She sat silently in a wheelchair, her 93-year-old silhouette stooped in the bathing light. I entered, held her hand for a moment and introduced myself. “Sit down, doctor,” she said politely.
I asked her why she had come to the nursing home, and she described the recent passing of her husband after 73 years of marriage. I was overwhelmed by the thought of her loss, and wanted to offer some words of comfort. I leaned in close and spoke.
“I’m so sorry,” I told her. “What has it been like for you losing your husband after so many years of marriage?”
She paused for a moment and then replied: “Heaven.”
Seeing my bewilderment, she smiled and went on to describe how she had endured decades in an unhappy marriage with a gruff, verbally abusive man.
As she spoke, I realized why my instincts were so completely off. In my misguided empathy I had committed what William James called the psychologist’s fallacy, assuming incorrectly that one knows what someone else is experiencing. With this newly widowed patient I imagined that only a life of sadness and decrepitude remained, and I felt bad about it.
But I was wrong. She had not fallen into the abyss. She was glad to have finally won a measure of freedom and was determined to make the best of it. As her life unfolded at the nursing home over the next year, she threw herself into new activities and relationships in a way that was quite unexpected.
All of us lapse into such mistaken impressions of old age from time to time. It stems in part from an age-centered perspective, in which we view our own age as the most normal of times, the way all life should be. At 18 the 50-year-olds may seem ancient, but at 50 we are apt to say the same about the 80-year-olds.
“So what’s it really like to be old?” I often ask my patients, who are mostly in their late 80s and 90s, and the responses are unexpected.
“I forgot I was so old,” a 100-year-old patient recently told me, and then excused herself to make it to bingo on time.
This age-centrism is particularly pervasive in people’s attitudes toward nursing homes. All too often we imagine that life seems to end at the nursing home door — that it is loveless and lonely, with death hovering close by.
We make this mistake when we refuse to see the needs for intimacy even in the most debilitated elderly. Our youth-centered culture equates love with sex; in contrast, I have seen with my older patients that love can be an endlessly blossoming flower, felt and expressed in hundreds of ways. A friend’s mother who suffers from Alzheimer’s disease has fallen in love with another resident on her floor, and they walk around holding hands and snuggling with a newfound innocence that perhaps only their memory loss restored.
We also project our terror of death onto the aged, assuming that fear and depression must stalk the final years of life. And yet in my 15 years of working in nursing homes, I have never heard a patient say that he or she was afraid of death. Sometimes there is acceptance, other times anticipation, but most often it is not a great concern. Life goes on in its shadows.
In the end, there is a cost to our myopic view of aging. We imagine the pains of late-life ailments but not the joys of new pursuits; we recoil at the losses and loneliness and fail to embrace the wisdom and meaning that only age can bring. Henry Wadsworth Longfellow captured the sentiment well:
For age is opportunity no less
Than youth itself, though in another dress,
And as the evening twilight fades away
The sky is filled with stars, invisible by day.