Here's my future.
    The link in the title to this post will direct you to a story about a 72 year old reclusive woman who lived in a "small town" in South Carolina. She died in her home. Her death, and body, and, by the way, the body of her dog who died subsequently due to dehydration, weren't discovered for 18 months, well after the sale of her house for back taxes which she hadn't paid (because she was dead).
    The story is sobering. It's also reviewed here as a cautionary tale (the link in the title has considerably more detail) at ElderGuru.com, a blog full of not-your-usual-eldercare-posts. I discovered the blog, and the post, yesterday when I was performing my monthly check of Honorable Caregiver Blogs, most of which are now inactive, and stumbled across this site in a comment to a post. The site looked interesting enough to peruse...that's when I found the post linked in the title.
    When I first read the post I thought of an episode of Northern Exposure which I've previously discussed. Sanderson's death in this episode was not unintentional and he made all appropriate arrangements, including for his dogs, before he committed suicide. However, this got me to thinking about unintentionally undiscovered deaths versus intentionally undiscovered deaths, a much less favored, I'm sure, but still occasionally preferred, I imagine, possibility.
    Considering that this woman's dog died of dehydration and she had a reputation in the neighborhood (that's right, she wasn't completely unknown by her neighbors) as caring for stray dogs, I doubt that her final wishes included dying unbeknownst to her neighbors. At the very least I'm sure, had she thought she was close to death, she probably would have made arrangements for her dog to be cared for after her death. According to the information about her health, though, she had no reason to believe that, at the age of 72, her death was imminent.
    As well, it's certainly true that contemplating such a long unnoticed demise is probably horrifying for most. I have no argument with the last paragraph of the news story and the commentary at ElderGuru.com, both of which bemoan the present lack of community in our society, speculate on reasons for it and consider the story a societal warning.
    Among my relatives, one (that I know of, there may be more) such death occurred. My paternal grandmother lived alone in a remote area of North Carolina. Although scads of relatives lived in a town close by and checked on her, they didn't visit every day; probably, though, close to once a week. They also ran errands for her, were her mode of transportation for appointments and were in fairly frequent touch by telephone, although it would not have been uncommon for her not to answer her phone, occasionally, especially since she had an outhouse instead of indoor plumbing. Grandma was an unapologetically depressive person. She could be considered reclusive but, frankly, I don't think she was that way by choice. The idea, alone, of visiting her could be oppressive. She was relatively young when she died, too, at 68, and not physically disabled nor was she considered unhealthy, although her long term (probably life-long) depression could have been considered a mental disability. She died, though, in the 1960s when neither chronic mild nor elder depression was considered cause for alarm, even if it was evident to families and acquaintances. No doubt all of these circumstances conspired to create her death circumstance: She died alone, in her rocking chair, of a heart attack. It was estimated that when she was discovered she'd been dead for "at least a few days".
    I've thought about such an ending. I have no spouse and no children. Since I am fairly reclusive and am (thank the gods) past childbearing age, these personal statistics won't change. Although I am in fairly regular to regular contact with a small group of friends and some relatives, it is not uncommon for me to go for periods of time not initiating contact and/or avoiding contact. I think my days of unplugging the phone for sometimes weeks at a time are past but if I were to, say, fall and incur a grievous injury that made it impossible for me to get to the phone, answer phone calls and/or call for help or to move about my house and keep myself physically sustained for survival, it is likely, considering what my cadre of friends and relatives know about me, that I could die without anyone noticing; probably not for 18 months, but at least for awhile and possibly long enough to compromise the life of my beloved cats.
    Added to that, some weeks ago when I was canvassing the neighborhood with pamphlets announcing the latest zoning issue meeting for the political protest group in which I was participating, I visited a home that had a notice of non-payment and threatened power shut-off from our local electrical company attached to the door. The door was mostly clear glass. Behind the door was a small dog yapping excitedly at me. After I placed my pamphlet between the door and the frame I peered through the glass for several long moments watching and wondering, feeling like an absurd cross between a Peeping Tom and a Concerned Neighbor. Except for the dog, I detected no other movement or sound inside the house. Was the occupant(s) hiding? Simply ignoring the electrical company notice (which is a common occurrence, I imagine, when someone is in dire financial straits)? Maybe the notice had just been placed that day while the occupant was out? Did the house contain a dead body? While I was contemplating what my next move should be, a neighbor pulled up in his car. I hadn't yet hit his house and he, being a concerned neighbor, stopped halfway to his driveway and stared at me. I scurried to his car, gave him a pamphlet and expressed my concern about the house I had just visited. Aside from seeming relieved that I was not dangerous, he nodded at my concern that the situation at the house would appear suspicious but, he assured me, he knew these people and he was sure "everything is fine." At that he delivered a crooked grin, indicating that, obviously, the power shut off notice indicated that "everything" is not exactly "fine" but that no one was dead and undiscovered, at least.
