A Book That Transformed The Relationship With My Grandmother
What matters in the end, really?
It’s become a cliche by now but I’m going to say it anyway: Covid-19 was harsh, and still is.
In one way or another, all of us were forced to change our lives, isolate ourselves, and maybe even fight for our lives. We took a glimpse of how it really is to be alone, locked inside a four-walled cage, thirsty for true human connection.
Amidst these times of uncertainty and lockdown, I couldn’t help but wonder:
Has it always been this way for the elderly?
Constant awareness and fear for your health. Self-isolation, communication through the internet, shopping groceries by delivery. Specific nutrition and medication to promote the best possible well-being level. Feelings of anxiety and uncertainty for life’s temporariness and for the unknown, scary future.
As an empath, I got deeply moved by these thoughts. They provoked me and compelled me to take action. What have I been missing? Was I giving enough attention to my elder relatives? Was I underestimating the fact that they were reaching their ultimate end?
In my home country, Greece, there’s an ongoing tradition of taking care of your parents and grandparents, and not putting them in nursing homes like mere prisoners. It’s something that gets transmitted from one generation to the other as an atypical, but the inviolable rule. So, I felt the urge to dig deeper into my grandmother’s already salient life conditions.
Towards that cause, Atul Gawande’s book, Being Mortal, was a tool of great importance. It cultivated the ground for a genuine relationship between me and my grandmother, who was then reaching her 80s in poor health.
It rejuvenated my sincere interest in the well-being of my grandmother, changed my perspectival knowing, and provided a deeper understanding of how it really is to contemplate mortality and to reach your death as peacefully as possible, as an elder. But most importantly, it showed me that I could have a role in that process.
What Really Matters In The End
If we were to meet last year, I would be a straight ambassador of ‘placing’ the elderly that couldn’t be independent, in nursing homes. Back then, it was a logical continuation of events, mainly for the better of those individuals.
I wasn’t considering that by speaking of ‘those’, I meant real humans and not just bodies with daily needs that couldn’t be met via causa-sui powers. I didn’t have in mind that these individuals have their own desires, emotions, sacred spaces, habits, and ways of acting in the world.
I was narrowing down the world to lift the ‘burden’ off my shoulders.
For instance, my grandmother sometimes behaves like a sound recorder. She says the same old stories every afternoon, as she can’t remember that we’ve talked about it again yesterday. She nags, ruminates, and gets melancholic about her past experiences, her old beauty, and her strength. As a listener, it’s tough to follow and be active during your conversation each day.
Other times, she creates conspiracy theories and gets angry about the Greek and Turk politicians (she’s not completely wrong by the way). But her stories go even further, as she manages to create illusory scenarios: That the Turks may invade the country, and her home any moment. ‘We should be ready, we shouldn’t sleep at night’, she often whispers.
It’s quite easy for a caretaker to throw in the towel and send her to a nursing home. There, she would be able to communicate with other people like her, watch boring TV shows all day, and have her needs met at any moment. No one would be ‘disturbed’ by the dozen of her weird behaviors.
But, is that the point? Is this what really matters in the end?
Gawande’s wonderful work took me by the hand and showed me something unbeknownst to me: the inner emotional world of my grandmother, and the respect I should give to it. After going through his book, I began being more receptive to my grandmother’s strangeness. I began listening, commenting, and giving her cues to continue further, and she did.
And guess what? Our relationship took an entirely different turn.
Today, I can see that she really values being listened to, despite the context of the conversation. She really adores talking about the past, especially about my deceased grandfather. She also needs someone to balance her illusions and conspiracy theories, and she also needs reassurance and guidance from someone close to her.
And that’s what matters in the end. To be close to those you love, to be heard, to be looked in the eyes inside a sacred space, to be protected and cared for until the final hours. By your beloved people, and not by strangers who, most of the time, are just doing their medical ‘duty’.
Is Anybody In There?
They say that time has sharp claws and demolishes everything in its path. Our bodies and minds couldn’t have escaped this equation, not in a million times. Our physical and mental health inevitably deteriorate as time passes, and all we can do is be active observers.
