We live in a cultural cage
For the most part, we are unable to see beyond the norms of our society
Bette Ann Moskowitz, author, creative writing teacher at Queens College NY, and ombudsman
I never played with glass marbles, but I owned some when I was a child. And because I belong to one of the last generations that had the privilege of getting bored, marbles filled in a lot of my tedious hours. The thing is that marbles can satisfy many senses. They are pleasurably heavy - not too much, not too little - and their weight contrasts with the lightness of the colorful spiral inside. I spent hours changing my mind about its material. Sometimes I was convinced that it’s rigid, and other times, it must be some kind of flimsy plastic floating in the transparency. Looking inside the glass, I can see tiny, irregular air bubbles and beyond them, the reality takes a marine hue. Even in a hot summer day, marbles feel fresh in my hand. I scratch a handful together and they produce a dull and “clacky” sound. I bring them to my ears to amplify the effect. Inevitably, their size is an invitation to stick a couple of beads in my mouth. They have no taste and, if they get in contact, they produce a muffled version of their unmistakable sound. The majority of my collection is in various hues of green, but I like the clear transparent marbles the best. In particular, there’s one with a monochromatic blue spiral and I lose myself in it. Had I known the word, it would have been a perfect wabi-sabi moment.
Fast forward forty-five years, I had another wabi-sabi moment reading Do I Know You? A Family’s Journey Through Aging and Alzheimer’s, a book that ties my story to the one of the American author Bette Ann Moskowitz. In this book (that won New York State Foundation for the Arts Fellowship for Literary Non-fiction), she described her journey along with her ailing mother, from the onset of Alzheimer’s disease to the hospitalization in a residence and, finally, her death. The ordeal is chronicled in a logbook in which facts and emotions are interwoven in sentences that create the swirling effect of my childhood’s marbles. “What I see is in the light of my mother’s spirit and self.” Hers is a bare and brave account that explores the depth of transformation - of existence, relationships, feelings, and beliefs.
By peeling off one layer at a time, Bette Ann gets to the heart of our frailty. After her mother passed away, she picked up the debris of her experience, signed up to become an ombudsman first and an Assistant Coordinator of the State Ombudsman Program in two upstate New York counties later. The result of this experience is contained in The Room at the End of the Hall - An Ombudsman’s Notebook, a book that questions the business of old age and how aging impacts on those who undergo it. A few weeks ago, her non-fiction book, Finishing Up: On Aging and Ageism arrived in bookstores. By exploring aging and ageism, Bette Ann inquires into the silent workings of our culture. I started this project with the claim “Disobey the stereotypes.” I would have never imagined that there were so many different ways to do that.
Can you tell us a bit about yourself?
I am a thorough New Yorker, born in the Bronx, schooled in Manhattan, married a man from Brooklyn and raised my two children in Queens. (Sorry, but I did take the Staten Island Ferry once.) I read a lot and have been writing since I was seven. I went to Music & Art High School in New York City as a vocal student, and studied at the City University of New York, getting my undergraduate degree in Literature at Hunter College and twenty or so years later my graduate degree in Creative Writing from Queens College, where I ended up teaching writing.
Right out of school, I wrote publicity and promotion for a record company, a column for a music magazine, and song lyrics and comedy material for various up-and-coming performers. While I was raising my daughter and son, I wrote freelance articles for weekly papers and a children’s magazine. My first love is fiction; yet much of my published work is in non-fiction. Life has just taken me that way.
After sixty years in the city, we moved to our weekend house in Woodstock, New York. The change came hard. It’s taken until now to feel at home here. I don’t like change. Maybe that’s why I like old people so much? They’ve been “at it” for a longer time than anyone else so they’ve done more things at least once than younger people? Well, I don’t think it is exactly that. But the question intrigues me.
Where does your interest for aging come from?
