As We Are Now - Book Report/Review Example

Book Analysis – ‘As We Are Now’ by May Sarton

As we are now, it is a short novel by May Sarton narrated in a first-person. The book mostly highlights the frailty that comes with aging through the story of Caro Spencer, its principal character. It denotes how the state often leaves seniors destitute, enraged, or in immense despair.

In the novel, Sarton denotes Caro as a 76-year old retired high school teacher admitted into a private nursing home administered by Harriet Hatfield and her daughter Rose, by her older brother and his wife. Although she is physically frail, her cognition is strong. The decision to admit her into the home followed her experience of a heart attack. This experience jeopardized her health and safety, signaling a need for her to give up independent home living and turn to assisted living in the nursing home (Sarton, 1992).

Besides Caro, the home also houses other seniors ailing from various health conditions associated with aging. However, a factor difficult to dismiss in these patients’ stories is their having to condone Harriet’s tyranny in her management of patients. Mainly, Harriet humiliates the seniors and subjects them to subtle acts of cruelty, including failing to call a doctor whenever one is in critical pain (Sarton, 1992). This situation horrifies Caro. She also cannot fathom how her colleagues put up with it. As such, determined to resist Harriet’s tyranny, she puts up a passive resistance front against her. It sees her begin to refuse to take their medication and food coupled with conveying the atrocities to acquaintances outside the home (Sarton, 1992). However, Harriet meets her efforts with ridicule and resentment. Ultimately, the norm throws Caro into a state of desperation, leading her to set the facility on fire, killing herself alongside the others in her final attempt to end their suffering. Overall, it gives lessons on how people should treat those in their end of life while revealing the relevance of investing in health and social capital in their younger lives to help them display radiant health and draw the social support of loved one's end of life.

An Analysis of Caro’s Life and Death from the Life-Course Perspective

The life course framework denotes an approach to analyzing human life within cultural, social, and structural settings. It mainly examines the effects of the opportunities and constraints arising from humans' cultural, social, and structural settings on their well-being and that of their generation (Van der Linden et al., 2020). This situation arises because one of its central principles argues that every stage of a person’s life are interdependent and intertwined with the lives of others of their generation, and with other generations in their family line. In this regard, it suggests inculcating the right actions early in one’s life-course and transitioning periods to promote healthy cognitive, physical, and psycho-social development through life. It also recommends joining forces among communities to create healthy environments and improve conditions of daily life, hence advancing the healthy cognitive, physical, and psycho-social development of members in their life-course.

From the attestations above on the life-course framework, it is arguable that a person’s childhood experiences profoundly shape their adult life. Precisely, they signal the existence of marked continuities in the cultural, socioeconomic, or structural circumstances that a person encounters in their life-course, which serve as a predictor of their adult life, health, and well-being (Van der Linden et al., 2020). For instance, in the case of Caro, Sarton described her as a person who spent her childhood living in private and self-isolated life. Thus, the tendency inclined Caro to prefer solitude, as is evident from her decision to lead a single life in adulthood. Hence, it saw her not having a person take care of her when her health began to become frail as a consequence of aging, forcing her to leave behind the comforts of her living space and relocate to live in the company of others. Mainly, the heart attack made it unbearable for Caro to climb up the stairs of her home, signaling her need for assisted living (Sarton, 1992). Here, her lack of an immediate dependent, such as a child, forced Caro to contend with moving to live at her brother’s house to obtain the care she needed.

Although living with John seemed like the best scenario in Caro's case, the experience did not last long. Mainly, as a young adult, Caro took for granted her relationship with her family, including her brother owing to her decision to prefer her solitude as opposed to their company (Sarton, 1992). This situation, thus, impeded her from creating mutual bonds with him. Also, unlike John, who seemed somewhat quiet and introverted, Caro was extroverted, stubborn, and loud, making it difficult for the two to share the living space. Hence, it was no surprise that John eventually found it difficult to host her owing to the tensions that marred their relationship. Thus, he resolved to admit her into the nursing home where Caro stayed until her untimely death. This uneventful outcome signaled how one’s actions in their life course affect their build of relations with those around them and influence their fates during the final stages of their life where social support is requisite.

Mainly, the life-course framework signals the intertwining of each stage in a person's life (Yoshioka & Noguchi, 2009). Hence, one could presume that had Caro opted to marry or raise a child; she could have had a person to rely on for her care needs, primarily since her health was still robust, seeing her need only short-term care. Mainly, comparing her health status to those of the other senior patients in the nursing home, it is arguable that Caro did not belong to the facility. This outcome culminated from her living a decent quality life both in childhood and adulthood. It helped to enhance her vigor, seeing her maintain admirable physique and mental fitness in her senior life.

In the same vein, if Caro had built stronger relations with her siblings, she would have depended on them for her care needs at this stage of her life, hence forgo the nursing home. From the story, it was evident that John was willing to stay with Caro as she recuperated. However, her indifference, which also domineered their childhood, made it difficult for them to live together. Thus, it informed John's decision to admit Caro to the nursing home, where she experienced immense suffering until her untimely death.

Personal and Social Conflicts That Caro Confronted

Caro's inclination to prefer solitude served as one of her significant weaknesses, which affected her life experience. For instance, while living at the nursing home, she could not help but be judgmental of her peers, who, unlike her, was frail in their physical and cognitive functions. This situation saw her fall out with most of them, thus advancing her susceptibility to loneliness.