For the elderly, there comes a time that they reach their cognitive nadir, often referred to as dementia. This syndrome is correlated with decreased capacity for thinking, recalling or remembering past events, and behaving functionally.
My grandmother’s mental health has shown many fluctuations in the past, so as to raise many concerned eyebrows. As aforementioned, she forgets quite easily, repeats events she mentioned a few moments ago, and sometimes stops in the middle of performing an otherwise ordinary action. It’s easy to get lost in her beautiful, deep-blue eyes, and simultaneously forget that this person is truly conscious of the present moment.
She mostly seems to be entrenched in a ghostly world of the past and trapped inside a now with an impaired brain. I’ve asked myself this question more than a million times: Is anybody really in there? Is there a conscious being that can engender a true and meaningful conversation?
Gawande’s book, and Christopher Sheppard’s movie, The Roads Not Taken, revitalized my belief in the individual behind the blue eyes, the silent human that’s unable to communicate like before, the life behind the void.
Is anybody in there? Even today, I’m not sure, but hell, I’m acting like it is.
I’m investing in my grandmother’s well-being, even during times of being uncertain about the person in front of me. That’s a huge change for me, a person who was trapped inside his egocentric worldview, and for my grandmother, who is now being treated like a human being despite her cognitive impairments.
Contemplating Death, Together
One thing that often becomes a taboo conversation for the elderly is the obvious elephant in the room, standing in the corner, like a silent guardian,
or a watchful protector: death
A few years back, I wouldn’t even drop a sweat for mortality, the fragility of our lives, and death. I was totally unaware of the consequences that might be generated if one becomes aware of that fragility. That changed after countless meetings, journeys, ideas, books, and a genuine feelings-formula of sadness, joy, and grief.
The idea of death can easily get the grip of you, suffocate you and leave you everything but unscathed. It’s a being mode that gets me estranged and bewildered, like no other, even if I’m only 22 years old. I can’t even begin to contemplate the notion of non-existence, and it can easily make me tremble.
But it's also something I try to counter by assuming and assigning meaning in multiple domains of my life, like family, friends, running, writing, and my prospective career. Remember though, I’m privileged enough to own these options.
What about my grandmother? She doesn’t have these possibilities.
As she’s continuously reaching her ultimate end, she’s also narrowing down her worldview, assigning meaning in a limited domain that mostly contains her familial relationships, and perhaps, cooking. However, as her health continues to deteriorate, even more, she won’t be able to cook in the future.
Shouldn’t we, as a family, be close to her, as her sole meaning and purpose? Shouldn’t we be around her and help her contemplate the paradox, the dilemma of human existence, called death? Shouldn’t we provide her a supporting hand, a fellow hug, a constant ‘it will be all right’ like Jesus?
We’re in this together, and the elderly are no exception. Every breath is another step closer to our ultimate end, but that’s okay because we have each other. And that should also be the case for the elderly, who probably need special treatment in the face of our collective paradox.
That’s a message that gets highlighted in Gawande’s book:
“Our ultimate goal, after all, is not a good death but a good life to the very end.”
Conclusion
Closing this article, I’d like to share that after transforming our relationship, my grandmother’s mental health showed slight general improvements. Even
though the ‘end’ might be near, she’s more independent, optimistic, and calm about her situation, and I believe that emanates from being heard and cared for like a real human being.
If you have relatives over 50, I urge you to read this book, so as to get a deeper and better understanding of what is it like to grow old, sick, and dependent day by day. You might already be aware of it, or you may receive a genuine slap of realism. Either way, I feel that this book will be useful to you because it can broaden your horizons and cultivate compassion for your grandparents.
Compassion is simultaneously a being mode where you perceive and feel the other person’s feelings, you somehow ‘go in their shoes’, but you also generate the urge for authentic action.
Go, do something for these people. You might be in their place soon.
“A few conclusions become clear when we understand this: that our most cruel failure in how we treat the sick and the aged is the failure to recognize that they have priorities beyond merely being safe and living longer; that the chance to shape one’s story is essential to sustaining meaning in life; that we have the opportunity to refashion our institutions, our culture, and our conversations in ways that transform the possibilities for the last chapters of everyone’s lives.”
— Atul Gawande
