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How the Oldest Old Can Endure Even This

January 07, 2021 2:42 PM | Office IFCPP (Administrator)

Reposted from The New York Times

It was sometime in the spring that Ruth Willig, then 96, first compared her pandemic life to being in prison. My mother, Dorothy, was still alive then, in a building much like the assisted-living facility in Brooklyn where Ruth lives. The buildings had shut down all visitors and stopped all group activities, including meals in the dining room. Residents spent their days in their apartments, alone.

“It’s very depressing,” Ruth said over the telephone in late March. At that time, the virus was raging in New York, most lethally in nursing homes. Facilities that were designed to prevent social isolation were now doing everything possible to enforce it.

“Two nights ago they came to my door and told me I couldn’t go outside,” Ruth said then. “I don’t know what reason there is, or if anybody has it in the building. They don’t tell you anything. But we’re stuck here. They bring the food. It’s just awful.”

That was how the pandemic began for Ruth Willig, the last surviving subject of a New York Times series that began nearly six years ago, following the lives of six people age 85 and up.

For Ruth, it was a year measured in what she gave up: visits from her children every weekend, daily meals with friends, chances to see her great-granddaughter, now 3 years old and changing daily. Also: Passover, Thanksgiving, her birthday and perhaps her last days of walking without a walker, even in her small apartment.

Her building’s management declined to provide numbers, but records at the State Department of Health show five deaths there either confirmed or presumed to have been caused by Covid-19. At my mother’s building, in Lower Manhattan, the count was three times as high.

“I say, ‘Why do I have to keep going?’” Ruth said back in the spring. “Judy” — her oldest daughter — “says, ‘Ma, if you die now we won’t be able to have a funeral. I won’t be able to see you.’” Ruth laughed. “That’s a terrible way to put it, but she’s right,” she said. “Meanwhile, I’m not dying. I guess it’s good. I laugh and I say I’m ready, but I’m really not.”

Her complaints over the next months were the same as my mother’s: the edict to shut down contact with other people, the food delivered cold to their rooms.

As Ruth’s building allowed a little more mobility over the summer, she became aware of the neighbors whom she did not see. “I don’t know if they’re alive or how their health is,” she said. “You have to ask, and they don’t always want to tell you. So we don’t always know. If I walk around I see a lot of empty rooms.”

The pandemic has wrought unequal effects on New York’s population groups. For older adults in institutional settings, it has meant ceding even more control of their lives to the institutions, unasked, in exchange for safety.

“It’s very paternalistic,” said Louise Aronson, a geriatrician and professor of medicine at the University of California, San Francisco. “Like, we know what’s better for you. I get that the intent is good. But it’s basically putting draconian measures onto frail older people for society’s failure to create better systems.”

Ruth, who trained as a microbiologist, understood the restrictions but resented them.

“I’d like more freedom to get around,” she said. “I look out at the water and see these people walking back and forth, and I wish, Oh, my God, wouldn’t that be nice.”

The hairdresser and the rabbi stopped coming to the building. The meals, the bane of most institutions, were even less appealing without a companion at the table. Ruth lost weight.

But one day, amid complaints, she said: “I get my joy out of my plants, I really do. My Christmas cactus has four or five flowers.” She read Michelle Obama’s memoir, then Barack’s.

A surprise of the pandemic has been how well many older adults have adapted to the restrictions. “There’s crisis competence,” said Mark Brennan-Ing, a senior research scientist at Hunter College’s Brookdale Center for Healthy Aging. “As we get older, we get the sense that we’re going to be able to handle it, because we’ve been able to handle challenges in the past. You know you get past it. These things happen, but there’s an end to it, and there’s a life after that.”

While people of all ages have struggled this year, those 65 and up are still more likely to rate their mental health as excellent compared with people under 50.

For Ruth and her family, efforts to stay connected came with frustrations. Her children bought her an iPad so they could share video calls, but for months she kept it in the packaging because it was unappealing or hard to use.

She eventually started using it to play Cryptic Quotes, and occasionally for FaceTime calls.

In the spring, the only way Judy Willig could see her mother was on what she called “window visits,” at which they would talk via cellphone from opposite sides of the glass.

“That was the worst,” Judy said. “She’d reach her hand out to touch you, and there was glass between us. I would do those window visits and then go sit in my car and cry. They were just awful.”

Early in the pandemic, Ruth’s closest friend in the building stopped answering her phone. Since Ruth could not leave her apartment to check, for days she was left to wonder: Had her friend gotten the virus? Finally the friend called from a rehab center, and they resumed daily calls. But it was a scare.