Caro also struggled with the need to attain a positive and profound kind of self- understanding, and empathy towards others needed to improve her social relations. Mainly, while she preferred her company, surviving in the nursing home called for her to create more reliable social connections through love and friendship. Thus, her failure to initiate friendships based on care opting instead to link with those that supported her rebellious stances, mainly Standish, saw Caro lose out a chance to connect with seniors that could have helped her contend with the living conditions at the facility, hence discourage her from opting to set it ablaze, risking everyone's safety. One can attribute this to her lack of trust for others, imminent in her childhood too. For instance, Sarton (1992) denotes Caro as a child who struggled to accept the words of endearment used by her parents. Hence, it was not surprising to see her struggle to open up to those close to her about her frustrations and plans, including the Reverend.

Caro also struggled with her failing memory, which compounded her frustrations. While the human brain seldom loses its creativity in aging, it often requires continual stimulation to stir it, non-existent cognitive stimulation in the nursing home (Shannon, N.d.). Thus, she took to journaling to help train her memory, which saw her further reserve her thoughts.

Physical and Mental Health Factors That Triggered Caro’s Breakdown and Rebellion

Since childhood, Caro tended to oppose living in a nursing home, deeming them as concentration camps for the old. This presumption and fear turned into a reality for her when she found the living conditions at the facility deplorable. It worsened when Caro's repeated attempts to improve the nursing home's living situation earned her contempt and ridicule, primarily from the head nurse, hence triggering her breakdown.

Also, Caro struggled with her spirituality. Mainly, owing to the deplorable conditions at the facility, she lost her faith in God, wondering why He could permit seniors to suffer terrible illness and die isolated at the camp. Thus, this situation made it difficult for her to listen to and take advice from the Reverend, opting instead to address the situation singly by setting the facility ablaze to end everyone's suffering.

The staffs at the nursing home were also demeaning, especially to Caro. Mainly, they stripped Caro of her dignity and patient autonomy through cruel and petty indignations. For instance, Caro endured solitary confinement every time she tried to speak up or confront the management at the facility for negligence. Mainly, Harriet took to denying Caro food, physically abusing her, stripping off her right to privacy, and visitation rights in her efforts to tame her (Sarton, 1992). These stances scarred her emotionally. At one point, Caro stated that she felt that her life had been taken away from her in the cruelest ways possible, signaling her emotional discontent. Hence, the despair clouded her judgment leading her to settle for setting the facility ablaze to end the suffering.

A renowned assumption in contemporary culture as advanced by research is that the human personality traits, including conscientiousness, agreeableness, and neuroticism, openness, and extroversion, get better with age (“Five Personality Traits May Change with Age”). Hence, as Caro tended to be in discourse with everyone during her childhood and young adult life, one may have anticipated her agreeableness to increase with her advancing age. This situation would have motivated her to resonate with Harriet and agree to disagree with her where a consensus was needed, instead of always reacting rebelliously. Also, contrary to the belief that neuroticism decreases with age, especially in women, in Caro’s case, her worries compounded with aging (“Five Personality Traits That May Change with Age”; Sarton, 1992). Thus, this situation intensified her fears regarding the intention of the nursing home to bring her untold suffering and death and the abandonment of God, which worsened her despair and clouded her sense of judgment in deciding to burn down the institution.

How Caro Might Have Fared Today

In the 21st century, Caro might have fared better. Mainly, unlike historically, numerous governmental and non-governmental organizations champion the provision of excellent health care services to all patients regardless of their demographic. Sarton's novel signals a society in Caro's time when health practitioners exercised dominance over geriatrics in their care attempts to foster cooperation. A case in point was Harriet's propensity to punish Caro through overmedication, physical and mental abuse willfully, and denying Caro the right to privacy or visitation (Sarton, 1992). Presently, such maltreatment of patients could culminate in criminal sanctions against perpetrators or the institutions' loss of accreditation by the participating institution. Mainly, healthcare regulators today prioritize the upholding of ethics in practice by advancing patient autonomy, beneficence, non-maleficence, and respect (McDermott-Levy et al., 2018). However, from the story, it was evident that Harriet embodied neither of these, which, in contemporary society, could make her liable to sanctioning or the cancellation of her license to practice.

Anna, a care practitioner that attended to Caro in the absence of Harriet, also witnessed the abuse of the people in the facility but did not voice it. One could attribute this to several wide-ranging factors, including the culture of society at the time, which may have normalized elder abuse or the lack of legislation. However, in the present times, there are multiple avenues through which a person witnessing elder abuse can expose it to regulators and stakeholders such as their family members. Doing so would have heightened the chance of these stakeholders intervening to prevent further harm. More notably, however, is the establishment of legislation that mandates reporting. One such is the Elder Justice Act of 2010. It mandates clinicians contracted in a long-term health care facility to report a suspicion or confirmation of elder abuse to the regulators, law enforcement agencies, or the primarily the Secretary to the United States Department of Health and Human Services. The law recommends that regulators penalize facilities with non-reporting members up to $300,000 or withdraw them from qualifying to federally funded reimbursement such as Medicare (Weinmeyer, 2014). In this regard, this law would have compelled Anna to report the incidences, hence liberate Caro from the experience of torture by Harriet while living in the nursing home.