THE CHECKLIST

by Liz David

Here I go again, bringing up stuff that makes us uncomfortable.  Let’s face it.  We may not be thinking about “end of life” issues, consciously, all the time.  But don’t tell me the topic is not just below the surface, nagging at us when we least expect it. Believe me, I don’t think about these issues all the time even though, over many years, I’ve taught courses on “aging with meaning.”

They say we teach what we need to learn.  And I’m still learning!  Is it possible to get dying right?  What is right anyway? How will we know when the time comes?

Like the Boy Scouts motto “Be Prepared,” I offer a checklist that’s meant to, at least, possibly, maybe, give us some peace of mind regarding ways we can be prepared, knowing full well that it’s impossible to be fully prepared in the moment.

                    CHECKLIST FOR CREATING PEACE OF MIND                                     FOR HEALTH, LEGAL DIRECTIVES, AND END OF LIFE ISSUES IN NO PARTICULAR ORDER

Personal Preferences:  Where would you like to be during your last moments, days, or months? Whom would you like to be present? A comforting presence.  Whom would you like to care for you? What would you like your surroundings to look like? 

What music would you like played as you are dying? What poems, prayers, writings or texts would you like recited?  What food can you imagine eating?  Your favorite?  What scents would you like to smell? What objects would you like to have nearby to touch?  What would you like your last moments to be like?

Practical Tasks:  Do you have a living will, health care proxy?  Do you have a will for possessions, investments, income?  Where is your will located? Who has copies?  My insurance policies are located? If you have a safe deposit box, where is it? where are the keys?  Who is authorized to access it?  Have you discussed funeral arrangements?  And if so, with whom?  Do you wish to be buried or cremated? Any particular funeral parlor? Clergy?  Who will make arrangements, and have they agreed? Who will arrange Kaddish/Mass or other prayer service?  Who will take care of my unfinished business whether legal or otherwise?

Anything else?  Brainstorm your own questions about your individual preferences…

So there you have it!  If you haven’t already, create your own personal checklist.   What are you waiting for?

One thing is for sure–we don’t get out of this life alive!

Offered with love,

Liz

Years ago, when we were in our 40’s, my husband and I bought a sundial with the saying “grow old along with me–the best is yet to be.”  I’m not sure whether or not I believed it then, and I’m wondering whether I believe it now. Stay tuned!

     A GREAT UNEASE — CROWDS

By Eleanor Jaffe

I grew up in Brooklyn, so you’d think that I’d be totally comfortable with crowds of people.  After all, our apartment was crowded as were the schools I attended, likewise the streets—especially the shopping streets, and certainly the subways.  When we celebrated, it was to go into Manhattan  (crowded),  to attend Radio City Music Hall (huge and crowded), the circus  (a mob), shopping (cutthroat with crowds vying for bargains.)  Almost always, I’d have to wait my turn, wait for the long lines to slowly dwindle, and be prepared to be jostled or poked by people in the City, all kinds of people.

Now I live in the heart of Boston, the Marathon heart of Boston. Every year, from my living room window, one week ahead of the Marathon, city workers construct a small city of tents in Copley Square to accommodate the runners as well as the supports and services they require when they finish their 26 mile ordeals.  Soon after, the stadium seats on Boylston Street along the Boston Public Library are erected, and the metal barriers are put in place along the gutters.  Huge trailers park on the side streets.   Enormous television cameras are hung from corner buildings so that crowds of people—as many as 8-12-24 people deep— can  visualize the runners on television because  they can not possibly see the runners through the density of spectators.  Indeed, I recall not being able to walk at all on Exeter Street  on my way to Boylston Street to join the cheering spectators.

By Friday at the latest, thousands of tourists and runners have invaded Boston.  Every hotel room is full.  Crowd controlling barriers keep people in or out of these few blocks.  Mounted police patrol while police cars and, later, ambulances park all around.  Hawkers will soon be selling t-shirts, pennants, and souvenirs.  I may have to present identification to show the police that I do indeed live in “that building,” so please let me pass beyond the barricade.  Of course, all day and well into the evening on Marathon Monday, we are not  permitted to drive our car in or out of our garage or, for that matter, drive for at least one mile in any direction.  Although I live on the second floor, when I look down from my window overlooking Copley Square, I can relate to a princess isolated in her tower.  I cannot leave.  No one can enter.