    Despite this man's acuity about his neighbor and even though I am fairly familiar with my own neighbors, my neighbors and I, I'm sure, would be hard pressed to know if anyone of us had died unexpectedly. Of my three closest neighbors, the ones I would truly consider "my neighbors", two of three live alone. One of these is elderly, the other has disabilities. Both of them are fairly reclusive but I can tell from comings and goings and a little informal knowledge that neither of them is likely to die leaving their body undiscovered for any significant length of time. I know the elderly neighbor has a check and balance system consisting, in part, of someone who visits regularly (a couple times a week), does errands for him, etc. I know the woman with disabilities wears a Medic Alert monitor and has far more visitors than I (which isn't hard to do). Among the four of us in what I would consider a neighbor-pod, I am the most reclusive, even though I am on speaking terms with all of them, likely the one of the four neighbors to whom unexpected and unnoticed death could easily occur.
    I should be frightened about this; most people would be. I should be calculating steps I could take to prevent the kind of death that Mary Sue Merchant, the woman in the news story, experienced. As regular readers will recall, immediately after my mother's death I did initiate a check system to cover me in case I should die of "a broken heart". So, I should continue that kind of system. Right? Well, that's a hard one. Aside from being a recluse and preferring to be left alone much of the time, the concept of dying unnoticed is actually a revered fantasy of mine. I like the idea of slipping away privately; of my demise being discovered by surprise some time after it occurs. I'm not thrilled about the possibility that any pets for whom I might be responsible when death visits me would be injuriously neglected if the discovery of my death took weeks or months. I'm not sure what to do about that. The point I'm making, though, is that for someone like me (and, I suspect I am not the only one who feels this way), setting up a death watch is a dicey option. It may have been for Mary Sue Merchant, as well. I'm sure she never wished that her dog would die because she died. However, considering her innate reclusiveness, it's possible that she may have harbored a death fantasy similar to mine.
    This, of course, I'm sure, isn't the reason that most of the elderly who die in such situations end up this way. Most of the time these death circumstances are due to neglect of family, friends, neighbors, professional associates, who are in the habit of neglecting the old. Such unnoticed deaths (although not unnoticed so long as 18 months, I assume) even occur in ASLs and nursing homes. Most people, young, middle-aged or old, don't want to be marginalized. This kind of marginalization, as well, isn't just responsible for unnoticed (and sometimes preventable...I suspect my paternal grandmother's death could have been prevented, for instance) elder deaths. It's also responsible for criminal deaths that are witnessed in some way but in which none of the witnesses wants to get involved, deaths of neglected children, deaths of neglected disabled and deaths of neglected mentally ill. Thus, it is perfectly appropriate, even urgent, to speak up on behalf of the unnoticed, unwilling dead and to pose such questions as: How could this happen? How can this be prevented? How likely is it that, in this society as it now exists, we can expect to change our attitudes toward the members of our communities in order to, at the very least, know about and, possibly, prevent unnecessarily unnoticed and unnecessary deaths in a timely manner?
    In the meantime, because of my personal idiocyncrasies, I have to raise one lone voice on behalf of those few of us who might want such an unnoticed death, who revel in the idea, who chuckle privately at the possibility that we might startle and befuddle our relatives, acquaintances and communities by dying some time before our deaths are noticed...
    A newsflash of sorts: As I was polishing off the last paragraph to this post, my Hospice Grief Counselor placed her monthly call to me. I couldn't resist telling her of the story about which this post is being written. She was as unpleasantly surprised as anyone would be, including, initially, me...but mentioned, as well, that in her experience, especially with the elderly, this is not an uncommon occurrence; it had even happened to one of her clients. A significant portion of our conversation revolved around this possibility, during which I told her that, although I share her discomfort with the story, a part of me actually likes the idea of that happening to me. We agreed about the pet-owner aspect of this type of circumstance; neither of us would want the same fate for our pets as was that of Merchant's dog. We also talked about appropriate preventatives in connection with me being reclusive and living among similarly reclusive neighbors, which she understood. She suggested an "unobtrusive" system about which she's heard that allows for privacy, eccentricity AND community awareness: Working out a system by which, for instance, you and a neighbor agree that at a certain time of day each of you always extinguishes (or activates) a light that is clearly visible from your neighbor's home, or open or close a particular shade. Thus, you and your neighbor can discreetly know that if such an action isn't taken it might be a good idea to check on the other or call the local police to do so. Good idea, for my cats' sake, anyway. If there comes a time, too, when I no longer have pets (I don't foresee this, I love my pets and, at this time in my life, know that I am inclined to host others as current ones die) I can opt out of the system...just for the mordant fun of it...
    ...later.
- posted by Gail Rae @ 13:41   email  this post