A part of writing these articles, which began in 2015, has been learning to say goodbye. By the start of 2020, five of the six subjects — Fred JonesJohn SorensenJonas MekasPing Wong and Helen Moses — had died, each facing the last days differently. For all, death meant not just the final heartbeat of one person, but a communal process that began well before the last breath and continued after.

The coronavirus, even when it spared a body in 2020, ravaged the rest of this process.

On May 30, my mother developed a urinary tract infection and went to the hospital in Lower Manhattan, where I was able to sit with her indoors for the first time in nearly three months. She made it back home but never recovered her strength, and in late June, when it became clear that she wouldn’t, her building let me visit in her final days. My brothers, in North Carolina and Oklahoma, who had not seen her since 2019, could not come to say goodbye.

Ruth was among the first to call me when my mother died.

As case numbers dropped in New York, in late August, Ruth’s building allowed family members to visit — outside, at opposite sides of a long table.

Her building started to open the dining room partially in September. A few times a week, Ruth goes downstairs and eats a meal by herself at a table, six feet away from her closest friend. It is near enough that they can talk a little, even with hearing aids. Intermittently the dining room will close again because someone in the building tests positive. But on days when Ruth dines downstairs, Judy said, she can notice the difference in her mother’s voice. “She’s much more alive,” Judy said.

In November, a day before her 97th birthday, Ruth fell in her apartment and hit her head, telephoning Judy from the floor when she could not get up. Mother and daughter were finally able to spend time together, four hours in the hospital emergency room.

By the time Ruth fell again a few weeks later, she had learned a lesson: “This time I wasn’t going to tell anyone, because I didn’t want to go back to the hospital,” she said. “You should’ve seen how I managed to get up. I moved around on my behind, otherwise known as my tush. And I had black and blue marks all over my elbows, and I managed to get up without calling anybody. I’m a stubborn mule.”

After the second fall, a physical therapist advised her to use a walker even in the apartment.

Just before her birthday, Ruth mentioned the prospect of living to 100 — a change from our past conversations, when she had said only that she did not want to get there. That same day she brought it up again with her daughter. “For the first time ever she said, ‘Maybe I’ll live to be 100, and if I do, we can have a party,’” Judy Willig said.

At last, on Dec. 7, the building opened for a few visitors — with an appointment and a negative test for the virus. Judy grabbed the first appointment, in order to get in before someone in the building tested positive and the doors shut again.

She was given one hour. She had a long list of chores, starting with Ruth’s closet.

“Mostly we hugged,” Ruth said, “which we haven’t been able to do forever.”

Judy Willig remembered it slightly differently. After 15 minutes of hugging, she said, “I finally had to say, ‘Now I only have 45 minutes left.’ And she said, ‘Can’t we just sit and talk?’ And I said, ‘Not today.’ Because my fear is that they’re going to shut it down again.”

The visit and the meals downstairs have made a difference for Ruth. “The nice thing is that things are getting a little better,” she said. “I’m lucky in one way that I can heat up the meals myself, but in the other way it’s nice when someone does it for you. So it’s like a tossup.”

My mother would have turned 92 on Dec. 21, largely against her wishes. Her remains rest atop a bookshelf in my bedroom, next to an action figure of Ruth Bader Ginsburg, waiting for a time our family can gather to scatter them.

Because of the pandemic, the medical school to which she had promised her body was no longer accepting them. The cemetery did not allow gatherings, so on a sweltering morning in early July, five of us said a few words over her in the loading bay behind the crematory, before her body went inside. The experience was probably worse for my brothers, who watched it on Zoom, but it would be hard to say how.

Her two home attendants, amazing women who traveled long distances to care for her during the pandemic, are still without work, their informal job network another casualty of the virus.

But for Ruth and others who made it this far, a better day was in sight: The first vaccine doses had started to reach nursing home residents.

Four years ago, at the end of 2016, Ruth wanted to knit a blanket for her coming great-grandchild, but she feared that the tremor in her hands would prevent her. She knitted it anyway. This year, during the pandemic, she was knitting again.

That is Ruth, 2020.

Catherine Thurston, chief program officer at Service Program for Older People, which provides mental health services, said her staff had seen this kind of resilience in many older clients this year.

“They’ve been a real lesson for us,” she said. “I often tell the story of my own parents, who were Holocaust survivors. And after 9/11 it was so good to talk to them, because they said, ‘Look, horrible stuff happens, and people rebound from it.’”

A motto to take into the new year: Horrible stuff happens, and people rebound from it.

And eventually, at Ruth Willig’s assisted living facility, the hairdresser will make a long-awaited return. “I really need a haircut so badly,” she said.

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