All this before the Marathon Bombers cursed us with their explosives.  Now, my aversion to crowds is complete.  Not only do the crowds seem to suffocate me, but they may also be dangerous.  Someone among those thousands of spectators. might very well have malicious intent.  Someone might cause mayhem.  Some others might even die — which is not what those spectators bargained for.

Which is why, now, I leave Boston before Marathon Monday,  Patriots’ Day, a day designed for citizens to celebrate and come together.  But not with me…  Somehow, over the years, my comfort with crowds has dwindled and disappeared.  My urge to celebrate and shout encouragement is gone.  Many years ago, I would stand  on the sidelines in Newton near Heartbreak Hill and cheer on the valiant runners.  Now, I am awed from afar by their feats. 

I wonder, is this aversion to crowds age-related?  Or terrorist- related?  How much does my comfort enter into it?  It’s a whole lot different than just becoming blase or jaded.  Have I seen too many marathons?    I doubt that it’s just my “comfort.”  A great unease overcomes me, and I want to flee.  Fortunately, I can–and I do.

Eleanor says that, “as I grow older, I am more interested in the conditions, changes, services, culture, and even politics affecting me, my husband of over 50 years, my friends — and my over 100- year-old mother.  What does it mean to be growing older in today’s society? 

 

TWO VOICES

I offer these two women’s voices quoted from the 2003 book, Wise Women: A Celebration of Their Insights, Courage and Beauty, by Joyce Tenneson. They speak for themselves and maybe for many of us who are facing our aging with grace and valor.

#1–

​I’m a bit envious

​​of the younger generation

​They have so much freedom compared to us

​​I got married the day I graduated!

​A lot of my friends are passing away now,

​​The rest of us are worried

​​​about outliving our pensions and assets—

​we don’t want to be a burden to our families,

​​​Now I live alone with my cat.

​​​​I’m always collecting feathers,

​I use them to play with him—

​​​​we’re good for each other.

–Sadie Simms Allen, 81

 

#2–

​​I still don’t dye my hair,

​My advice is to follow your conscience

​​I’ve had several lives,

​I’m not the same person I was

​At twenty, forty or even sixty,

​​Now I’m a role model

​for women in their seventies and eighties!

When you’re this old, you can reconsider your whole live.

​​You can relive your life and

​understand it with a pleasure and perception

​​not available when you first experienced it.

​​​People are extremely nice to me now,

​because I am no longer a threat to them.

–Polly Kline, 97

 

#3–

I used to perm my hair,

but now, and for many years, I have let it go natural,

straight as a stick,  silvery white.

I used to be shy,

but now I say what I think,

choosing my words carefully

so as not to offend.

I have concerns about the future,

but they don’t paralyze me.

the future is in the faces of my grandchildren,

ALL children.

in them I have hope.

–Elizabeth David, 82

 

Who are you?   Who would you rather be?

A friend encouraged me to join BOLLI where I began to offer courses in which we discuss our aging–from the physical, emotional, intellectual, and spiritual aspects of our lives. My passion is to help others to gain deeper understanding of themselves and the changes, losses, gains, and glories of aging.  So, “grow old along with me–the best is yet to be.”

THE OPIOID CRISIS, ME…AND YOU

By Eleanor Jaffe

     I don’t know about you, but the current opioid epidemic in the U.S. feels… distant.  I don’t personally know anyone or anyone’s child who is “hooked.”  But when I think more deeply, I must admit that prescription drugs almost did me in about twelve years ago.  At that point, it was less well known that prescription drugs, painkillers, are often the gateway to addiction.  At least it wasn’t known to me.

