For the Time Being: Reflections on Growing Old
Me and Mrs Baldwin: One of the greatest fears for us oldies is losing our marbles. I’m hoping most of mine are still in the jar.
And then there’s the one about the old woman
Who very apologetically asks the way
to Church Lane, adding, “I ought to know:
I’ve lived there since the war”. So you go with her.
Fleur Adcock: Mrs Baldwin
Poor Mrs Baldwin. Imagine somewhere as comforting as the place you have lived since the war — that place you call home — no longer being your safe haven from the outside world, but turning into somewhere unfamiliar, even alien. Imagine knowing that this is happening to you, knowing that it wasn’t always like this, and apologising for needing help. Imagine…. The poet does imagine:
“This comes with variations, usually leading
(via a list of demented ancestors)
To calculations of how much time you’ve got
Before you’re asking the way to your own house.”
Have you ever had a Mrs Baldwin moment? Do you, like me, ever wonder if you’ll end up like her? When I think of ageing, I picture myself as me, only older. Because Mr C is a decade older me, I am alone in this scenario, even though we both know that that is not a given. I am a little more hard of hearing, my eyesight is a little weaker, my body a little frailer. But hey! I’ll still love going into town to meet a friend for lunch, and if I can no longer drive, I’ll call a cab. I’ll go to the supermarket and back, and someone will help lift my bags into the house when I get home. I’ll do my own Christmas shopping.
No, wait — big family, lots of friends. I’ll do what I do now and order a lot of things on line. And if I don’t have the energy to wrap them all, if I can’t do what I do now, which is spend the whole of December organising and hosting present-exchange gatherings, I can have them gift-wrapped and sent direct to the recipients. As my body becomes frailer, I can have my groceries delivered. I have great neighbours who will look out for me. My children do not live close by but it’s an easy train journey north to my daughter and south to my son, and I have space for them here when they make the journey to me. Between visits we have the technology that brings us together. So that’s old age sorted!
Except…Mrs Baldwin is lurking in the shadows. What if? What if I hear the ping of an in-coming message and instead of happy anticipation I feel confusion, about where it’s coming from, and what it means? What if the taxi driver drops me off at the supermarket and I don’t know where I am, or why I’m there? What if the names in my contacts list become just words, devoid of the love and friendship and the stories they invoke now? What if I pop out to post a letter and can’t remember my way home? Oh Mrs Baldwin, I feel for you! But before I allow myself to wallow in what ifs, I remember my own guiding principles: reflection without understanding is fruitless. I need some facts. Knowledge is power. So I do my research.
We know that forms of dementia are not exclusive to old age, but are more likely to lurk there than in other phases of our life. If we are interested enough in the science we can learn a lot about the physiology of aging, including changes in the brain as we age. Even without access to academic papers we learn from the popular media that as we age the brain shrinks, blood flow to our grey cells decreases and there is reduced communication between the neurons in the brain that affect memory and recall. And yet we witness the exceptional minds of some very old people: think David Attenborough, for example. I learn that Alzheimers is not an inevitable part of aging. Phew! But then I read that Alzheimer’s is most prevalent in the over 65s. The risk then doubles every five years, so that it affects one in six people over the age of 80 and a third of people over the age of 85. I learn that there are lifestyle influences too: you are more likely to get dementia if you smoke, have diabetes or high blood pressure, and if you lead a limited social life. People who exercise frequently, stay slim and have a healthy diet are less susceptible. Thankfully my social calendar is full, my health numbers are good (blood pressure, heart rate, cholesterol) and I do exercise in the form of a regular brisk walk, though I am overweight…. Should I still be worried?
The more I read, the more I learn about the general trends in the population as a whole and the less I feel I know about the age of my own brain. And I am still worried.
