Abandonment was the theme of two news stories last week. The Washington Post reported on a Japanese man found in his micro-apartment in Kawasaki four months after his death. https://www.washingtonpost.com/news/world/wp/2018/01/24/feature/so-many-japanese-people-die-alone-theres-a-whole-industry-devoted-to-cleaning-up-after-them/?utm_term=.28e61b3bf457 The focus of the story was the new “cleaning industry” that has taken root in Japan to tidy up after “lonely deaths” that go undiscovered until the landlord comes to call. The same day, the New York Times ran a story about the discovery of a six months old baby in China, left in her stroller with a note from her family that was unable to care for her and her epilepsy. https://www.nytimes.com/2018/01/24/world/asia/china-abandoned-baby.html These stories cry out for compassion, though the man, Hiroki, is beyond its reach. The parents of the baby wrote of their sense of shame for abandoning their daughter, but no one could be found to feel remorse for Hiroki’s lonely, unnoticed death.
They are not unique – in fact, they are legion, homeless in the streets of cities or refugee camps. But these two people, the unnamed baby and Hiroki – whose surname was ironically withheld to protect his privacy – speak to us as individuals, chosen people by the media. Like George Bell, who died alone amidst his hoarded belongings in Queens in 2015, https://www.nytimes.com/2015/10/18/nyregion/dying-alone-in-new-york-city.html, they were abandoned not as a consequence of distant war or drought, but of circumstances that are familiar to the readers of the Post and the Times: the inability to care for our own.
Long term care for the chronically ill and the frail (and failing) elderly, and many who fit in both categories, in our own country is challenging even when family and money are available. When there is a shortfall of either, it becomes next to impossible. Planning and giving for elder care are both in perilously short supply. Median retirement savings for families with any savings is $60,000; the median for all families is $5,000. Private philanthropy provides no backstop: only 2% of institutional giving in the United States goes to aging programs, a proportion that has stayed the same for 20 years. Generations, Journal of the American Society on Aging (10.22.2015). Social Security and Medicare are the tenuous lifelines for our aging population, but we shamelessly ponder ways to reduce spending on the elderly, who are living so much longer than we expected, too long for us to be expected to care for them. Until “we” are “them.”
It has been repeated so often as to be a truism that America is aging; that the fastest growing segment of our population is 85+ years old; that the over 85 population will triple, from under 6 million in 2012 to over 18 million in 2050. Lynn, J., MediCaring Communities (2016), p. 14. Despite the handwringing over costs, there is still no sign that, as a nation, we are trying to come to grips with that reality. Issues about care abound: how many health care aides must we train and pay – and where will they come from? How will they get to where they are needed? In New York City, the number of home health aides has grown from 61,700 in 2006, to 151,700 ten years later. They earn an average of $25,000 a year and typically travel almost an hour each way to and from their work site, the home of their elderly patient. https://www.nytimes.com/2018/01/31/nyregion/health-care-worker-commutes.html How will we provide accessible, affordable housing? How will the elderly even be adequately fed? In Atlanta, just one example, thousands were on waiting lists for Meals on Wheels in 2014, the same year that organization delivered over 2.4 meals to seniors nationwide. www.MealsonWheelsAmerica.org ; http://www.myajc.com/news/thousands-waiting-lists-for-meals-wheels/O1HTQBFi0InPg9P4KVRlpK/ . In some places, seniors may wait a full year before they are served. Medicaring Communities at 70. As we indulge in the myth of aging in place, we ignore the isolation that comes with it, the absence of the pleasure, challenges and stimulation of the company of others. We remain ill-prepared to provide moral and practical alternatives to abandonment even in the face of a growing imperative.
It is all too possible that a “cleaning industry” will grow up in the United States as more of us outlive productive years by decades, and families continue to disperse in search of jobs, education, housing and the amenities of a good life. Hiroki, the man found dead in Tokyo, was not missed for four months, but four days would be too long to die unnoticed, like George Bell. Perhaps had Hiroki been found sooner, it would be less repulsive to us, the readers, but the real sadness here came weeks, months and probably years before his death when no one cared he was alive.
“You can’t eat the orange and throw the peel away — a man is not a piece of fruit,” Willie Loman cries in Death of a Salesman. But Hiroki was. Medicare, thankfully, can provide us with doctors and medicine, but who will see to it that we take note of the frail elderly and provide care as if they matter? For they do. Not just because of who they were, but who they are, in their illness, their weakness, their dementia.
Friends marveled that my father celebrated his 98th birthday last year. Words like “wonderful,” “amazing” and “awesome” were offered as commentary. And, though he was deep in dementia before his death, these words were apt, for my father had outstanding home nursing care 24/7, a beautiful apartment, daily visits by family, friends and colleagues, the energy to walk in the park and occasionally a museum, food that he relished, a weekly concert in his home by student musicians. He had contentment in the context of his diminishment. How many of those millions among us who will live past 90 will have such a life? Who among us would wish for less?
Cultivating the lives of the elderly in a meaningful way is no less an obligation than educating our children. Failing to do so reflects on us as badly as if we’d abandoned them as infants. It is in a sense a higher moral obligation for we have nothing tangible to gain from it. Nothing but the gift of loving, the satisfaction of responsibility met, the pride in a civilization in which our endings are no less valued than our beginnings.