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THE MAN behind me on the airplane is old and frail, traveling with a frail old woman. Across the aisle is a tall, burly young man — I’m guessing he’s an aide. The old man has to go to the bathroom. He keeps standing up — his gnarled hand curls over the seatback next to my head, and through the corner of my eye I see his tall frame laboriously rising, his watery eyes full of anxiety and determination. Across the aisle the aide rises too, and follows the old man’s shaky progress toward the rear of the plane. But we’re in a pocket — no, repeated pockets — of turbulence. The plane bucks and lurches, the old man staggers. Even with the aide’s steadying arm, he can’t make it down the aisle, and eventually he falls back into his seat, to rest for several minutes before trying again. Each time he makes a move to rise, the aide gets up too, like a dancer attuned to a partner’s cues.

The aides. We don’t think about them until we need them. Then we think about them all the time. During the last six weeks of my grandmother’s life she was in a state I never understood medically — unmoving, unspeaking, largely unresponsive, but her eyes were open. Once I asked her if she was scared, and her face contorted and then became impassive again. One of the aides who cared for her, Eurith, was a Jamaican woman with a soft voice. Even though she had never seen my grandmother conscious, she treated her with a gentle respect that earned the respect and gratitude of our family. If my grandmother knew anything of the last weeks of her life — and I think she did — she knew the touch of those gentle hands and the sound of that voice.


The world of old age, of sickness, of aides is always there, but most of the time, for most of us, it’s a shadow-world, parallel to ours. I lived in it for a little while when my grandmother was dying, but then I left it and didn’t think much about it again for the next 30 years, until my mother got sick. Suddenly there were hospitals and rehab hospitals and assisted living, and walkers and commodes and wheelchairs and aides. She was paralyzed and incontinent, and was mortified by the helplessness, the loss of privacy. Once, she told me, she heard the aides arguing outside the door of her room about whose turn it was to change her. We knew, we knew: They were tired, overworked. But still. I was sad and angry when she told me this story. And even now, five years after her death, I burn when I think of the aide who came with us on my mother’s last outing, six weeks before she died. After lunch, my mother asked if we could drive along the shore for a bit. She was nearly blind, but we opened the windows of the van and she kept saying that the ocean smelled wonderful. The aide was tapping his foot, rolling his eyes, impatient for the outing to be over.

Others were patient and gentle, joking with her, telling her their stories. She was so dependent on the aides, so much at their mercy. I am grateful that almost all of them, almost all of the time, were merciful. They came to her in the night when she needed help. They prayed for her, and she thanked them even though she didn’t believe in prayer. They knew things about her, at the end, that I didn’t know: her small routines, her humiliations, what pills came when. She knew the names of their children.


Somewhere, walking around in the world right now, are the people who will take care of us when we are old and frail. I hope that they will be very well paid and well rested. I hope that their profession will be regarded with respect, even with reverence. They are the people who will accompany us at our most vulnerable, when reality catches up with us and the quality of our lives will depend on the quality of our daily care.


Behind me the old man makes another move to pull himself to his feet. Across the aisle the aide gets up too. His face is kind, his arm is out, ready to brace or catch. He can steady the man, but he can’t make the plane stop pitching.

Joan Wickersham’s column appears regularly in the Globe. Her latest book is “The News From Spain: Seven Variations on a Love Story.’’