Not so Quietly into the Nght

One of the fundamental accomplishments in life is to develop a sense of self. So there is a poetic justice to the recent findings of David Kahn, Ph.D.: Those who live long enough get to partake of a last stage in adult development-deconstruction of the self.

Now a university professor, Kahn lived among and made detailed observations of the inhabitants of a Seattle nursing home for six months. Fully a third of them were well into their nineties, a population group rapidly growing in number.

The most obvious deconstruction takes place in the physical being. Although in fact all had been slowing down for years, they felt the decline had recently accelerated, and most cited a specific incident as the onset of "going downhill." For one woman, it was the day she took a bath and couldn't get out of the tub; her son, alarmed by an unanswered phone, extricated her the next day.

In addition to the changes in their physical self, their social world was collapsing as well. Outliving even the shopkeepers who had long served them seemed to make a particularly strong impact. It signaled that they were living in the wrong era.

At once the most subtle and the most striking aspect of the deconstruction of the self, Kahn found, is "a stepping away from time." These people assumed a different orientation to time. They no longer paid attention to things that change in the world, such as technological advances. They wore no watches. The markers of time they did use were different; Wednesday was not "Wednesday" but "bingo day." Friday was not "Friday" but "bath day."

It was obvious to most that they had passed through some change in self. But they were not grieving. They were waiting. "They had no emotional attachment to time or death," reports Kahn, who found himself "surprised by the elegance of how they were able to say things." And saying things-talking about themselves--was one of the few ways they still found meaning in life.

Nursing homes need to be radically restructured, Kahn concludes. "Most nursing homes focus on filling time. They play games. But older people need recognition of where they are in life, not avoidance of it. They don't want to be treated as members of a different species."