were very much like statues, not talking, not moving.
Seeing them always jarred me into an uncomfortable reality.
It could happen to anyone. According to selected long-term care
statistics posted on the non-profit Family Caregiver Alliance website:
In 2012, there were 1.4 million people in nursing homes
Sixty-nine percent of people age 65 or older will develop
disabilities before they die, and 35% will eventually enter a
“I hope I never wind up like this,” I kept saying to myself – in one of
these facilities, my body pumped with pain-relieving, stupefying,
constipating opioid medication. Seeing this close up and personal
has dramatically changed my views about death and dying. I guess it
was long overdue to witness this kind of thing. I have been fortunate
over the course of my life thus far to be able to selfishly avoid ever
having to visit a nursing home or hospice care center.
I say “selfishly” because with this experience came a sense of guilt:
Perhaps simply as a human being I should be doing something,
anything, to help such poor souls, at least on occasion. All the
healthcare workers and volunteers who are deeply involved in this
kind of environment on a frequent basis are surely more generous
and caring fellow human beings than I.
An elderly woman (they are all elderly) politely asked me a question
as I excused myself while being forced to walk directly in front of her
wheelchair stationed in the center of the hallway. They are out there
in the open so the nurses can keep a close eye on them. These are the
residents who have extenuating circumstances that may cause them
to do things that could cause harm to themselves and/or others. They
are all clearly in view. Everything is pretty much clearly in view.
Everyone’s room is open for any passer-by to peer into unobstructed.
Privacy takes a back seat to expediency and full openness.
“What’s going on? When does it start? the woman in the hallway asks
“I don’t know, ma’am. I don’t work here,” I respond.
“Well what’s that man doing down there at the end of hall?” she
“Looks like he is simply looking out the window, ma’am.”
“Well, where is the art show? I saw a sign that said there is an art
“Sorry, ma’am. I don’t know. I don’t work here, and I wasn’t aware of
any art show today.”
She turns to one of her cohorts who just wheeled up and asks her the
“Leave me alone. I’m not interested,” the cohort says.
“I’m sorry, ma’am,” I repeat. She avoids me completely and I go on my
For an excellent, first-hand, and detailed depiction of these types of
facilities, see “Nasty, Brutish, and Long: Adventures in Eldercare,” by
Ira Rosofsky, a psychiatrist who traveled around to nursing homes
[mostly in Connecticut) and talked to “sad, confused, and occasionally
happy old people.”
“Everyone dies,” Rosofsky writes early on. “When you can’t go home
and are permanently in the nursing home, they ironically call it long-
term care. Most long-term-care residents last two or three years.
Long-term care means you are on the banks of the River Styx waiting
for the ferryman, or maybe you’re already on the ferry. At least that’s
what’s on the mind of those who still have one.”
River Styx, in case you did not know, is the moving body of water
between Earth and Hell, according to Greek mythology.
Another informative read comes from Al-Jen Poo, author of “The Age
of Dignity: Preparing for the Elder Boom in a Changing America.”
There’s plenty of disturbing details in Poo’s book. For starters, she
calls the rapidly growing institutionalization of elder citizens, due
primarily to the longevity revolution, “undignified and unhealthy.”
She writes that “a fundamental problem with our current health care
system is that its measure of success is the delay of death, rather
than the quality of life. Living with dignity, feeling comfortable, and
having self-determined, steadfast loving care until the end should be
our goals for health care for our elders.”
The other very big related problem is that “the need for professional
caregivers is skyrocketing.”
Poo calls for “a new society-wide caring infrastructure [that] will
enable us to minimize our reliance on the old and often
dehumanizing institutional model,” and rely more on home-based
health care provided by better-paid and better-trained caregivers.
Poo outlines the great amount of work that needs to be initiated and
developed in the very near future. But the sad truth is what she calls
for seems next to impossible.
means you are on
the banks of the
River Styx waiting
for the ferryman,
or maybe you’re
already on the
- Ira Rosofsky