It is not quite “aging” that has been my long-term interest, it has been “old people.” Maybe it has something to do with my early and abiding love of fairytales. The maidens are privileged but powerless, the kings are just there, the princes are either cut off in their prime or recipients of dumb luck, but the (mainly female) old people - witches and crones and godmothers - have the knowledge and power. They are the ones who make the wheels turn, the frogs leap, and the trees talk. In real life, the sight of an old man in the street or eating alone, or shopping alone, has always made me get a lump in my throat.
My own family story is that my paternal grandmother and grandfather – neither of whom I ever met – died within minutes of each other, in adjoining rooms. It fascinated me. My husband of 56 years just died. He was a month short of his 85th birthday. I was a month-and-a-half short of my eightieth.
My interest in aging is easier to understand. It is directly related to the stunning changes I saw in the strong, intelligent woman who was my mother as her physical abilities declined, and then her mind started to go.
When we think about aging, it is always a bit abstract. Dealing with someone else’s aging and decline, like you did with your mother, brings an emotional toll along, as you described in the book Do I Know You? Does a system designed to accommodate the needs of the young and fit make it more difficult to come to terms with the emotional ambivalence of the situation?
In a “system designed to accommodate the needs of the young” as you put it, aging physically is a source of alarm and shame, and brings on the desire to hide, misdirect and deny. The extra burden this puts on an older person is a likely reason for many older people becoming depressed, despairing, and sometimes it even contributes to their derangement.
What I saw during my mother’s decline was a system of help with huge gaps. Agencies could not help her because she had too much/too little money, was not in their “category” of assistance, was out of the geographical area. Seeing (trying not to see), feeling (trying not to feel), what she had “come to” brought on feelings of guilt, sorrow and anger that I could not do better for her. (Nothing ambivalent about that!)
After she died, I kept thinking about it and thinking about it. Specific incidents disturbed my sleep. Why had “they” treated her that way that day? Why hadn’t I said or done something about it? Those questions of her treatment in the nursing home, and the guilt of not having done well enough for her, led to my volunteering to be a long-term care ombudsman. I was trained and certified by New York State to observe and advocate for residents of nursing homes. The program is Federal, but administered by individual states, through county offices of aging and other non-profits.
Stemming from your experience as an ombudsman, what have you learned about the way old age is treated and managed in our society?
Ombudsmen have access and agency, but no power. They cannot condemn, cite, fine, dismiss, or otherwise take action concerning a bad act perpetrated on a resident. They can report it to the Department of Health, which is often problematic, because the Department of Health is large and bureaucratic, and by the time they get to it, the issue is resolved, or the resident has forgotten about it or is dead. What I had begun to learn when my mother was a resident, I continued to learn in a larger sense. All residents of nursing homes are subject to regulations of institutional living. And although those regulations protect the residents from gross neglect and abuse, the institution itself operates for efficiency, and profit (or, for non-profits, self-perpetuation).
What has impressed you the most about this experience?
Congregant living, especially for individuals without the power to advocate effectively for themselves, is a poor kind of life. You get up and go to sleep on the schedule easiest for the staff’s shift changes, medication passes, kitchen prep. If you were a night person, saxophone player, say, who was used to going to bed at 4 a.m. and sleeping till noon, too bad for you. Now you have to conform to the schedule of the institution. Food is the homogeneous lowest common denominator you can guess it would be, with bulk purchasing, and cooking done to accommodate people sensitive to salt, or sugar, or fat, or spices.
The institution is set up and run like a hospital without the healing going on. It is not home living. The things you once took for granted, like skipping lunch and stepping outside for a breath of fresh air, say, or sleeping in, or having a beer with dinner, are all subject to regulations and permissions. There are homes now that are attempting to run on the residents’ schedules and responding to their lives. They are few and far between, so far.
You wrote about the need to demedicalize aging. Can you elaborate on this?
We consider aging as a chronic ailment rather than a passage or time of life. This means that sometimes we under-treat it, by seeing something treatable as a feature of aging, to be endured because it “comes with the territory” or, on the other hand, over-treating it, seeing expected changes as we age as a disease, subject to unnecessary tests and treatments. The specialty of geriatric medicine, by the way, is young. As recently as the 1970’s and 80’s, trainings and certification began to be offered for students of internal medicine. Even so, it remains an unpopular choice for young doctors starting out.
