The Law of Life, or Is Assisted-Living Living?

Lag too far behind and they cut you out of the herd.

Posted Feb 28, 2009

At the Roarke'a Drift Retirement Community, I meet Mrs. Rita MacKenzie. It's a medium-grade assisted-living center. The couches in the common area are fabric, not leather. The carpet could be thicker. I hear a hollow thud from the cheap construction materials as my big frame walks down the corridors to the McKenzie apartment. Each apartment has some pictures by the door. I pass a photo of the Verrazanno-Narrows Bridge, a model sailing ship, the rocky coast of Maine, a resident's photo along with grandchildren and great-grandchildren. At Mrs. MacKenzie's door is a photo of what I learn is the Canadian Rockies and there's a little display shelf too with a replica of the Eiffel Tower.

They tell me Mrs. MacKenzie won't leave her room. Her meals are brought in from the dining room by her aide who helps her get up, eat lunch, before helping her back into bed. In her room are the usual detritus of a long life. Photos, bric-a-brac, oil portraits, vintage furniture, and stacks of correspondence and magazines. Very few books.

Mrs. Mackenzie is as tiny as a child. If she told me she were in her seventies, I wouldn't blink. Blue, mostly clear eyes with only a tinge of red, wetness along the lower eyelid. Skin remarkably unlined for any woman over the age of sixty.
"How old are you, Mrs. Mackenzie?" It's one of my standard mental status questions.

"I'm going to be one hundred four on Saturday. I was born July 14, 1903."

"Bastille Day, eh?"

She appreciates the "eh" being Canadian, born in Saskatoon, Saskatchewan. I love that exotic, alliterating name, but shiver internally knowing that it gets to many degrees below zero, global warming or no.

Innocently I ask, "You have any memories of World War I?"

I'm making conversation, but her eyes get wetter.

"I remember my brother Bobby, only seventeen--I used ride on his shoulders--marching off to war. He looked so fine. Three months later, he was killed at the Somme. Every day I think about him. I said I'd never forget. The Eiffel tower is from when I went to visit his grave."

Bobby is more than a lifetime away--ninety-three years away. A young girl when he left, he died young enough to be one of her great-grandchildren. Born a Clarkson, she went on to marry Tom Mackenzie, an oil engineer.

"We traveled all over the world, until we settled in New York when Tom got a job in the home office."

"How did you wind up in Connecticut?"

"Well, Tom died more than twenty years ago, and I was already eighty, so my son who had moved up to Connecticut got worried about me being alone. I sold my home in Rye and moved into a condo near my son."

Her son is seventy-seven, which doesn't quite attain the filial agedness of the one-hundred-two-year-old mother and her eighty-two year old daughter I met at another facility. They were both in bad shape, but Tom Mackenzie Jr., his mom tells me, is currently visiting his daughter in Italy, and she's upset she can't be with them.

They tell me she's depressed, a woman who was living on her own just six months ago. I ask her how she passes her time. Does she like to read?

"Oh, I never was much of a reader. More of an active person. I liked to travel. And I like my TV shows."

"They tell me you don't go to any of the activities. That you prefer to stay by yourself."

"Wouldn't you? Who wants to be with a bunch of old hags! Half of them just sit around and gossip. The other half don't know their ass from their elbow."

She sees my expression. "At my age, I say want I want." And then she laughs.

"And there's this fellow who is always trying to flirt with me--a mere child of eighty-seven. He should be ashamed."

This from someone who was already nine years old when the Titanic sank, whose brother disappeared on the Somme, whose childhood friends perished in the great postwar flu epidemic, who had her first child before the stock market crashed. She finds it hard to reconcile her ancient status with her sense of self.

"I'm still me, unless I feel the aching in my bones or look at my walker."

Me too. I can still feel as immature as ever, and when I look into the mirror I wonder, "Who is that guy?" I have a feeling that Mrs. Mackenzie avoids the mirrors in her apartment too.

Mrs. Mackenzie has it all going on except any kind of reasonable life expectancy. In the purgatory of assisted living everything is subtraction. It's a high school where graduation is only a negative thing--death or the nursing home. This is the underlying current, the insistent minor key bass line walki

ng below every illusory melody of independence.

In assisted living, there is a sorting out of who sits where in the dining room, who gets invited to drinks before dinner, and who replaces the just-deceased member of the bridge foursome. The more competent want to surround themselves with their peers. The frailer minds and body are unwelcome omens of the probable future.There's a natural sorting out as in high school. Not in terms of the popular kids, the jocks, the hippies, the goths, and the nerds, but a more callous sorting out in terms of cognitive capacity. If you are not capable of holding up your end of the conversation, you're not going to be invited to a table where there is a conversation. Lag a few steps behind the others, and they will cut you out of the herd.

We're not quite the Alaskan nomads who leave behind Old Koshkoosh in Jack London's "The Law of Life." Koshkoosh waits helplessly by his fire, dreaming of youthful hunts while the wolves circle in. Resigned and uncomplaining, he reflects, "Nature was not kindly to the flesh. She had no concern for that concrete thing called the individual. Her interest lay in the species, the race." In our supposedly humane culture, we keep our elderly alive as long as scientifically possible, and the eldercare industry profits from our humanity-to the tune of a couple of hundred million annually. Bottom line for me: If life expectancy werelower, or if it didn't so often end in a frail passage through institutionalization, I'd be in another line of work.


Adapted from Nasty, Brutish, and Long: Adventures in Old Age and the World of Eldercare (Avery/Penguin, March 19, 2009)




About the Author

Ira Rosofsky, Ph.D.

Ira Rosofsky, Ph.D., is a psychologist in Connecticut who works in eldercare facilities and the author of Nasty, Brutish, and Long: Adventures in Old Age and the World of Eldercare.

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