Faustian bargain: trade autonomy for safety

“Ma, that sounds like three out of five stroke symptoms.”

My mother had just told me about her day, which included falling, one eye going dark, and dizziness – all at once. In recent years, I’d learned that patient listening reveals how well my parents are aging. “Oh no honey, those are just Transient Ischemic Attacks” she said before resuming her stories. “Ma,” I said as calmly as possible, “that’s a TIA, that’s a stroke. How did you know that’s a TIA?” Big words like that usually come from a doctor. “Oh, it’s not a real stroke,” she replied, “the doctor said it’s just a little stroke.”

I asked, “Does Dad know?” referencing the guy most likely to drive her to the ER. Apparently not, and that’s how she wants to handle it – independently.

Raising children is a process of helping them to build their independence and guiding them till they branch off on their own. However, supporting elderly parents is generally the reverse process, where adult children slowly encroach on their parent’s autonomy in an effort to balance their independence with their safety. What role should adult children play in the lives of their parents? A harder question is when to stand by and when to intervene for their safety? When is their business? When is it our responsibility? Tough questions.

Growing up in a big family, I learned early that the number of opinions are greater than the sum of the family members. When my brother called to tell me about a recent parental calamity, he started off by saying, “Now, don’t panic!”, as if that works on anyone. The night before my dad had tripped and fallen in the back yard while taking the dog outside. Too weak to get up, he laid there for an hour, maybe longer in the middle of the night. At least the dog kept an eye on him, but she didn’t go for help like TV’s dog-star Lassie. He was supposedly the stronger of my two parents. Or at least he was.

Of all the familial archetypes, I must be Chicken Little, with a typical reaction of, “OMG! OMG!” My brother is the Mr. Spock of familial mythology, logically saying that we should pace ourselves for the rough road ahead. My sister is the mythological equivalent of an accountant, which she is in real life, as she runs the balance sheet on their net safety. But who’s to say which reaction is right?

If my parents remain alone in their home, it’s likely that one of them will have a serious fall. Falls and the subsequent complications are a leading cause of death for elders. Certainly, such accidents are tragedies. Yet my parents want the dignity of “aging in place” to watch the seasons go by in their own home.

If we could choose, wouldn’t we all prefer to live out our days while doing the things we loved rather than to be held hostage by life support systems? This is especially true for seniors who can afford to remain in their own homes. It’s often a Faustian bargain to trade one’s freedom for the limitations of safety.

These questions become even more pressing given the growing number of people who are aging alone. According to the 2010 US Census, 11 million people over the age of 65 (28 percent of all seniors) were aging alone. The federal Administration on Aging reports that as of 2015, there were 13.3 million seniors living alone. The Institute on Aging show that demographically, statistics vary widely: 40 percent white women and black women are more likely to live alone, whereas only 21 percent of Asian women and 23 percent of Hispanic women live alone. According to SAGE USA, LGBTQ elders are twice as likely to live alone. That’s a lot of people at risk of falling with no one around to help.

Perhaps there is no single best role to play, no single informative archetype to follow. There will be tragedies, there will be the dignity of independence, and there will be everything in between. Most certainly, there will be questions and choices for what supportive roles we should play as adult children, neighbors and others. Because the same village needed to raise a child will also be pressed into service to support the aging members of our community.

This story was originally published August 30, 2017 at 8:28 PM with the headline "Faustian bargain: trade autonomy for safety."