Monday, May 07, 2007

Getting Old Stinks

Chris and I have been thinking a lot about aging lately because we're trying to set retirement dates and, in my case, muddle through the chaos that is my 401(k). It also came to the forefront the other day because my maternal grandparents are 94 and 87(?) and it has become apparent than they are no longer able to live independently. This, of course, weighed very heavily on my mother and uncle. They determined pretty quickly that, due to heavy work and family commitments, it probably wasn't feasible for grandma and grandpa to move in. So, they started looking at other options. Personally, I cringe a bit when I think of the traditional retirement homes; I used to volunteer at one in junior high and it was a very grim place. I couldn't imagine Grandpa George and Nana there. But frankly, as the population in the United States has aged, retirement living has become a big business. And it's become better. My mom and I toured several facilities while I was up in Seattle and I was completely blown away. Chris and I had visited both of my paternal grandmothers when we went back east for Brian and Amanda's wedding a couple years ago and they had lovely apartments in retirement communities. I don't think there is any way to get around the fact that most of the people here are waiting to die; however, (and it's a big however), it was new, clean, the people were cheerful, and there were lots of planned activities. I think that counts for something. My maternal grandparents are currently very sedentary, don't socialize much, and have trouble taking care of everyday household tasks. My mom and Uncle recently signed my grandparents up for a two-bedroom apartment that is practically the size of my current house. I'm excited for them: I think this will be a great opportunity to get my grandmother out walking and my grandpa reminiscing with other old fogies about the good old days.
At some point, everyone has to make really difficult decisions regarding the loved ones in their lives. It's agonizing. But I'm feeling pretty optimistic about the decision that Mom and Bill made. I can't wait to visit them in their new plush digs when we go up to Seattle this summer.

This article caught my eye this morning in the Seattle Times.
How much should we sacrifice for our parents' care?
By Liz Taylor
Special to The Seattle TimesQ: My mother, age 95, wanted to die in her own home, and we supported that, so she stayed in her apartment several states away. She's on oxygen 24/7, and her mental capacity is still pretty good, but she's frail and needs 24-hour care.
We've been fortunate to have trustworthy caregivers who love her, rotating on 12-hour shifts. The problem is, she's almost out of money. Her Social Security check is now her only income. In her state, Medicaid pays only for a nursing home, which she firmly resists and doesn't need. So my husband and I have been paying for her care from our own funds. Her total expenses run close to $12,000 per month. My mother is still mentally alert enough that she resists any changes in her routine, and although she's frail, there's no sign of impending death. Our funds will soon run out, and I'm puzzled (and panicked) about what the best choice is in this case. How do I honor my mother's wishes? A: Here's an analogy — hard to swallow, but I believe it fits. When flight attendants instruct airline passengers on what to do in emergencies, they tell parents to put their oxygen masks on first before their babies' — the parents' survival ensures the protection of the child. You and your husband have to survive, and I believe your first duty is to each other, saving enough for your own retirement and future care needs. Your second duty is to your children if you have them; your third is to help your mother when the sacrifice is within your capacity to provide. It's a wonderful gift to support her financially. But when the gifts stop you from protecting yourself, it stops being a good deed and becomes martyrdom.
Nobody's at fault for your mother living so long, including you. The hard reality is, she spent a small fortune ensuring she could live at home — it would have cost much less if she'd moved to an assisted-living facility or adult family home, and her savings would almost certainly have lasted longer.
Like most states, hers covers only nursing homes for people on Medicaid, which is absurd; Washington is one of the few states that allows recipients to live in adult family homes. You might consider moving her here through private pay, then converting her to Medicaid once she arrives (it will be easier placing her here private-pay, then dealing with the state bureaucracy after the fact). But any move is going to be difficult — all relocations are perilous for very old, frail people. I don't envy you your choices.
Q: I've just spent the past year running a one-person retirement center (cook, maid, bus driver) for my mother in my home, and my health and marriage have suffered. She cannot walk or see and lives only to eat. She says she feels terrible about this, and she just wishes she could go to sleep and never wake up. I believe my mother is the last of a generation who will feel entitled to eat their young. I have my plan, and I know my children will be grateful to me for not taking their last few years of good health.
Q: Based on experience, I know there are many poor choices my mom might make, leaving me, her adult child, holding the bag. She could lose her savings to a con artist or the stock market, then fall and need round-the-clock care but have no money to pay for it. Guess who now has a "dependent" in the home once again? I spent the first half of my life taking care of my children; in all honesty, I do not want to spend the rest of my healthy years taking care of a parent.
A: These two letters share with the first a notion that adult children owe their parents unfettered sacrifice. It reminds me of a question raised by a woman who attended one of my workshops a few years ago: What do we owe our parents — our lives? Should we give everything up to care for them? Where do we draw the line in our obligation?
Each of us will answer this differently. Those from other cultural backgrounds or with the means and ability to provide care may opt to sacrifice more. However, my response for me (and most others) is no. We may owe our children greater chunks of our lives if they're disabled, but I don't think we have the same obligation to our parents. In the eight years I cared for my parents, I know they didn't expect me to give up my life for them.
Each of us needs to think about this as we start down the caregiving road — how much can we do, and where will we stop? When more is needed and we can't do it, there are three choices: Someone else in the family must step in, it must be purchased, or we must rely on what the government provides.