The Guest House (Excerpted)
This being human is a guest house.
Every morning a new arrival.
A joy, a depression, a meanness,
some momentary awareness comes
as an unexpected visitor.
Welcome and entertain them all!
Even if they are a crowd of sorrows…
still, treat each guest honorably.
He may be clearing you out
for some new delight.
The dark thought, the shame, the malice.
meet them at the door laughing and invite them in.
Be grateful for whatever comes…Jellaludin Rumi
Rumi’s words resound loudly for my contemporaries as we age and find it essential to manage both welcome and unwelcome circumstances. A June 23 Washington Post article by Melissa Bailey discusses some seniors entering their twilight years privately mulling “rational suicide.” She quotes Yeates Conwell, a psychiatrist specializing in geriatrics at the University of Rochester and a leading expert in elderly suicide. Dr. Conwell says, “The concern that I have at a social level is if we all agree that killing yourself is an acceptable, appropriate way to go, then there becomes a social norm around that, and it becomes easier to do, more common. That’s particularly dangerous with older adults because of widespread ageist attitudes. As a society, we have a responsibility to care for people as they age. Promoting rational suicide “creates the risk of a sense of obligation for older people to use that method rather than advocate for better care that addresses their concerns in other ways.”
A Kaiser Health News article(khn.org/news/suicide-seniors) in April found that older Americans — a few hundred per year, at least — are killing themselves while living in or transitioning to long-term care. “Many cases KHN reviewed involved depression or mental illness. What’s not clear is how many of these suicides involve clear-minded people exercising what Davis would call a rational choice. Suicide prevention experts contend that while it’s normal to think about death as we age, suicidal ideation is a sign that people need help. They argue that all suicides should be avoided by addressing mental health and helping seniors live a rich and fulfilling life.”
What would make living into advanced old age with a need for care and support an option more appealing than dying? With my mother’s recent death, I believe she chose death, not because of an existing misery but because she feared the misery she believed she would have to face. She created a narrative of doom and didn’t have the support and care necessary to overcome her fears. She feared death less than the realization of her imaginings. Why do so many elderly people say being hospitalized or living in a care facility or the very thought of leaving the home they love is a fate worse than death? Part of it is due to deeply held perceptions and biases that are not challenged or held up to scrutiny. I believe we will see a sea change of acceptance and even relishing of the opportunities we can plan for as we age that will make old age similar to any other age through which we live. Facilities, attitudes and understanding of skilled care need adjusting and our capacity to provide mental health services to those suffering from depression, anxiety, physical limitations and dementia require a significant upgrade.
Why do we insist on looking at the decline of old age as a horror? There are more stories of people living quite happily until they die than stories of being miserable every minute of every day of old age. What if I could dictate my desired circumstances in a variety of possible aging and dying scenarios? What if I could put in place a plan that would support these various circumstances and make sure that plan is realistic? What if we quit viewing it as a tragedy that we can no longer do all that we did in our prime?
Mary Pipher’s Women Rowing North, Navigating Life’s Currents and Flourishing as We Age is a book for these times and these very concerns. While she specifically interviews and learns from women of my generation, all she says pertains too, to men. She doesn’t waste time spinning genuine tragedy, loss, confusion, fear, physical and mental demise into a picnic on a summer’s day. She speaks realistically and respectfully about this time in our lives. There is so much here to ponder and to embrace I haven’t room to touch the surface in this column. The most important lesson I gleaned from Pipher’s research and the conclusions she reaches are reflected, I think, in these words. “All life stages present us with joys and miseries. Fate and circumstance influence which stage is the hardest for any given individual. But attitude and intentionality are the governors of the process. This journey can be redemptive if we find ways to learn and grow from the struggles this stage offers us. Just as adolescents must find the North Stars to guide them, so must we elders maintain clarity about who and how we want to be.”