Planning the Great Escape (or Planning for the End)

Contributed by Alicia Nimonkar,  Editor and Writer with, Certified Trainer with Equilibrium Dynamics

After I became a hospice volunteer, I was fascinated and concerned to hear the residents in a full care facility regularly discuss their escape plans. In hushed tones over soft drinks and cookies, under the gaze of the nurses, they would share their plans with me and each other. Even though I’d completed a nine-week training program and had been visiting my assigned patient weekly—not once had escape come up—until my hospice patient wanted to start attending community gatherings!

One person wanted to go to a quiet comfortable place with someone to lie with.  Another person fretted about where they would even go but they definitely wanted out. One even offered to pay me to help them escape! When I asked why they wanted to escape, they said they didn’t want to die in “captivity”!  These conversations about escape seemed to me the most poignant of all.   

It led me to think about the progression to dependency that we all experience as we age.  As babies and children, we begin fully dependent on others and gradually undergo an evolution.  As we gain the knowledge and skills to take care of ourselves, we become more and more independent. Teenagers are notorious for fighting for more and more independence. However, at the same time, we must rely on others as well as support others: interdependence.  

As adults, we gain an ever greater amount of independence through our relationships, education and careers.  With each of these phases, our identity changes.  One view of ourselves is connected to our level of independence.  However, we have multiple perspectives of our identity: our public personalities and our private view of ourselves.  Changes in our roles and level of independence impact our identity in both of these areas. 

Some residents of this full care facility struggle with how to integrate their growing need for assistance— dependence—with their identities.  Discussing the exciting possibility of escape serves as a form of denial and resistance to this unwelcomed change.  Their escape fantasies provide a temporary sense of complete freedom: “Somewhere over the rainbow!”  While the realities of having to live with constant support seem bleak in an institutionalized medical facility, being able to escape terminal illness to an imagined place of complete free will is enticing.  Even if they were really able to escape the location, the reality of their material needs would be unchanged. 

Sometimes residents expressed the opposite desire, in wishing that they would die tomorrow. I rarely heard anyone say today, it was always tomorrow.  So the escape fantasies seem an understandable desire to escape increasing dependence as well as painful body and self-image changes from growing loss of control and freedom, I wondered if I could I use them to start a conversation about how to navigate these changes. We will all eventually face something similar if we are lucky enough to live so long. Perhaps the escape fantasy is just more evidence for the resilience of the human spirit, a way to have fun while coping with any obstacle, even death. 

Surprisingly, I’m learning how to live, and celebrate life, by witnessing how others choose to approach death.  It’s an honor to support them through this phase of their life.  I think our finales are just as important as our beginnings and deserve as much attention and care. 

|| February 1, 2017