      It wasn’t really known to physicians, either.  Siddhartha Mukherjee wrote in the NY Times Magazine on February 4 that “We were living, then, in what might be called the opioid pre-epidemic…Pain, we had been told as medical residents, was being poorly treated (true) —- and pharmaceutical companies were trying to convince us daily that a combination of long and short-acting opioids could cure virtually any form of it with minimal side effects (not true.). The cavalier overprescription of addictive drugs was bewildering….”

     So I write this as a cautionary tale.  Major surgery may be in your future as it was in my past, and terrible pain may accompany it.  The use—or overuse—of painkillers, Vicodin, Percocet, or Oxycodone, can lead to dependency or getting “hooked.”  That’s what happened to me, at least temporarily….and innocently.

   My major surgery about twelve years ago was double knee replacement.  My painful arthritic knee joints which had limited me in so many ways were replaced by artificial ones.  Both were done at the same time during the same surgery, and while it was a success, I was in terrible pain for several months. 

    I needed “heavy duty” drugs to keep me going, to tolerate movement and physical therapy, even to sleep.  The labels read, “Take 2 every 4 hours,” and “Take 2 every 12 hours,” and “as needed.”  At the same time, the advice was to “Stay ahead of the pain,” that is, anticipate that you will be in pain, so take the medication before the pain seizes you.

     But if you “Stay ahead of the pain,” how will you even know if you need the pain killer? And how will you know when it is time to ease off the medications? This was the conundrum, at least for me.

     My surgeon was no help.  When I told him, after one month, that I had become melancholy and depressed, was frequently crying, and had no appetite (I lost 14 pounds in 6 weeks), and (almost distressing of all) I could not understand what I tried to read!  He simply told me to “get off the drugs.” But when I tried to stop the meds completely, it was worse.  I was in terrible pain.

     Another physician—my son who practices physical medicine and rehabilitation 2,000 miles away in Utah—advised that I needed the meds, but that I needed to get on a regimen of phased withdrawal, gradually reducing and then extinguishing my needs.  “I can’t believe this is happening to my own mother!” he said.  It took three months to get past the need for the drugs.

     Physicians are now well aware that prescription medications—their prescriptions—provide gateways to addiction.  Physicians are supposed to limit the amount of these prescription meds to a few at a time.  Additional meds now require additional prescriptions.  And yet, too many are willing to keep signing prescriptions.

     This is a “painful” story in many ways:  my gullibility regarding pain medication, my “addiction,” my poor choices, my surgeon’s insensitivity and mismanagement of my condition post-op, and more.  But in light of the opioid crisis facing all of us in this country, I share this dismal and frightening medical history with you.  After all, you, too, may be a candidate for major surgery with its accompanying pain.  Be wary of these painkillers.  In the short term, they relieve your pain.  In the long term, they cause addiction and possibly even death. 

As I grow older, I am more interested in the conditions, changes, services, culture, and even politics affecting me, my husband of over 50 years, my friends — and my 100 years old mother.  What does it mean to be growing older in today’s society? 

      

NARROW BRIDGE

by Liz David

In 1988, I wrote a thesis entitled “A Narrow Bridge” in partial fulfillment of the requirements for my Masters Degree in Expressive Therapies from Lesley College. The major purpose of the thesis was to explore fears and how they get in the way of healing and then to conceptualize ways to deal with fear.

“Life is but a narrow bridge with no beginning and no end, and the main thing, the main thing, is not to be afraid,”  said Rabbi Nachman of Bratzlav.

The following is a piece I discovered as I was researching the thesis. I offer it as an inspiration and a challenge.

                                                TRANSFORMATION

The old woman who was wicked in her honesty asked questions of her mirror.  When she was small she asked, “Why am I afraid of the dark? Why do I feel I will be devoured?” And her mirror answered, “Because you have reason to fear. You are small, and you might be devoured.  Because you are nothing but a shadow, a wisp, a seed, and you might be lost in the dark.”

And so she became large. Too large for devouring.  From that tiny seed of a self, a mighty form grew, and now it was she who cast shadows. But after a while, she came to the mirror again and asked, “Why am I afraid of my bigness?” And the mirror answered, “Because you are big.  There is no disputing who you are.  And it is not easy for you to hide.”

