Dealing With Elderly People in Decline

When I was in my 20s, most of my friends were elderly musicians in their 80s. They're all gone now, and now, in my mid 50's, I'm repeating the process with my parent's generation. This loop I find myself in has provided insights into old age. A few observations:

1. Let's look at you, first. If you've taken advantage of your own all-too-brief time here by observing your inner life, then you know (as I keep explaining from a multitude of angles) that you are not the sum of the objects in your mind or body. Your body contains not a single atom from your childhood, yet you've been unmistakably you all along. Your thought stream, knowledge, and memories are utterly unlike those of your seven year old self, yet you are unquestionably still that person. The only reasonable conclusion is that you're not a collection of stuff; you are, rather, the observer of It All (it's the old subject/object question).

So...no matter how fuzzy-headed a person gets with age - no matter how feeble their memory, or how exposed the bare sidewalls of their mental processes - they're still them. Absolutely, unmistakably, and unquestionably them. The machinery - even the CPU - may fritz and spark, but the awareness peering out through their eyes is the same as ever. Their bedrock "them-ness" isn't affected or diminished in the least. If you need this to be confirmed via words or actions, such confirmation may not be forthcoming, yet there is a presence to a human (really vice versa), regardless of their mental state, and that presence is immutable. If you're unable to feel it - to register and appreciate the Them-ness - without tangible verification, then I have bad news. You're the one who's lacking; who's not quite all "there". Seize the opportunity to learn and grow.

2. Talk to that presence. Even if you must speak slowly and loudly, and your words aren't later recalled. It doesn't matter what you say. Just pitch your words straight there. It needn't be solemn. In fact, jolly irreverence is often best. Just do your feeble best to bear in mind who you're speaking to, despite the visuals.

3. By speaking to the presence, you reassure them that they're still them. That's critical. The problem for old people isn't so much the isolation, or loved ones talking to them like to a child or radiating distress over their condition. Those things are awful, but mitigated by the natural opiate-like endorphins that flow near the end of life. What they need - and you can help with! - is deeper and more necessary: evidence that they're still them. In the absence of an energetic thought stream - lacking cognitive bandwidth for self-reflection - this is incredibly helpful. You're helping them reboot for a moment. It's the best gift you can give. And it takes only a brief moment. You don't need to spend the afternoon chatting at them.

The following are two things I typically tell an 88 year old I know, who's down to 15 seconds of short term memory and who's pretty foggy, overall, when she starts to get rattled about her predicament:

Are you a different person just because you're old? Of course not! Still the same you as ever! There's stuff you can't do, but, really, what needs doing? Just relax and enjoy the moment! Here you are, still you after all this time! Still here in 2018! You won!

and...

Yes, your memory is bad. You should definitely not be running a business or raising a family. Thank goodness you don't need to! You can let go. Nothing to worry about, nothing you need to handle. Memory was for before. Now: just enjoy right now! That's your job!

The beauty of it is that I don't need to keep finding new ways to express it. Thanks to the perpetually refreshing memory, I can endlessly re-use whatever works!


Seth Godin once suggested that I tinker with the front page of Chowhound, to see which exact verbal construction yielded the greatest success of sending users where we wanted them to go and persuading them to buy what we were selling. I appreciated the shrewdness, but it was a bit cold-blooded for me. But now my elderly friends and loved ones give me an opportunity to apply that same shrewdness not for manipulation but out of compassion. A few thousand iterations in, I'm pretty much nailing the pitch!