November 30, 2005

Ms. Hertz needs some assistance with her computer printer. We call technical support at Epson and I am on the phone for a half hour. We finally get her printer to work after I am talked through the process of cleaning the printer heads. Ms. Hertz is amazed that today you can just call someone and have things fixed instantly. Her daughter bought her a cell phone for emergencies, but when her cell phone rings she thinks it’s the door buzzer and gets up to answer the door. She does not completely understand the impact of technology. She’s from a different time when letters were the prime mode of communication, when there was an art to letter writing.

I wonder when I get older whether I will embrace change. It seems that my healthiest clients do just that. They are able to adapt to the breakneck speed of our current society. Not that they are as active and involved as the movers and shakers in this world, but they have a philosophy of life that allows them to appreciate what is going on. They can talk of the political shifts, the youth movements, the art and literary scene, the state of society from a higher place.

They just get it. They get the present discourse. Their worldviews are not rigid generational ideologies, but a relevant and continuous questioning of their present place within a bigger whole. Some of my clients despise the youth movement, they think in terms of the relevant and productive times of their generation and think it is the end and be all of society. They cannot see or maybe cannot accept that they a just one link in the chain of civilization.

I think this has to do with death. Accepting death is very difficult for anybody, but more so for older people. It can seem very acute and imminent for an older person as they experience the aggregate of losses that are inevitable as we age. Gerontologist Stanley Cath said, “the primary task for all older people is to deal with the preponderance of losses which dramatically impact on their lives.” The work then for older people then is too not fear death. To be okay with their life, accomplishments, disappointment, incongruities, losses, and say that when it is their time to die they will go knowing they have blessed the earth with their contributions. This is easier said than done. The fact is that majority of older people are depressed and unhappy. And with the 70 million baby-boomers who will start to hit age 60 in January of 2006, a serious crisis will be hitting that will effect all of us.

Older people must adapt. They cannot afford to be rigid and set in their ways. They cannot look at dependence as a bad thing. The fact that using a walker or a wheelchair is a vanity issue for many older people has as much to do with us as it has to do with them. Why should older people feel ashamed to get old in our society, why are they looked at with pity when they board a bus and hold up anxious active people for a few minutes? In other societies older people are revered as sagacious figures. Here people roll their eyes as older people are rolled into nursing homes to die.

Erik Erikson said older people should strive to “accept the not knowing of childhood and with it playful curiosity. This is a way to acknowledge death without fearing it.” Erikson believes that older people have to experience all the stages of his life cycle theory again, not with the same physiological and psychosexual changes that accompany the first go around, but with the same psychosocial modality. Like the baby who looks to trust instead of mistrust in loving a mother, the older person looks to trust again in new relationships and a new life that always hold the greater possibility of loss,

They look to find new purpose and identity in new activities such as a new hobby or going back to school or deciding to travel the world. They must learn to trust in their new role as an older person in a new life that cannot be defined by the old life that no longer exists. They must be confident and guiltless of the past in this new sense of self. It literally means in some sense being reborn if the older person chooses to take that initial first step of trust.

This work is not linear. The fact is that everyone has had difficulties in different stages based on their own unique life experiences. Some older people never got married and had children so they struggle with the Eriksonian Generativity vs. Stagnation stage where the task is to impart your learning and care for a younger generation. Many older people who never experienced marriage, children, and family have difficulty with self-absorption. They are hyper-focused on themselves because that is all that they can attempt to master. Older people who have come to terms with this fact of their life may make a healthy choice to seek out volunteer relationships where they work with young people.

Of course there might be deeper origins as to why they never got married. This might have to do with not successfully mastering an earlier life stage such as Intimacy vs. Isolation. There could be so much damage early on in childhood that trust was never attained, which leads to insecure and precarious relationships throughout life.

What this means for older people is that even with the closeness of death becoming a reality they must be engaged in life. Their independence diminishing, they must learn to rely on others and turn inward. There is no more time to run from things because they literally cannot. And the soul knows this. Older people who do not engage in the processes of life when the chickens come home to roost, will experience an extremely acute and miserable existence.

Unfortunately many of my clients are facing this existence.