And so she began to stop hiding. She announced her presence.  She even took joy in it. But still, when she looked in her mirror she saw herself and was frightened, and she asked the mirror why.  “Because,” the mirror said, “no one else sees what you see, no one else can tell you if what you see is true.”  So, after that, she decided to believe her own eyes.

Once, when she felt herself growing older, she said to the mirror, “Why am I afraid of birthdays?”  “Because,” the mirror said, “there is something you have always wanted to do, and you know time is running out.”  And she ran from the mirror as quickly as she could because she knew, in that moment, that she was not afraid, and she wanted to seize the time.

Over time, she and her mirror became friends, and the mirror would weep for her in compassion when her fears were real.  Finally, her reflection asked her, “ What do you still fear?” And the old woman answered, “I still fear death.  I still fear change.”  And her mirror agreed.  “Yes, they are frightening. Death is a closed door,” the mirror flourished, “and change is a door hanging open.”

“Yes, but fear is a key,” laughed the wicked old woman, “and we still have our fears, “ she smiled.

*

So, “life is but a narrow bridge with no beginning and no end and the main thing, the main thing is not to be afraid.”

If we can teach ourselves to approach life as a bridge with no beginning and no end, as if life were an endless bridge onto which we are placed on a section labeled “present,” then we have the potential for healing our wounds rather than remaining stuck in our pining for past desires or future hopes, both of which are fantasies that do not serve us because they remove us from the present.

There are no magic formulas for overcoming fear but developing the skills it takes “not to be afraid” is possible.

It takes courage!

1. Develop understanding and knowledge of our fears
2. Develop awareness and sensitivity to the times when we are afraid, in the moments of fear itself.
3. You may think it is not possible, but try making a decision not to be afraid, or, at least, to put fear on the back burner.
4. Imagine making a choice whether or not to be fearful, scared, or worried about the future.
5. Imagine making a choice not to be afraid of change, loss, death
6. Imagine, as the old woman in the piece above did, choosing to make fear the key to moving beyond fear into living a fearless life!
7. It takes courage!

Courage may not be the absence of fear but, rather, courage enables us to move ahead in spite of fear.

Rollo May once said that “To live into the future means to leap into the unknown, and this requires a degree of courage for which there is no immediate precedent and which few people realize.”

Courage seems to be connected with knowing that there are choices and the ability to make them in the face of fear. Returning to the metaphor of life as a bridge, imagine this life-bridge as filled with choices. We do not choose to be born.  Most of us do not choose to die. We choose on the life-bridge between.  Rabbi Nachman’s life-bridge is the dwelling place of the things we have the most control over–our choices.

May also said that  “A man or woman becomes fully human only by his or her choices and his or her commitment to them. People attain worth and dignity by the multitude of decisions they make from day to day.  These decisions require courage.”

Courage gives us the ability to make choices knowing that mistakes are possible and making them anyway.  Our  choices further our quest to live life without being afraid. This requires knowledge of the self,  being self-centered  in a way that has nothing to do with being selfish but has a lot to do with authenticity.

May talks about courage as well.  “Courage is not a personal virtue or value among other personal values like love or fidelity,” he says.  “It is the foundation that underlies and gives reality to all other virtues and personal values.  He  also points out that courage comes from the same stem as the French word Coeur, meaning heart.

LET ME INTRODUCE MYSELF

My name is Courage

I live in the place of the heart

My door is always open to friends

And strangers alike—welcoming all

I can be very helpful when danger or fear develop

But like it most when I can just hang out

My favorite color is white, which allows me to be quite visible

But not alarming

What is puzzling is that people seem to forget about me living in their hearts

They behave as if they don’t know I exist

Or, worse yet, they know I am there and are afraid to make friends with me

Sometimes I feel crowded in my residence

Because the owner of the heart sublets to fear

And fear thinks it owns the owner

But I am honest, confident and valiant

And the main thing, the main thing is…

I am not afraid

*

My passion is to help others to gain deeper understanding of themselves and the changes, losses, gains, and glories of aging. So, “grow old along with me–the best is yet to be.”