Interview with a 'Well Older Adult': A Nursing Student's Perspective An older adult relates her philosophies on coping with aging to her grandnephew, a nursing student.

BY K E N N E T I I P E A R L S T E I N

I took the bus from the elevated subway, and it let me off on busy Roosevelt Boulevard, just one block from her home. I passed by the markets that crowded the

main section, marking the variety of stores that served the neighborhood: meats, fresh produce, fresher produce, bagels, pizza, restaurants. This was a neighborhood in which the sale went to the person offering the greatest bargain. This neighborhood served those who had sur- vived the Depression, who, however well established, never forgot those hard days, who cherished the saving of a dime not for the sake of the dime, but for the hour's wages that a dime was once worth.

I followed the road away from the markets toward houses designed to the same blueprint, each indistin- guishable from the next except by number and detail. Edith's ltome was the one with the yellow railing leading to the front door. This was the trademark of her duplex; this and the weil-kempt plants that lined the window that faced the s t r ee t s . . , and the velvet backs of photo frames. The lawn was neatly trimmed. Everything in order.

My Great-Aunt Edith answered the door with her por- table phone in hand and let me in while she finished a conversation w i t h . . , someone. She would be with me in a moment, she told me with her e y e s I m a k e myself com- fortable. I sat down. I took in her surroundings. Her house was filled with books, those most immediately to be read lying about for easy access. On the coffee table were stacks of playbills collected from her December visits to New York. In the corner was a springboard designed to exercise her knees and ankles.

Edith had much to say on the subject of being an "old- er adult" and was pleased with this phrase as an alter- native to any less current way of describing herself. The following is an interview that she granted me on the sub-

KENNETH PEARLSTEIN is a second-year nursing student at the Community College of Philadelphia. Copyright @ 1993 by Mosby-Year Book, Inc. ISSN 0197-4572/93/$1.00 + .10 34/1/39969

ject of living life as a "well older adult." In it she gave me a tour through her 76 years, shared with me her strategies for coping with deteriorating health, and offered me an opportunity to evaluate my attitudes toward senior citi- zenship.

She described life with children of the Depression era as living "scrappily ever after." There were no toys for the chi ldren-- the family read poetry to one another for evening entertainment and in this way reminded one an- other that being rich had little to do with money and ev- erything to do with having one another. The family ran a grocery store that was maintained long after the children had married but abandoned after a gunpoint robbery. After this, she and her husband were assisted by their now-successful son into jobs at a bank, where they worked productively until their retirements.

She described a supportive marriage in which both partners worked. She described her husband's trepidation at putting his wife in the position of "working woman" in an era in which men's and women's responsibilities were so clearly delineated. She told me a touching story about her husband's desire to get a driver's license and his thrill at having the opportunity to transport her to and fro as if, at least in this way, he could take on the more customary responsibility of a husband to his wife. She confided to me that for this reason she never got a driver's license. She didn't want to take away that one pleasantry he had in providing for her a means of transportation. She told me that although she is too old to learn to drive now, she would make the same choice again for the sake of her husband's self-esteem.

She described her courting days. She described her husband's love for her, their awkwardness in the knowl- edge of affairs of the heart, and the successful means by which they conquered all: trial and error. She described what it was like to wake up in the morning in early mar- riage and gawk at this "beast" in her bed. She told me, in a discreet yet certain way, that once they had figured out what sex was, they were good at it and had a healthy sex

36 Geriatric Nursing January/February 1993 Pearlstein

life. Yet she was emphatic in having me understand that what she misses about her husband most of all is his pres- ence.

Edith likes this interview business! Being considered a well older adult is in itself a mark of success to Edith; she tags each question that I put to her with a joke and then expounds wisely. Some of her philosophies on living the life of a well older adult are so new and vital that they warrant special at tention--and she knows it. She knows it and wants this interview as a marker for posterity's sake. In this line of duplex apartments in northeast Phil- adelphia is one duplex with a yellow railing that contains what is unique about every human being: individual per- ception and insight.

"Tell me about what it is like for you being an older adult." I tried to ask this question casually, in the context of our general conversation. Her response was, "I could ask that same question of you!" There was extreme glee in her voice: she loves to be funny, Edith does. And so there were some mischievous comments made about "old folks" before she would settle down. Then she looked at me squarely and began a serious answer to my question and to the questions that she knew were implied. "I don't mind being older," she said. "I 've had a good l i fe--a good home life. Good memories. If you're asking me if I 'm afraid of dying, then I must tell you that I am not afraid of dying as a result of being 'older.' Death, as you well know, could happen to any of us at any t i m e . . . " She was referring to the early death of my father, among others with whom I would be familiar. "As long as I can take care of myself . . . . "

I asked her to give me an idea of a day in her life. Her tag phrase was, "They're all pretty much the same--only the names are changed to protect the innocent." And some more funny business: "First thing in the morning," she said, "I pick up the paper and I read the obituaries. If my name is not there, then I know that everything is going to be okay. No, seriously, I wake up and I read the paper first thing. Then I call my best friend (or she calls me) and we discuss what's in the newspaper today. We have known each other for 60 years, Kate and I." She got up from the table and got a card that Kate had sent her. The card read, "You're the best thing that has ever hap- pened to me in 60 years."

"She and I, we work it all out. For instance, this Judge [Clarence] Thomas scandal. We don't know who's lying, but we know that someone is lying, so what do we do? Throw out the ent i re issue! Let ' s look at the man 's quali f icat ions! He's simply not ready! Any man who is not ready to discuss Roe v. Wade is not ready to serve on the Supreme Court. I read something the other day that I must show y o u . . . " She got up from the table, left the room, and came back carrying a clipping from Philadel- phia's finest newspaper. The headline read, "Asthmatic After Atomizer Shoots Herself By Mistake." "Can you believe this?" she mused. "The woman keeps her inhaler under her pillow in case of an emergency. She also keeps a gun under her pillow in case of an emergency. This time, she reached for the wrong one. Here it is ill print! I love the newspaper!

"So we talk about the newspaper, Kate and I, and then

I put the coffee on to brew. Then I take a bath, dress, have my coffee, write checks, pay my bills, and then I go shop- ping. I love to shop with my friends! We eat out, discuss books, sit outside, go to the mov ie s . . , then I come home and I take another bath, undress, watch television, and go to sleep. You will please notice that I do not have a re- mote control for the television! People think that I have an old television. Look at that television--does it look like an old television? I don't have a remote control because I don't ever want to get s t u c k on that couch. If I want to change the channel, I make myself get up and change it! Now if I 'm watching television in my bedroom, this is an- other story. I have a remote control in the bedroom. Older people can fall in the dark, so I use the remote when I 'm in bed. And that's my day."

"I notice that the phone is always ringing in this house, Edith."

"Can I help i t?" she asked with a proud smile. " M y friends and I have a system whereby we call each other at certain times in the morning. This way someone will know right away if something is wrong. This is how we cope with living alone. We take care of each other. We watch out for one another. And then there's family. I have family all over this area as well as abroad. They call me and I call them. Friends and family. This is a big part of my day. I am very grateful to Alexander Graham Bell for his superb invention."

Edith's ankles look more swollen today than they did at our last visit. Otherwise sfie looks fit for 76 years old. Her weight is appropriate, her skin is well colored, and she is warm and dry to touch (she insists on a kiss and a hug of- ten). Before my visit today she had been to her doctor for the torn cartilage in her knee, which prevents her from her usual walking routine. She has just received a corti- sone shot. She occasionally and discreetly reaches a hand down and rubs her knee, but does so as if she were straightening her clothes so as not to draw attention to her ailment. When she does this her face becomes overly composed so as to control that which I perceive about her physical process, so as to keep the focus on her spiritual self.

She knows that she has been caught, however, by the content of my next question, "Edith, how would you de- scribe your health?"

"Well, I don't worry about my health and I don't spend much time thinking about it, but if you insist on a litany of my ailments then here it goes: I have a torn cartilage in my knee; I have a heart condition, a murmur; pooling of blood at my ankles; and my heart skips a beat. Other than that I 'm fine."

We laughed, and then there was a lull. Does Edith un- derstand what causes her ailments? "Let ' s be realistic. Eventually our systems run down. When I go out with my friends in the afternoons, we never, never speak of our ail- ments. It would be futile and a waste of time. Could you imagine? A clutch of senior citizens trying to 'out-sick' one another? We just don't talk about that which is so blatantly apparent!"

The phone rang again. "Should I answer it," she asked devilishly, "or should I let the machine pick it up?" She decided the route to take would be to answer the phone

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and make a show of it. "'Hello!" She winked at me. "Lis- ten, dear, I am in the company of a handsome young man, and so I couldn't possibly stay on the line right now! All right, love. Bye!" She hung up the phone. "Now, where were we? Oh, yes, old age- - I mean, 'the aging process.' Inevitable!"

I asked her whether, besides the aging process, any other factors contributed to her health. Again, her first response was a tag phrase: "My good health or my bad health?" And then came the most vital and unique part of what she has contributed to this interview. She leaned in and her eyes became intent. "'Good health," she said, "is a direct result of how we react to bad health, and now let me explain myself. When something bad happens to us, we can perceive that bad thing as the means to something that is bad or the means to something that is good." She wanted to be clear and was not yet satisfied that she had done so. She went on after a thoughtful pause. "People often ask me, when I stand on 'liberal principles,' how I would react if I were to meet the man who once held my husband and I at gunpoint in our grocery store. I always tell them this: if I were to meet that man, I would kiss him because if it weren't for him, my husband and I might never have changed careers!" She was becoming more ex- cited. "When something goes wrong with my body and I am presented with a symptom, I am presented with the challenge of fixing it! The challenge is in trying, to the best of my ability, to fix it. The act of taking care of my- self is the reward! Do you see? There is no reward for the complainer. The complainer complains and does nothing with his symptoms, but even the chronically ill person can live a long time by perceiving each of his symptoms as a warning that is to be heeded and dealt with.

" W h a t troubles me is a disease like cancer which creeps in with no announcement. There is no application of my philosophy to a sneaky disease, only an apparent one." She was quiet. Then she added, "My best friend has cancer." More silence, and then a deep breath. "I can even deal with this news--any news, any disease, any ail- ment, any ache, any pain-- just leave me my mind. If I have my mind, I am entirely grateful. If my mind were to ever fail me, then I would wish for an end to my life. Like the title of the book, They Shoot Horses, Don't They?"

The room was filled with a momentary despair at the thought of such a time, and we both faltered for a mo- ment, each looking at the other, hoping for some smart phrase that would empower us both to move on. I tried to focus, though somewhat awkwardly, on those things she had some control over to generate the steam necessary to bring us into the present. "So," I said, "here you are in northeast Philadelphia in a cozy apartment, surrounded by the rewards of a full life! Let's talk about your home and your neighborhood."

She jumped right in. "I love it here! I mean, I really love it!" She started to gesture in each direction as she mapped out her surroundings for me. "I have my laundry room right back there, I have my books, I have a layout that makes things easy for me. I have my shopping cart and plenty of places to shop for groceries. This home

makes many things possible. I don't ever want to move. Everything is just right here."

"Would you ever consider moving to New York to be with your son?" I asked.

"Absolutely not!" "Why, 'Absolutely not '?" "Because my friends are here, my family is here. I have

a son in Philadelphia, too, and other family. I don't have to tell you: a majori ty of those who I love deeply live within a 3-mile radius of my home. I need that. Family and friends." She leaned in to me once more and said flatly and factually, "It 's very hard to make friends when you are older. My newest friend, Lillian, I've known for 32 years. If she sticks around, she might make it on my list. Do you see? [ am attached to my home, to the phys- ical layout, to the neighborhood, to my friends and rela- tives. A move would be devastating." She was quiet for a moment and then she revealed what was at the heart of the matter: "I have survived the greatest of life changes in the loss of my husband. Living alone after 47 years has been quite the sufficient challenge I spoke of when I spoke of turning bad things into good things. I'll tell you how close we were so you'll know what I mean by a sufficient challenge, so you'll understand when I say that living alone in this apartment is the' rest of my life's work.

"At the end of my husband's life, when he was in the hospital and very sick, he recognized no one. I would stroke his face and ask, 'Morris , who am I? ' And he would say, 'I don't know, but you look very, very nice.' And one time when he said this I said, 'So, if I look so nice, do you want to sleep with me?' And he answered, 'You don't look like that type of girl.' " Edith was smiling right down to her soul. "Do you see," she said, "even when he didn't know me, he knew me."

I remember riding in a car with Edith and her husband. How the other drivers used to honk their horns at us as we cruised down busy Roosevelt Boulevard at 20 mph! They would sidle up to the car before they passed and spew frustrated insults through two car windows and the air between. Edith would look over and smile and wave to them, and under her breath she would mutter in Yiddish, " M y belly button is very sorry that I have upset you." That's the literal translation of a saying that has no par- allel in English. "My heart bleeds for you," comes close, but is too biting. She was telling this impatient driver that her pr ior i t ies--pr ior i t ies that he would not know for many years to come--were in order, and she was telling him that all is well because apples are on sale at Acme Market for 39¢/Ib.

Edith is lucky. She has a family that loves her and will always be able to provide her with the most exceptional care, perhaps one-on-one. She knows this. Still she has to fight for her dignity in this world. From here on in, she will have to struggle every step of the way.

Edith raised her coffee cup. "Here 's to change! Let's make the most of it." •

38 Geriatric Nursing January/February 1993 Pearlstein