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Wellness Wednesday for September 4, 2024

The Wednesday Wellness threads are meant to encourage users to ask for and provide advice and motivation to improve their lives. It isn't intended as a 'containment thread' and any content which could go here could instead be posted in its own thread. You could post:

  • Requests for advice and / or encouragement. On basically any topic and for any scale of problem.

  • Updates to let us know how you are doing. This provides valuable feedback on past advice / encouragement and will hopefully make people feel a little more motivated to follow through. If you want to be reminded to post your update, see the post titled 'update reminders', below.

  • Advice. This can be in response to a request for advice or just something that you think could be generally useful for many people here.

  • Encouragement. Probably best directed at specific users, but if you feel like just encouraging people in general I don't think anyone is going to object. I don't think I really need to say this, but just to be clear; encouragement should have a generally positive tone and not shame people (if people feel that shame might be an effective tool for motivating people, please discuss this so we can form a group consensus on how to use it rather than just trying it).

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Paul Harrell, the actually competent firearms videoblogger, is dead after losing to pancreatic cancer. His prerecorded farewell message is up.

Cancer and Alzheimer's are two things that scare me the most about aging. How do you cope with the idea that you or your loved ones might not go gently?

Gone through this a couple times with family unfortunately. To be honest the prolonged degradation of these diseases twisting your loved one into a mockery of their former selves makes their actual death come almost as a relief. With Alzheimer's, pretend the victim's normal personality and mindset is like a radio station one is driving away from.

At first, it's all fine. Then there are occasional static bursts in the signal, small things you can dismiss as a fluke. She'd forget what year it was or not recognize an old friend. Then bursts of static interrupting the song you know and love. She started occasionally calling me the name of her cousin who was killed during D-Day.

You realize that this is really happening, and the signal is failing. She put dirty dishes in the microwave to clean them. The further out, the more static and less signal. She tried to plug an electrical cord into a water faucet. Eventually it's almost all static and you just hear some pieces of the song coming through. She could not remember her husband's existence and would repeat the same words over and over in a loop.

Then just a roar of static with an occasional pop that might be caused by the original song. She recognized almost no one and was near comatose, just had a vague sense we were connected and called us all by the names of the dead. It's like a perverse ship of Theseus where at some point so much has rotted away that the person you knew is gone. She would lay silent, glassy eyed and drooling for hours.

My other close relative who died from it had a quicker progression, but it made him act out of character in a very aggressive and violent manner to the point he had to be institutionalized because he kept trying to kill my aunt and caretakers. It can degrade people unevenly; his body stayed strong for a long time after his mind was destroyed, while the first person I described lost both simultaneously.

Somebody dropping dead of a heart attack is something you deal with the sharp pain of, but the mind can switch to categorizing them as gone, it doesn't consume the lives of multiple relatives taking care of them, and memories of the dead aren't tainted by a cruel decline. With these degenerative diseases attacking the mind, it's like your loved one becomes an animate corpse with just enough scattered fragments of their old self resurfacing to torment everyone around them but not enough to comfort them or bring the victim happiness. The death process takes ages and drags out everyone's pain. When they finally die, there is grief but also relief that their suffering is over.

With cancer, usually their mind is intact but they get twisted into a miserable, pessimistic version of themselves from all the pain and drugs for a couple years until giving up. Opioids help greatly with pain but make them zombie-like. I am not a doctor, but from what I observed marijuana edibles and tinctures are very helpful for mitigating low-medium level pain and delaying when the cancer patient has to start taking opioids. It made the difference between them being unable to sleep well due to itching sensations from the cancer and reducing that enough to sleep through the night.

If diagnosed with Alzheimer's, dementia or an incurable cancer I would strongly recommend writing up some memoirs, recording tapes for your family and friends then committing suicide.

If someone you know is in the early stages of Alzheimer's or dementia, I'd recommend surreptitiously recording your conversations with them and asking them a lot of autobiographical questions. How they met their spouse, their favorite songs, their first job, travels, funny stories, etc. The audio will be of great comfort to you and other relatives later. People remember to take pictures but almost always forget to preserve someone's voice. Also, with degenerative brain diseases IME older memories endure the longest, and you can have almost lucid conversations with them pretty far along by sticking to topics from decades ago. Playing their favorite songs also tends to bring their mind back together for a little bit.