This idea of “independence” is a western construct. It is what we have been taught since childhood. The bastions of psychology such a Margaret Mahler tell us to “separate” and Carl Jung told us to “individuate.” We all go through an ego maturation process where we first differentiate ourselves from our mother, then we find our own identity outside of our peer group, and then we strive to lead independent lives, which is the result of a healthy productive citizen.

People fear old age because they fear the loss of independence. Losing independence is not what society deems normal. The stigma of dependence for people who see themselves losing their independence greatly affects their self-esteem and feelings of competence. I always hear my clients saying no matter what they do not want to be a burden to their families and friends. They would rather risk falling in their apartment instead of asking for help, instead of feeling like they will not be looked down upon for using a walker. Older clients will neglect their hygiene and appearance and in turn will seclude themselves even further because they smell, all because they do not want to be a burden to their families. Even within my social work training the emphasis has always been on getting older people active and independent.

Pride can be a wonderful strength for older people. As a social worker, I definitely encourage a proud vigor that facilitates positive behavior. The key is encouraging this pride within a reframed idea of what dependence means. What is this reframing?

We have to give older people control of their lives where they can still have control, where they can still exercise self-determination. This means at the very core of our society we must change the perception that dependence is bad. If we let older people make decisions and support them positively through the transition to more dependence they will feel more positive about themselves. Just knowing that there are decisions they can make will greatly improve their quality of life and sense of self-mastery. It can be as involved as making major life decision about health care or as subtle as knowing that a cognitively impaired older person will be signing the check once the family member balances the book. Clients should know what they can do and what they need assistance with. This clarification of roles and the paradigm shift to dependence as a natural continuum in the life cycle can mean the difference between misery and vital engagement in life.

We sit in her living room. She has asked for some rough drafts of the book I am working on. Today, I bring her about twenty pages and she quickly sifts through. She tells me she will read it this evening.

We talk about current events, politics, art, but mostly we talk about writing and books. I value her opinions and insights. At 94, she has accumulated so much wisdom on writing. Her advice is always practical. Write simply, clearly, no flowery, incantatory passages that are vague. She likes coherent streams, plot, character development, and historical context. She shows me old charts she made on oak tag paper that list her characters. Next to each character she records information that puts her characters in their historical period where they live and breath. She says, “I even put down a characters grandparents, where there from, dates of birth and death, and pertinent information even if I never mention the grandparents. It is about being infused in your characters lives and then your writing will take on a life of it’s own, it will write itself.”

She constantly refers back to her 8 published books, taking them off her shelf like precious artifacts. She feels the smooth cover, I like the sound of her hand on the burlap cover, the cracking open of virgin spines, perhaps extra copies that were never opened; she fingers through it slowly and passionately. I say to myself, “She is living.” She peruses and finds a passage that pertains to my questions or her imparting some wisdom.

“See here, read this, “ she says, pointing hard at the passage, as I begin to read silently, and then she says “Out loud, out loud.” I read out loud and her lips mouth my novice reading, which is not yet filled with the years of passion and introspection that she has experienced in the words.

She tells me she just bought a DVD off the web and she is proud that she was able to navigate the transaction. The movie is called Hotel Sacher. It’s a classic Austrian film. She begins to give a history of Hotel Sacher and then asks, “Have you ever had Sacher-torte?” And to her surprise I have. I actually had the Austrian chocolate cake at an Austrian function that was given for our agencies Holocaust survivors.

Ms. Hertz is off to her papers to find something that connects to hour conversation. She hands me a copy of an advertisement in an Austrian publication for Hotel Sacher. It reads:

The Mystery of the Viennese “Sacher-Torte” Revealed by Stella Hershan.

The Prince was enchanted. It is safe to assume that he sent word to the kitchen expressing his full approval and even giving permission to name it after its creator. To this day, the management of the Hotel Sacher in Vienna, originally founded in 1876 by Franz Sacher’s middle son Eduard, sill insists that there is only one original formula for the Sacher Torte and that this is buried in a steel safe where it will remain a secret forever.

I pictured Metternich as some corpulent dictatorial King, a sort of Henry the VIII of England, demanding that his every whim and pleasure be satiated by his obsequious servants, as they scurry up and down sconce-lighted corridors with linens and gastronomic treats, some plotting in dark wainscoted hallways, a nervous chef’s icing hand shaking as he know that if the King doesn’t approve he risks being beheaded.

This prompts me to find out more about who Metternich was.