De-medicalizing aging would have revolutionary implications. We would have to ask more questions about the meaning of life and the end of life, we would have to make a different set of choices. What do you think?
We start and stop when we begin conversations about death and dying. It is too frightening. Maybe we would feel differently if we talked about long life and living, instead? Books like Atul Gawande’s Being Mortal come to mind. But in order to talk about long life and living, yes, we would have to think outside the ageist belief that aging equals “the long road down.” (Play the dirge here.)
When it comes to the rights of old people, we are stumbling in a place with no clear boundaries. What is your take?
After a few years, I was asked to become the assistant coordinator of the ombudsman program in two counties of upstate New York. So, I began to see nursing home life in an even larger context. I saw the often-repeated problems. I began to get a handle on what a congregant life could offer. Some homes were better than others. No homes were where I would want to live. They are famously emphatic about Residents Rights. Every nursing facility has to post these rights prominently: to be treated with respect (the most widely ignored of all “rights” and the most difficult to enforce); to participate in activities (though most activities are devised to keep residents busy and not much more); to protection against discrimination of any kind (though I am aware that many members of the LGBTQ community go “back” into the closet); to freedom from abuse and neglect (though both still go on, if more subtly); to freedom from physical or chemical restraints (though both continue); and freedom to complain.
Residents are afraid to complain. They are afraid they will be retaliated against. They are afraid they will be “thrown out” of the facility. This adds fear to the growing vulnerability (of mind and body) of aging, and I believe it infantilizes many residents. The families of residents are often afraid to complain, too. They feel if they do, that the moment they leave the facility, it will be “taken out” on their parent. (It rarely is, by the way.) What is more, the children of these old institutionalized parents are ashamed of their parents’ aging, whether it is physical, like incontinence (can you imagine a parent scolding a baby for peeing in the wrong place or at the wrong time?), or behavioral, if mom has refused to do something she didn’t want to do. That is what got me thinking about ageism.
You described ageism as “incomprehensible.” Why did you choose this definition?
When I say ageism is “incomprehensible” I am simply referring to the reality: if you don’t age, you’re dead. So why not celebrate the process of moving on with life, moving into the experience of living while you age, seeing what can come out of it?
What is your perspective on the way we construct an ageist and self-ageist view in our society?
My thinking about ageism has been going on for a long time, coming out of the rest of the work I have done, things I have observed and lived through as a close observer. But then, I aged! And I observed my peers aging. And another layer was added to what I see and feel and know about ageism. And then, ironically, I was in the midst of writing a novel (remember, fiction is where my heart is) and the granddaughter of my main character asks her a question about how it is possible not to know something when it is all around you, and my main character (an aging woman) says, “We live in a cultural cage. We don’t see beyond the bars. We don’t see what we don’t see.”
The idea of the cultural cage, of growing up within a society (as we do) that has its norms, and our inability, for the most part, to see beyond these norms, makes it possible for us to grow up thinking certain things are “supposed to be” the way they are. And if we have been born into an ageist society, we will live it out that way, even as we age ourselves. The metaphor hooked me.
What prompted you to write your latest book Finishing Up: On Aging and Ageism?
Thinking of all this, and observing my peers and feeling in myself that peculiar mixture of self-hate and self-pity that old people often feel, I began to write. I was pushed by the fear that my inner bitch had become a bit too calm. I wanted her back; I felt I needed her to be with me as I age. I have written Finishing Up: On Aging and Ageism as a narrative, because I love stories, and because I think that is the way most of us experience the world. From a writer’s standpoint, I am particularly pleased that I have been able to get my real “voice” across and I think if this book can make a difference, it will be because readers will really hear me. I consider this book as an act as much as anything else. I feel as though I am pushing hard against the bars of the cage.
