All of us are getting older. This is troublesome, but consider the alternative!
For those of us who now have quite a few decades behind us, concerns about our remaining time are getting more pressing. Two major concerns are death and dementia.
It’s pretty clear that each of us inhabits a physical body, and that, sooner or later, that physical body will very likely deteriorate and die.
My father died at age 95. I was at his bedside. My sister had been with him for most of the day before. Our brother called, and patched us all (two brothers and three sisters) into the same call. Our father was unresponsive and breathing quietly, but I choose to believe that he was aware of us as we were all gathered around his bed, talking and laughing, celebrating our lives together in our family. Sometime during our conversation, he slipped away. That is about as close to a “good death” as anything I can imagine.
A few months later, my mother died at age 91. My sister had also been with her, but my mother sent her away and settled down to sleep. When the nurse checked on her in the morning, she had died quietly in her sleep. Again, this seems like exactly the kind of “good death” that she had been looking forward to.
Another few months later, my wife’s mother died at age 99. She had been living in our house for years. As always, she had joined us at the dinner table the night before. As usual, she ate little and didn’t speak, but she clearly enjoyed our togetherness. The next day, she stayed in bed. In the early afternoon, with all of us gathered around, and with her son and daughter holding her hands, she quietly closed her eyes and slipped away, into a “good death”.
Years earlier, my wife’s father died in our home just a few days before turning 90. Less than two weeks before, my wife’s parents had moved from California to our home, then in Texas. He was very ill, but I am convinced that he held himself together to make sure that his wife was settled in their daughter’s home. Then he could let go. His whole family was gathered around him as he died peacefully.
Of course, not everyone is as blessed as we have been, with our parents experiencing “good deaths” while surrounded by love. And we can’t be certain that we will be blessed in the same way that they were. But these experiences have left me without a fear of death. I have plenty of things I want to do before that time comes for me, including plenty of time with my friends and loved ones. So I am happy to postpone that day for as long as I can. But I do not fear death.
Still, there are plenty of other things to fear, internally and externally.
I have spent my professional life teaching and doing research, writing and talking. My personal life also revolves around relationships. My mind is central to my identity. Illness and pain are certainly scary prospects, but the possibility of dementia is particularly scary, because it threatens my mind and my identity. Dementia is scary as a threat to me, but it’s also scary as a threat to my loved ones, especially to my wife, the love of my life and an essential part of my being.
But here we are. Over the years, we have learned how to respond to various threats, some of them quite scary. We have learned to understand them, to prepare for them, to avoid them when we can, and to deal with them if we must. Dementia is certainly scary, but how should we respond to this threat?
Above all, it seems important to defuse the paralyzing fear. We joke about “losing our marbles” and “feeling the marbles trickling away”. I’m told that forgetting where I left my car keys is not a great concern, but forgetting what car keys are for is a real problem. I believe that recognizing and talking about the threat of dementia is an important step toward avoiding panic.
Exercises, both physical and mental, are obviously good for our health in many different ways. Can exercise forestall dementia, even if it can’t prevent it entirely? Perhaps, and there doesn’t seem to be anything to lose by trying.
Reading on a variety of topics, often related to my current professional interest in Ethics for AI and Robotics, and then writing short essays on particular topics, are important and meaningful activities for me.
When enough marbles have trickled away, I hope to focus more of my time and attention on less intellectually demanding activities. I enjoy trimming trees and caring for bushes in the woodlot on our farm. I enjoy mowing the pasture. I plan to learn more about small-scale gardening. I have never learned to really play the piano, but I do enjoy picking out melodies on the keyboard, and I can imagine doing more of that.
There are two threats that I am told are associated with later stages of dementia, that are worth thinking about.
One threat is a change in personality, to become meaner, angrier, and more combative. Fortunately for us, our parents largely kept their essential sweetness of personality to the very end, though my father did lose his temper a few times. I have been told that it is important to consult with a gerontological psychiatrist, and that proper medication can be very effective in avoiding this personality-change problem. This seems to have helped my father a lot.
Another threat is becoming unable to recognize people who are important parts of one’s life. Someone who has been a loved one for decades becomes someone who is no more than a friendly stranger. I don’t know whether this is more threatening from the inside or from the outside. Is it worse if I no longer recognize my beloved wife, or if she no longer recognizes me? From the outside, there is a heartbreaking loss of decades of intimacy. From the inside, what is it like? I don’t know. However, people do write on this topic, and I expect there are insights to be found, now before we actually need them.
Once upon a time, I thought that when I was grown up enough, I would know how to handle all the challenges of life. This has turned out not to be true. Each phase of life brings ways to handle the old challenges, but also new challenges. And these are some of those new ones. And not all of them, I’m sure. We’ll see.