ONE OF MY many totally unrelated and utterly fragmented theories about life on planet Earth is what I call “Listen to the Day.”
It just means that if I pay attention to the day, it will usually tell me what to do or what kinds of things to do.
It certainly tells me (most pointedly) what not to do, regardless of whatever it is that I thought I wanted to do.
I try not to disagree with any given day, on the tried-and-true theory that I will, inevitably, lose.
An example of this happened this past week.
For reasons known only to the Grand Keeper of Reasons, this particular topic came up in six different conversations in four different counties, so I take it that I’m supposed to do a column on it — so I will.
The topic is what I call, “The Promise.”
We all know The Promise. It usually goes something like this:
Promise Extractor: “Promise me that you’ll never put me in a nursing home.”
Promise Provider: “I promise that I will never put you in a nursing home.”
And the sound you hear, at the exact moment The Promise is either extracted or provided, is the sound of the beginning of the end.
You don’t need an advanced psych degree to understand it: The Promise Extractor is usually a person with one or more serious illnesses, disabilities or early dementia — or any combination thereof — who is smart enough and honest enough to be able to look ahead and see that their future is an inevitable downhill slide into the third level of hell: nursing home.
It’s a place they conceptualize as a dehumanized warehouse full of useless bodies and mindless faces and populated solely by the clones of Nurse Ratched.
Echoing halls filled with the endless wailing of the damned, all hope abandoned.
In my world, people fear nursing homes more than morgues.
And so, in the grip of that overwhelming fear, they cry out to whomever it is that is caring for them (spouse, offspring, relative, friend, partner): “Save me! Don’t send me to that hell!”
And their person (spouse, offspring, relative, friend, partner), out of love, duty or the simple human desire to stop the suffering of another, says, “I promise never to send you to hell.”
And so, the Extractor is relieved, and can face, again, the reality of decline, secure at last from the thing they fear the most, believing absolutely that their caregiver will abide by the most important promise of their life.
The pity can be that the caregiver often does exactly that: Keeps that promise and takes it to their grave.
No, I’m not being overly dramatic, because I’ve seen it way too many times.
That caregiver will work, work, work and work, and care, care and care and never ask anybody for any help at all while the Extractor goes down and down and needs more and more while the days get longer and longer and shorter and shorter and … eventually, something happens.
Something always does.
One thing that sometimes happens is death.
No, I’m not talking about the patient — The Extractor — I’m talking about the caregiver.
From sheer exhaustion and stress. Gone.
And who is left alone? Needing more care than they needed before?
And needing it from people, agencies or bureaucracies … who have no interest whatsoever in anybody’s “little promise.”
So where does the Extractor often end up? Right: In the third level of hell. Betrayed.
Alone.
Ironic.
What’s more ironic, at least to my way of thinking, is that The Promise is almost always extracted, and provided, in the name of love: “If you love me, you will promise this.” “I love you, so I will promise this.”
If I love you, why would I try to kill you? I wouldn’t.
If I love you, why would I kill myself and leave you alone? I wouldn’t.
But we do.
We do because we didn’t look for help, we didn’t ask for help, we didn’t accept help — we didn’t do any of those things because we (the caregivers, the Promise Providers) decided that any kind of help equaled breaking that Promise, so we toiled on.
And on. And on.
No, of course, this doesn’t happen to everybody, and sometimes The Promise is fulfilled (not without taking its toll, but fulfilled, nonetheless).
However, it happens more often than you might care to know, veiled in the guise of this-or-that diagnosis or condition.
But it wasn’t the diagnosis that killed them. It was the love.
It was The Promise.
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Mark Harvey is director of Clallam/Jefferson Senior Information & Assistance, which operates through the Olympic Area Agency on Aging. He is also a member of the Community Advocates for Rural Elders partnership. He can be reached at 360-452-3221 (Port Angeles-Sequim), 360-385-2552 (Jefferson County) or 360-374-9496 (West End), or by emailing harvemb@dshs.wa.gov.
