Friday, February 14, 2014

Home Is Where the Heart Is

My mom, Mary Delano Langton, in her room in assisted 
living with the son of my friend, interviewing 
her for a school project on seniors.
Some of the tiniest and most challenging living that people do often comes at the end of their lives. 

In their early 80s, my parents had a great apartment near the beach. It had a pool and was only 10 minutes from our house and their new, and only, grandchild. But within a year of moving in, my mom fell, breaking her pelvis and arm and almost doing herself in. 

While she was in the hospital, and then rehab, it became clear that my dad’s growing forgetfulness was actually a serious memory problem. A nurse I trusted studied him closely when he visited my mom, and realized how much he and my mother compensated, convincing us all that he was fine. My mom emerged from rehab a much frailer version of herself, and all agreed she could no longer do all that she had been doing to help my father. 

They moved into an assisted living facility two blocks from my house. Among seniors who need care as they age, they were the lucky ones. They both had retired from the railroad, so they each had good pensions to supplement social security. They were just able to afford their new home.

Paring down her stuff to move was hard for my mom. She had done wonders when she moved from my childhood home, a four-bedroom Dutch Colonial on Long Island. She had lived there for 50 years, and it was crammed to the rafters. But she blazed through it, and she and my dad moved to a two-bedroom apartment with their most precious possessions.

Now, faced with moving into one room, she had to pare down in earnest. I did most of it while she was in rehab, and my husband helped with a giant yard sale. My mom directed Operation Downsize from her bed. She said it was actually easier that way, to say good-bye to things she had not seen in a month. “Out of sight, out of mind,” she proclaimed bravely. 

They settled into their tiny new home, and were quite happy. “It’s like a cruise ship, but with bigger windows,” laughed the woman who had never been on a cruise. “It’s like a college dorm, but with no classes,” crowed the man who had never been to college. My folks were always known for making the best of things.

Three years later, my dad died. Without his pension, my mom moved into a smaller, more affordable room. Again she carefully chose what to keep, what to give away, and what to make me promise to save forever at my house. Her room was about 10 feet x 10 feet, and she loved it. “It’s my nest!” she’d proclaim, perched like a tiny bird on the edge of her loveseat. 

My mother had several wonderful years in her little nest, with constant visits from family, friends and the staff who loved her. Then she fell, breaking her pelvis again. Even after rehab, she could no longer walk and her chronic heart disease forced her to use oxygen. Her medical needs had increased beyond assisted living, and she decided to move into the nursing home next door. The room was the same size, but it also held a roommate and institutional furniture. 

One final time, she and I made decisions about her things. She kept her clothes, a small dresser and two little containers she called her treasure boxes. I saw her every day for two years, and did my best to be sure she was happy and cared for. Most of the staff was wonderful, but a nursing home can never be the same as home. It is a place you go when your life gets very small and you are out of options.

But yes, my mom was one of the lucky seniors, in more ways than one. She had the grace and pluck to see her through forced downsizing, she had a decent railroad pension and free full health care (Thanks, Amtrak!) and she had loving family to support and visit her.

This Christmas, my mother-in-law Irene made the same transition, moving from her daughter’s house to a small group home after a series of strokes. Now my sister-in-law visits her every day. Irene, too, is one of the lucky ones.

Those who are not so lucky, without family support or finances, end up in nursing homes way before they have serious medical needs. Some states have programs to fund in-home or group-home care; most do not, or have long waiting lists. Senior service agencies, such as the vibrant Council on Aging in our town of St. Augustine, do all they can to help people remain in their homes. But they fight for funding as baby boomers flood the system. 

People don’t need big houses, they just need support to live in their own homes as long as possible. And it would be cheaper in the long run: the very system that fails to fund low-level services that keep people at home kicks in for a nursing home, possibly more care than needed, at five grand or more a month. 

Meanwhile, not only seniors are faced with the support dilemma. For example, nearly 200,000 Americans under 65 have younger-onset Alzheimer’s, according to the Alzheimer’s Association. One of them is a dear friend. These families haven’t even made it to retirement, and their family finances are being decimated.

So this is kind of a depressing Valentine’s post. But if you love someone who plans to age—and it beats the alternative—talk to him or her now about the future. Learn about the services in your community. Petition your elected officials to recast elder care. And call your local senior center right now to volunteer. It’s a great way to spread the Valentine love. 

No comments: