“Go slow” is not only the slogan for Caye Caulker, one of the islands I visited, but a way of the life for the entire country of Belize. As a nurse I am accustomed to having too much to do in too little time. Our society as a whole is on fast forward, and always looking towards the future, forgetting to live in the present.
Not having anything I need to do at a certain time is both a challenge, and a huge relief. Yes, I’m looking at aging and dying, but it’s not a research project. I don’t have a hypothesis I am trying to prove. I don’t have a million appointments set up. I take opportunities to learn as they arise. The purpose of the Bonderman Fellowship is to “wander and wonder”. It’s about how people die, but more importantly about how they live.
I found the pace of life so much slower and more enjoyable than I’m used to. When I visited Sister Cecilia’s Home for the Elderly in Belize City, no one seem rushed. There were many nursing assistants and students, all taking the time to talk to the residents, play games, and share stories.
During my time working in nursing home and assisted living settings in the United States, I wanted nothing more than to do this. Being responsible for anywhere from thirty to fifty patients, I hardly ever had the time.
Atul Gawande is a renowned author and physician. His book Being Mortal brings into question what is really important at the end of life. He describes the flaws in our medicalization of aging. Dr Gawande states “ Medical professionals concentrate on repair of health, not sustenance of the soul. Yet— and this is the painful paradox— we have decided that they should be the ones who largely define how we live in our waning days.”
Senior care in Belize and elsewhere in the developing world may lack our stringent safety standards, but allows the aging person to maintain their autonomy and dignity. If a person with a walker wants to walk on a bumpy road to buy apple juice from their favorite store, they are allowed to do so.
There are risks, but are these risks worse than taking away everything that makes a person feel human? I don’t think so, and there are a lot of others who are starting to see things the same way. It’s about quality of life, not length.
Each person should have the right to live their life to the fullest whether they are eight, or eighty. They should be able to pursue their goals and needs, not anyone else’s. There are exceptions, like those with advanced dementia who do not have decision-making capacity. However, there are many people of advanced age who are of sound mind, but are denied their rights to self-determination because their bodies are deteriorating.
Where I’m from, nursing home residents are forced into waking up, eating, and bathing at times that are convenient for staff. Many times they are capable of participating in their own care, but staff don’t have the time to allow this, so they do everything for the resident. They are given little choice in what their day is like. A large part of this is simply understaffing, but what if we slowed down and saw the patient as a person, instead of as a box on a checklist of work to be done?
We need to start seeing senior and end of life care in a more holistic manner. We don’t need more medications, diagnostics, or surgeries. We need more interaction, music, recreation, and animals. There are numerous studies that show these non-pharmacological interventions improve both quality and length of life. They are more cost effective, and more important.
Older adults have spent their lives contributing to our society, and deserve to be honored and respected in their final days. I refuse to work under any entity that doesn’t treat them as such. Please policy makers and health administrators, what we really need is more time. Help us put the life back in living for those that we care for.