We go out in the car. We are heading for the station to pick up a friend who is coming to stay for a few days. Mr C no longer drives because of failing eyesight, but he can see well enough to know that I am heading in the wrong direction. ‘Where are you going?’ he asks, his manner as mild and gentle as always, as if he’s asking ‘did you remember your umbrella?’ I have no idea where I am going. There was a time when I set off for the station, and with seemingly no recourse to any thought processes, arrived without incident15 minutes later at. Today, I pull off the drive just fine, and I am driving just fine. My car is in the right gear but my brain appears to be in neutral. I pull myself up. I take in where I am and within seconds my mind has mapped a new route to the station, where we arrive only a few minutes late. What has happened? Why do I now have to make myself think before I release the handbrake: Where am I heading? How will I get there? Why does my brain need this prompt?
We have friends for dinner. The conversation is intelligent, lively. I am really interested. But I am not interesting. I have a contribution to make, but I know that some of the words I need to articulate my ideas just won’t come, so I remain silent, busying myself by passing the wine round. Did anyone notice? After our guests have left Mr C brushes off my concern as whimsical, but I still wonder if something is wrong.
I decide I need to find out. I discover an Alzheimers research project near me, and call them. They are sufficiently interested in my stories to bring me in for cognitive tests. They send a taxi for me, in case I can’t find my way. This upsets me a little. Are they judging me already? I feel vaguely slighted.
The initial conversation goes like a dream. I know my name, the day of the week, and I work out the date because it was my grandson’s birthday three days earlier. I even know who the prime minister is of the country I live in. The on-line tests feel a bit more tricky. They remind me of the 11+ exam I took in 1960. There are shapes to put in order and other tasks around numbers and words. I worry that I am a bit slow but in fact I finish with time to spare. Does this mean I’ve rushed, got them all wrong? Finally, I have to recall ten words that were read out to me at the start of the test, about half an hour ago. I remember ten words, but am not certain they are the right ones.
As she hands me the results the young doctor looks vaguely disappointed. I fear the worst. But it turns out she is disappointed for herself; she needs candidates for her research and I am not suitable. Measured by the criteria of the tests in question, I have failed to show sufficient cognitive decline. She is a lovely young woman, so I venture to express that my relief is tinged, only slightly, by disappointment. A part of me was hoping that whatever was wrong was going to be diagnosed, and treated early to positive effect. She has a ready-made, informed response, and I feel encouraged. She tells me that yes, it is true that some older people show very little cognitive decline. There are lots of reasons for this. She enumerates them, but I don’t remember them all, and I look them up later. It seems that it is mostly to do with the cortex — the outer layer of the brain — that in most of us thins with age but in intellectual ‘superagers’ retains the thickness of that of a 40 year-old. Mine, she tells me, has probably thinned quite a bit. Perfectly normal. I’m afraid, she tells me, that you are a victim of your own intelligence. You are perceptive. You have noticed what is undoubtedly a decline. Is it serious? No. Because, she tells me, you have cognitive reserve. Epidemiological studies, she says, suggest that lifelong experiences such as higher education, a professional career and intellectual hobbies all lower the risk of dementia. I am relieved. I go home and read more. I read that sometimes cognitive reserve masks the symptoms of dementia. I worry again. The Alzheimers doctor has written to my general practitioner (GP). I go to see him and tell him what I have been up to behind his back. He insists I am displaying no signs of dementia. This is because I can accurately draw a clock face and put the hands at 10 minutes to two. I feel I’d have to be pretty far gone to get that wrong, but I don’t say anything.
Mr C and I visit my son in Canada. He is actually working in New York City, but we decide to take a break together in Montreal. As we take a rest from our descent of Mont Réal, with McGill University spread out beneath us, I recount my experience and my anxiety. He rejects any notion of mental decline. I am relieved, but on reflection I think about my own response when my father told me of his cancer. I could not accept that it was terminal. Of course not. Not my father. Maybe Joe is simply rejecting any notion of a demented mother.
We get back to our Airbnb apartment. I look in the mirror. I see someone who has had a lovely day in the sunshine with two of her favourite people in the whole world. She is tired (we walked miles) but by no means exhausted, and she can remember exactly where she has been. I resolve to stop feeling anxious and start living in the moment, because whatever the future holds for her, the woman I see in the mirror has just had a day that she will remember with joy for as long as she is able. No amount of reading, or testing, will tell her when, or even if, she will have a Mrs Baldwin moment, but for the time being, all is well.
