Our Aging Population

I never wanted to be like my father. Not because he wasn’t a good man, but because I wanted to forge my own way. He was old. He had old ideas. He was set in his ways. He was inflexible. Or so my brain thought at the time.

I think the first time I realized I was doomed, was when I saw a picture my daughter had in her room. I picked it up out of melancholy and said, “that is a great photo of Grandpa.” She looked at me like I had 3 eyes and said “Dad, that’s you”!

Sheesh when did that happen? I had become my father in more ways than one. My evolving mannerisms were becoming eerily familiar to me.

I have had many people tell me I sound like dad. It seems as though I am oozing his characteristics. Sadly, as documented in earlier posts, he passed way too early, at 72 years old. It seems craven now, but my thought at the time was that he had had a good life, full of memories. Now that I am closing in on that age, it is so apparent that he was robbed of so much.

He barely had time to know his grandchildren and experience the joy they bring.

Mom on the other hand, was a year younger than I am now, when she became a widow. Much of her life from that point forward was spent battling decaying health issues, eventually being confined to a wheelchair for the last several years of her life.

Dad passed within a few days of having a brain hemorrhage. Mom lived for many more years, suffering a much more drawn out demise, through dental issues, residual pain from a brain tumour many years prior, severe arthritis and the many vagaries so many experience as age brings down it’s inevitable hammer.

My in laws on the other hand lived well into their eighties, enjoying a full life, surrounded by many grandchildren, friends and an active social life. They were wonderful people and gave as much as they received. However in their late 80’s, they both developed dementia and later alzheimers disease. Locked in their our minds and recalling only the distant past, they knew each other, but few others. It was hard on the family.

So, the age old debate:

What is worse? Having your faculties, but not the physical ability to enjoy even the basics of life? Or Being physically able, but not having the mental acuity to participate in the most rudimentary of tasks?

One is harder on the individual and the other harder on the family.

In our country, we look to long term care facilities to provide basic care to those that are unable to look after themselves on their own. Out of sight and out of mind, in many cases. Forgotten and ignored by loved ones, busy with their own lives. No one to advocate for their basic needs.

While my mother was in a nursing home, I saw many residents that never had visitors – no one to advocate for them. Nothing to look forward to, despair and loneliness etched on their faces, as they watched the seconds tick away each day – counting down the moments till they would take their final breath on earth.

How do Other Cultures Approach an Aging Population?

In other cultures, it is an expectation and perhaps even an honour to care for elderly parents. Despite failing health, they are recognized as possessing critical information to learn from – to share wisdom from one generation to another.

India’s culture for instance, requires that children care for their parents well into old age, making caregiving in Indian families a cultural practice. In fact, a child takes it as blessings from God to care for their parents and many even consider it a ‘punya,’ or accumulation of good karma.

In Indian culture, the responsibility of caring for aging parents is deeply ingrained. Children are expected to provide care and respect to their parents as they age. Here are some key aspects of how Indian families handle this:

1. Filial Piety: Parents invest their love, time, and resources into raising their children, with the belief that their offspring will reciprocate with care and respect in their later years¹.
2. Cultural Practice: India’s culture requires that children care for their parents well into old age. Many consider it a blessing from God to care for their parents, and some even view it as an accumulation of good karma².
3. Legal Obligations: Not caring for elderly family members is considered immoral and cruel. The Maintenance of Parents and Dependents Bill of Himachal Pradesh (2001) ensures proper care for dependents. Article 41 of the Indian Constitution guarantees Social Security Support for healthcare and welfare for elderly citizens. Additionally, traditional values mandate that children support their parents if they no longer do so themselves².
4. Respect for Elders: Traditional Indian values instill respect and honor for older and wiser family members. Elders are regarded as fountains of knowledge and wisdom³.

Caregiving in Indian families is not just a duty; it is a cultural practice deeply rooted in love, respect, and tradition.

