A sadness close to grief, but approaching horror, pervades our thinking about nursing homes — they combine the anxious atmosphere of the hospital with something of the morbid finality that accompanies hospice. At least tombs are still. They’re conducive to meditation on the possibility of eternal peace. Nursing homes, in contrast, are troubled by a constant, mostly unarticulated foreboding in the air.
Forgive me for describing them as most of us, I think, perceive them to be, groaning waystations to the grave. They remind us of death by gathering the dying, whose demands on our conscience are more urgent than those of the already dead.
We Look Away
The pandemic has put an exclamation point on this widespread impression, of nursing homes shrouded in gloom and infected with misery. Not only have they taken a hard, disproportionate blow from the coronavirus. They’ve been shaken by a surge in death from causes in addition to Covid, as Charles Camosy explained in The Catholic Herald in November. How much do we care?
Even in the best of times, nursing-home residents are prone to suffer from neglect, a consequence of our instinct to look away from the bodily and mental deterioration that we recognize as leading indicators of natural death. Most people who move to a nursing home will die within a year.
Even in the best of times, nursing-home residents are prone to suffer from neglect, a consequence of our instinct to look away from the bodily and mental deterioration that we recognize as leading indicators of natural death. Most people who move to a nursing home will die within a year. No one goes to live there except under duress, typically of advancing senescence. The decline might be managed and mitigated. It will not, in this life, be forever reversed.
Both my father and my mother spent their last months in a Catholic nursing home. They died there within three weeks of each other. All the medical professionals who cared for them were competent in a textbook sense. But only some cared for them in the psychological sense of the word care.
Bless those who communicated respect without drama, and warmth without lapsing into baby talk. What they did was often a matter more of body language and tone of voice than of saying anything in particular. They practiced benevolence. It can’t be verified or quantified on an exam you take at a Prometric center.
The Girl Has Grown Aged
My heart sank when, walking down the street on the Upper West Side of Manhattan many years ago, I passed an ancient woman sitting outside a nursing home and beaming with tranquil joy as she stroked a doll. Briefly overcome by pity, I wondered then, as I wonder now, why the sight of her second childhood should fill me with emotions so different from those I would have felt if, at the other end of her lifespan, the toddler she once was had invited me to join her for a while in her magical kingdom where the distance between what you imagine and what is true shrinks almost to nothing.
We feel a certain shame for her. Only yesterday she dressed herself and went where she pleased. Now, again, as in her infancy, she stretches out her arms as her caretakers dress her and prepare her to be led wherever they decide.
What would have charmed me then discomfits me now that the girl has grown aged. We smile at the four-year-old denizen of Neverland, trusting that soon enough she’ll join us full-time in the “real world,” as those of us midway, more or less, between conception and death are so myopic to regard it. We frown when, not a century later, her lease here is about to expire and she begins to make the move in reverse.
Not in entire forgetfulness, but trailing clouds of glory did she come from God, who is her home. Wordsworth did not add, but could have, that the clouds that come rolling in to escort her on the return trip are much the same.
Our reaction isn’t. Her involvement with the other side as she babbles on her deathbed unsettles us, whereas we were delighted when she was a cute tyke and babbled mysteries we didn’t comprehend then either.
We feel a certain shame for her, the nursing-home resident with one foot in the grave and her head in the clouds. She’s lost control — of her faculties, we say, venting our chauvinism of the roughly middle-aged. She no longer exercises her will in her own interest. Only yesterday she dressed herself and went where she pleased. Now, again, as in her infancy, she stretches out her arms as her caretakers dress her and prepare her to be led wherever they decide.
Follow the Logic
We who have acquired and still retain the ability to navigate this physical world have a duty to protect the infirm elderly, as well as the unformed young, from bodily harm and dangers that could lead to their premature death. The ancient woman stroking her doll remains as human as she was as a charming toddler, as worthy of our care now that she is dying as she was when she had her life ahead of her. But we tend to forget that, especially when we see the aged in the groaning waystation to the grave.
Our emotional and economic incentives to care, in both senses of the word, for the beautiful child more than for the decrepit Alzheimer’s patient are obvious. We should care for them with equal effort and concern, but be ready with an answer for the skeptic who asks why.
It’s harder to make the case for elevating principle over sentiment and over expediency than we like to think. Let’s be clear that we start from the proposition that all human lives are of equal moral worth. We don’t consult public opinion or determine the value of an octogenarian’s last year of life in dollars or pounds.
This conviction leads us to affirm the dignity and humanity of the infant even when she’s still in the womb. Let’s follow our logic and advocate for her with the same resolve when she’s near-helpless again, at the other end of her life, in the somber rooms and hallways of her nursing home.
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