Recently I should have been running a day's training on this very topic with my colleague Penny Grieve in St Andrew's. I should have been shipped in as "Exhibit A", but alas I was not there. Let me explain, if 1st age is childhood, 2nd age adulthood, 3rd age active retirement, then 4th age is when one finds oneself unavoidably in need of care.
For some this movement from 3rd to 4th may happen slowly, be well planned, regrettable perhaps, but accepted. For others it may happen unexpectedly, in a trice, through a fall, stroke or heart attack.
Those who die suddenly or young may miss 4th age altogether, and some insist that they will never grow old and that planning for 4th age is "negative thinking" and not for them! Family, neighbours and Church community all watch with concern when people on the brink of 4th age steadfastly deny any possibility of it, and I know GPs and social carers who realize that some people will just have to "come to a crisis" as no amount of talking will "make them see sense". This crisis may well involve a broken bone or broken health of the older person, or their exhausted carers.
Yet many professionals are not overly critical of an older person's refusal to see what others think is self evident; they know through experience that the gifts of determination, optimism and fierce independence always have their blind side, but are the qualities that keep people going and enjoying life while they can. Most-times "living dangerously" at home feels better than "a risk-assessed life in a care home"! I think we can all sympathise.
In January I catapulted myself temporarily into 4th age status breaking through both tibia and fibia bones above the right ankle. There then ensued the predictable and unavoidable progression of ambulance, hospital, temporary cast, little sleep, operation, 2nd temp cast, less sleep, 5 days in hospital, solid cast and them finally home to hopping on an arthritic left knee with a zimmer to support me! To add insult to injury, our house has precipitous stairs, and no loo on the kitchen level, so I stayed upstairs until I had worked out how to get safely up and down.
I described myself as being on 8 weeks work placement, doing Module 2, 4th Age Empathy Studies, use of zimmer and crutches. What have I learned? Well firstly how kind and thoughtful people are in a crisis. The church has excelled in cards, flowers and prayers and messages of support, and my family and neighbours have been wonderful, I am truly grateful. Luckily we live in a large house with big windows and I have not developed cabin fever, but how would I have coped if all this had been permanent? What if this break had meant the beginning of not walking unaided, or not driving, or not going outside on my own again?
Everyone has supported me magnificently in my temporary distress, but how good are we all at the long haul, when someone moves to 4th age permanently? What sort of help and support is it possible and helpful to offer? These are the questions I wrestle with much of the time in my work, and the answers are different for each person.
Some accept practical help, or share the pain with bitter humour, others need a listening ear to hear the story for the realisation to unfold; for others their faith in God's love and the promise of Jesus' presence with them no matter what their trials keeps them whole; almost all welcome the visits of professionals or caring faithful friends and family as they come to terms with their change in status.
Secondly as “a patient” with a broken bone, learning to “wait patiently” (pun intended) becomes a vital skill. Waiting at the outpatient orthopaedic department for stitches out, X-ray, new plaster and meeting with consultant takes a whole morning. At home, almost any of the things one expects to be able to do for one’s self - shop, get food or a drink, answer phones, put away laundry, etc., are all either impossible unaided, or take time and have to wait until someone else is able or perceives it needs doing!
From being able to “do things” one becomes humbled into accepting that things will be done by others. The task for the patient is to give up power with good grace, to become a leaf on the water and “go with the flow”. This may be relatively easy to start with, but the novelty soon fades and it becomes a difficult discipline. “You must be very frustrated” friends say.
It is connected with how we see ourselves –if it is through others eyes i.e. as useful, or by what we get done, then giving up the status of “useful person” is hard. I feel like I have given up rather more than I intended this Lent!
Waiting is not a high status activity, in a way, the longer you wait, the lower your status, and as a society we don’t rate those who “wait on others”, carers, waiters or shop assistants. Yet we all know how valuable a really good “servant” can be, one who sees others needs and willingly, quietly attends to them.
I have been reading a wonderful book “Waiting on God” by Denis McBride and in it he explores many aspects of waiting.
As I write, we are in Lent, coming up to Holy Week and the story of Christ’s passion. He reminds us that the root of the word passion, ‘passio’, is also the root for passive (and patient!) and that Jesus moves from being a doer, a healer, a preacher, to allowing things to be done to him. His passion is a time when he suffers what is done to him – the word “suffer” has also changed its meaning over time. To suffer was to allow in the King James Version – as in “suffer the little children” but we now use the words suffering and passion in a rather different way.
The moment when active turns to passive in the gospels is after the last Supper. There is the terrible agonising still point in the Garden of Gethsemane when Jesus accepts “not my will, but thy will be done”. He asks the disciples to stay awake while he prays, but they are unable and he struggles on his own.
It is very hard for any of us to “stay awake” to other people’s suffering, and I realise that the change from active to passive that comes in the 3rd age to 4th age transition often has its own painful Gethsemane; the still point or breakpoint where much is given up.
Our duty or gift is to stay awake, not to turn away from the moment of decision or suffering – we cannot alter the outcome but we can stay awake with people to accompany them “com passio” (with compassion).
“Gethsemane is an image of sorrowful waiting, of being present to the prospect of what people will do to you; but it is also a story of resolve to endure, literally to hang in there. And this is very difficult to do. Half the world lives in Gethsemane, and the other half is asleep. It is difficult to stay awake to the suffering of others and to wait with them; we want to get on with life, as if life is somewhere else, at an address safely distant from suffering.”
From Waiting on God - Denis Mc Bride –
ISBN 0 85231 284 9 Redemporist Publications
While I have been waiting for my leg to heal – hoping to be released from the strictures of 4th age and permitted back to my normal life style – I realise it is what I have learnt in the process, about waiting, that has been the gift.
I have greatly appreciated the attentiveness shown to me at the moment of crisis and many of those who have been most sensitive are those who have suffered that shift from action to passion themselves. Their gift of compassion at the time of need has been a vital complement to the capable medical attention I have received.
Mary Moffett
This article first appeared in The Sign the church magazine of St Cuthbert Colinton