I appreciate your writing this post.

How do you cope with the idea that you or your loved ones might not go gently?

I've been thinking about this topic a lot recently. My fiancee basically lost her entire 20s having to be a stay-home caretaker for her grandmother, who had (and has) Alzheimer's. While she frames it as a choice that she was happy to make, from talking to her family, I really get the impression that she was basically the one who was sacrificed so that nobody else would have to address the situation. Honestly - I think it's an atrocity, and I can't listen to her talk about those years without boiling up with anger.

I love my parents, and when they get to that point, I want them to be safe and well cared-for; however, I'm not going to value their wellbeing above the wellbeing of the other members of my family. I grasp that there will be sacrifices to make, but the rest of us deserve a chance to live too. Furthermore, I don't see that any of the adults on either side of my family are making the appropriate preparations for their old age, and I intend to defend my nuclear family from potential consequences of this.

I am aware that my attitude about this is very hard and negative these days, and it may soften with time. I can't say I have a specific plan. I try to cultivate my material prosperity and physical strength all the time, because I think I will end up needing them.

This comment resonates with me. I come from a culture where elders are respected almost to a fault, and people are expected to defer to the whims of the oldest people in the family at all times.

This kind of setup was probably fine and maybe even made sense for most of human history, but now that people are being kept alive into their 80s and even 90s with ease, it leads to a lot of material and emotional burden on the rest of the family.

To give an example, I live in an apartment with my wife and my mother is the landlord. My mother charges me MARKET-RATE RENT with the stated reason being to help her support my grandfather and pay for his rent and living expenses. In a previous post I mentioned family planning with my wife, and the fact that we’re paying rent to support my grandfather is a non-trivial stressor on our discussions about having kids. Now what kind of fucked-up arrangement is this? The family unit is sacrificing its future material prosperity to care for somebody who probably shouldn’t even be alive except for modern medicine and is an active burden on the rest of the family?

Until me and my generation, essentially nobody in my family has had to worry about supporting their grandparents in old age (not just financially, but emotionally and in the sense of having to defer to their wishes and antiquated opinions) and often their own parents would be dead by the time they became productive members of society ready to build wealth.

At least from my anecdotal perspective this kind of absurd arrangement of transferring wealth from the young to the very old and infirm (I haven’t even mentioned social security and medicare) is a major cause of declining birth rates. How many more families would we have if people died at a natural age, they passed on their wealth and estate, and the next generation could focus on building wealth and supporting their own children?

To give an example, I live in an apartment with my wife and my mother is the landlord. My mother charges me MARKET-RATE RENT

Ugh this boils my blood. We are going through a similar situation with my future Father-in-Law, had to argue tooth and nail to get below market rate rent at the house we're moving into.

Despite the fact that my fiance has put in literally hundreds of hours of unpaid work helping him renovate that damn house. All because he 'needs to be able to retire this year'. He just turned 60.

Makes me furious too, and she wants to care for him if or when he gets dementia. I'm a hard no on that one.

Oh, man, this sucks. Harrell was a solid dude.

How do you cope with the idea that you or your loved ones might not go gently?

Pretty basic; I assume my loved ones love me.

I'm dealing with this right now as a child. Parent's are past the stage of "ha ha senior moment!" forgetfulness, but can still operate on their own mostly. They aren't forgetting to eat or bathe and aren't getting in fights with strangers. But, multiple times over the past year, one has been pulled over for driving at night with no lights on.

The best way to take care of them is to take care of them as far as they'll let you, and then be willing to fight for that extra 20% that they don't want, but you know is necessary. The love comes in being willing to fight that fight and not build resentment towards them.

The useful thing I was surprised to find is how much going through photo albums or other "memory media" helps both parties. Long term memory often stays intact well into Alzheimers and dementia, so the mom/dad feels familiar and safe when talking about 20,30 years ago. For me, it helps reinforce the concept that even though they are deteriorating now, they were, at one point, like Superman and Superwoman to me and the facts of the past are still very much real.

The next big mental hurdle I can see is when the required care becomes too much and we have to go assisted living. Trusting your loved ones to strangers is ... trusting your loved ones to strangers. That doesn't sit well with me at all right now.