Saturday, September 28, 2013

Independence in the Later Years.

Mother on her daily walk.
My mother is 85 years old.  She has never quite mastered English, but she is pretty feisty and has no problems going out on her own and interacting with individuals in various settings (though most people have no idea what she is trying to say to them).  Growing up in Japan, mother was raised with the expectation to be dependent on others.  However, being an immigrant in the U.S. had forced her to step out of her comfort zone.  She learned to drive a car when she was 43 years old, and she is still driving today (quite nicely, I must admit).  We encourage mother to be as independent as she can, but we also help monitor her health and make sure that she is safe and well.  The challenge for me has always been balancing independence with interdependence in caring for my mother.  For many Japanese immigrants, it is culturally acceptable for older adults to be dependent on their adult children, even when healthy and able-bodied.  My mother, after being in the U.S. for many years, is fairly independent.  Nonetheless, at times I can feel her envy towards her Japanese friends whose daughters do everything for them.  Personally, I think my mother will thrive into old age because she is invested in her health and well-being.    

There are times, on the other hand, when I think independence is overrated.  It's important to do what you can for yourself, yet insisting on being totally independent can be problematic when physical and cognitive changes compromise one's abilities to manage self-care.  I've witnessed this scenario with a few older persons, and my mother's former acupuncturist / massage therapist, Hana*, is a prime example.  Hana, who is 83, has led a remarkable life.  As a young woman, she left Japan to attend college in the U.S. and never went back.  She never married and lived alone throughout her life so she could pursue her interests.  It is uncommon for a Japanese woman of her generation to choose passion over social convention, but Hana had stated that she was too strong-willed and unable to compromise with others.  I don't know her complete history, but Hana was dedicated to her studies on health.  Until January, she continued to take classes to perfect her therapeutic skills.  More than a healer, Hana was a great companion for my mother.  Her prediction was that she and my mother would grow old together and live to be 100.

To make a long story short, Hana was also stubbornly independent.  She became ill recently, and during her hospital stay, it was discovered that her cancer, that had been in remission, had returned.  Worse yet, the cancer had metastasized throughout her body.  It was probable that she would not live longer than 6 months.  Nevertheless, Hana was convinced that she could live independently at least until her 90s.  Friends offered to help, but she didn't want to be a burden.  She had been staying temporarily at a nursing facility, but when my mother went to visit one day, she was no longer there.  Friends do not know her whereabouts, but it seems that she left with a young couple that she had befriended.  Clearly, we don't have the complete story, and do not know where she is. 

Hana's story reveals a person who treasures independence above all.  She was too proud to ask her younger siblings, all residing in Japan, for assistance.  Furthermore, it wasn't clear whether they knew of her condition.  I cannot help but wonder whether her situation may have turned out differently if she were less independent and willing to have others care for her?  But, perhaps she was perfectly fine in her decision despite outcome.  And…maybe this is more of a problem for me because I am struggling to accept it.

Where do you draw the line between independence and dependence?  It's not always easy to know.  I would be interested in your thoughts.  As always, thank you for visiting my blog.

*By the way, Hana is a pseudonym.

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