We age according to two hourglasses. One is biological, shaped by bodily boundaries subject to laws of physiology and pathology. The other is personal, existential and pious.
Here, the sand of what matters can undergo seismic shifts. Here, we wrestle to find our spot in the universe, our Place. Note the Buddhist term for "suffering" — dukkha — literally meaning "dislocation," a sense of being without or in the wrong place. Ultimately, suffering comes from displacement. In our society of scattered families and rushed lives, displacement is aging's scourge.
Our two hourglasses co-exist in natural tension, affecting each other. Destined for biological bankruptcy, we also weave through what Abraham Heschel calls that "dark and intricate maze we call the inner life ... frequently defying pattern, rule and form."
Now for our silent tragedy. When it comes especially to caring for our elders, we overlook this second hourglass. We focus on the pathology, the problem, of aging and ignore its mystery.
Let us suppose that grandma is afflicted with congestive heart failure, or any of the chronic disabilities that generally wreak havoc on elders, like cancer, osteoporosis, diabetes, glaucoma, hypertension and obesity. Medicine may treat these conditions, but fails dismally in managing them.
While our health system addresses medical complications, non-medical implications from chronic disabilities intensely impact quality of life. And here's the heartbreak. Elders' quality of life profoundly entails feeling genuinely connected, especially with family.
Grandma may have once been "young-old," enjoying new-found freedom, energy and independence. Now, frail and increasingly dependent on others for care, Grandma has joined the ranks of the "old-old," a distinction coined by the late University of Chicago psychologist Bernice Neugarten. The old-old, facing terminal loneliness, need connection more than ever.
Grandma is not alone. By the end of today, nearly 10,000 Americans will celebrate their 65th birthday; 70 million (20 percent of our population) will be over 65; and 8.5 million over 85 by 2030. Inadequate resources to manage chronic illness, severe nursing shortages, the majority of health professionals lacking gerontology training, ongoing government fiscal squeezes, deep cultural bias against elders, more families spreading out across the map. With competing expenses to raise kids, there are less family caregivers.
And what about Grandma's second hourglass? How will we connect with her? Is Skyping the best we can do?
True connectedness requires regular face-to-face, physical contact, for which there is no substitute. Skyping Grandma is a nice and easy way to stay "in touch." But it's at arm's length.
There are better ways. Physical touch reaches into our depths. Do we not call our emotions "feelings"? Touch grips our sense of self. There's abundant evidence that touched, caressed infants grow more emotionally healthy than those deprived of touch. The hand that caresses, the kiss that warms, the hug that reassures are lifelines to the heart.
We are not merely biologies, but biographies, narratives through which we seek purpose. Annie Dillard reminds us, "There is no shortage of good days. It is good lives that are hard to come by." Yet, without a philosophy of life that connects our hourglasses, we assign no moral, cosmic, or spiritual meaning to entering the Kingdom of the Old.
Can we carve out a fresh, rich meaning and purpose for aging? We leave this pilgrimage with what we've given of ourselves. We depart etching our indelible imprint on those we've touched.
— Dedicated to the caregivers at St. Mary's Healthcare in Amsterdam.
Brannigan is the Pfaff Endowed Chair in Ethics and Moral Values at The College of Saint Rose. His email address is michael.brannigan@strose.edu.