In traditional Asian cultures, there is a strong emphasis on filial piety, which refers to the expectation that children will support their parents in old age. Historically, this concept played a crucial role when families were large, pension schemes were unavailable, and life expectancy was around 50 years old¹. Here are some key aspects of how Asian cultures handle aging parents:

1. Living Arrangements:
   • Confucian teaching significantly shapes the living arrangements of elderly individuals in countries like China, Japan, and Korea.
   • Approximately three-quarters of elderly Japanese parents live with their adult children, a pattern that is also replicated in Korea and China².
   • China’s Elderly Rights Law even mandates that children visit their parents frequently, regardless of how far away they live².
2. Respect and Care:
   • Confucian values promote a positive view of aging, encouraging younger generations to treat older adults with respect, obedience, and care³.
   • While families remain central to elderly care, demographic shifts (such as smaller families, increased divorce rates, and fewer adult children living with parents) are challenging this traditional model.
   • Many Asian countries are now exploring community-based care solutions to support older people who lack around-the-clock family assistance¹.
3. Challenges and Creativity:
   • Fulfilling the demands of filial piety can be emotionally difficult for adult children who are unable to provide direct care due to work or other family responsibilities.
   • Hiring live-in domestic workers, while common, can still lead to negative self-esteem among adult children.
   • As Asian populations age rapidly, innovative approaches to community care are being developed out of necessity, and these strategies can potentially benefit other parts of the world as well¹.

We Are Not Unique – Just Different

In our culture, we don’t treat our elderly with the reverence of other cultures. That doesn’t make us better or worse – only different.

In general terms, our culture is in its infancy, relative to many European and Asian countries. At only 157 years old, we are still young and evolving – unencumbered by traditions thousands of years old.

One would get the impression that a large proportion of our elderly are in long term care. Records would indicate otherwise – only a little over 4% of our elderly are in these facilities. Affordability, family dynamics, physical, emotional and mental acuity among other things are all factors.

One might argue that the elderly in our country are better served in long term care, as a last resort. Health concerns both physically and mentally are attended to on a regular basis when it has been determined that the individual simply are no longer able to do it on their own.

When is Enough, Enough?

There is violent debate about end of life decisions – who is capable and who is not, to be able to make those decisions responsibly?

Many suffer through their final days alone, in pain and wishing they could simply drift away. Euthanasia, though more accepted now, is a controversial topic. But one that many of our elderly loved ones would welcome, given the choice.

Having lost most of their friends and loved ones, they have infrequent contact with the world outside their shrinking existence and have lost any impact on those around them. They watch the seconds tick away, each moment one less than the moment before.

We would not allow our pets to suffer in their final moments, but we seem to lose our nerve with those we love.

For several years, my mother prayed every night to die. She was tired, lonely, in constant pain, no longer able to walk and confined to a wheel chair. Chronic arthristis had crippled her. Her teeth and gums were sore. She had bed sores that required regular attention. She had to be assisted on and off the commode. She had no dignity remaining. But her heart was strong.

She wanted to die and I would argue she had the right to make that decision. But our laws don’t allow it.

I have seen too many friends with terminal illness, waste away, dying a slow painful death – suffering days and years on end – never having what one would consider a good “health” day. But they are forced to live until their heart gives out – no longer able to support their failing bodies.

I am not advocating one way or another. Every individual and every family has to make those difficult decisions.

Many of you are of the age where you are dealing with, or have gone through the difficulty of dealing with elderly parents. Some in perfect health and living life’s remaining years gracefully. Others are watching one or both parents struggle through their final days.

What I learned through my experience, is if we don’t advocate for our elderly’s care, they will get lost in the shuffle of day to day life. Health often deteriorates so gradually that those caring for them don’t notice. So it is up to us, to ensure our loved ones are getting the best care possible. Be an advocate for your loved ones.

What I can say, without equivocation, is that should I be in that situation someday, I would choose euthanasia, should it be available – rather than putting my family through the agonizing difficulty of watching me suffer a long, drawn out demise. I want my grandchildren to remember me as the goof I am – not some miserable skeletal old man, waiting to die.

Just hit the easy button and remember the good times we had!