Caring for the Old
July 11, 2008 1:34 PM   Subscribe

The NYT has a new blog on aging and eldercare. Thanks to the marvels of medical science, our parents are living longer than ever before.The Gray Lady has started a blog catering to the sandwich generation, with topics, so far, ranging from when to take the car keys to personal accounts of eldercare crises. The 290 comments on this post in particular are eye opening and heartbreaking.
posted by mygothlaundry (20 comments total) 30 users marked this as a favorite
That post you linked to is astonishingly powerful and I wouldn't have seen it otherwise. Thank you for provoking some thoughts...
posted by patricio at 2:41 PM on July 11, 2008

Nice post. Incredibly depressing issue, but one that's unavoidable.
posted by bardic at 3:13 PM on July 11, 2008

Having had my father die at 90 a couple of years ago, and now watching my mother-in-law decline in assisted living at 92, this post hits close to home, and I have to take the linked site a bit at a time. Excellent post.
posted by languagehat at 3:27 PM on July 11, 2008

No one's posting because we're all too engrossed. Thanks for the great post, mygothlaundry.
posted by infinitywaltz at 3:40 PM on July 11, 2008

Yes, I have barely scratched the surface of what is to be read here. I just want to stop and thank you for the post before I spend the time to read more.

Thank you, mygothlaundry!
posted by jaruwaan at 3:50 PM on July 11, 2008

I'm glad you posted this because it's an important issue. I can't really spend much time on the links -- it's a little to close to home for me -- but I really hope other people do take the time. It's important to be aware of this stuff. I know that when I first started caring for my parents, my other friends didn't really relate and tried to avoid the subject... but now they are slowly starting to see their parents age too. It's a tough situation for everyone, and definitely a crisis in this country.

Hate to say it... but although I love my country, getting old in America sucks. Period. It's just awful.
posted by miss lynnster at 4:49 PM on July 11, 2008

I really wish NYT would put more than the post title and one line in the RSS feed.
posted by junesix at 5:19 PM on July 11, 2008

From one of the comments:

Many of us are just living WAY TOO LONG…Dr. Kevorkian had it right. We “put down” our loving pets with a great deal of remorse, sadness, etc. but the vets know that it is for the best because they aren’t as money-hungry as most of our human health care industry.

I, for one, can see suicide as a viable alternative to making younger family members fret over care issues, spending hundreds of thousands of dollars to keep me alive an extra few years or even another decade. I’m almost 60 and most of my work on this earth is done. Why can’t I just move aside as is my choice and not be a burden? For those of you who want to see me live until I’m 90+ and not coherent, continent and all the rest….GET OVER IT!!! Oh, my organs can be taken by any who need them too. I’ll be happy to loan them out to whomever for forever as I say goodbye.

I echo this sentiment. I have family history of alzheimer's and my criteria is that if I get lost on the way to the grocery store twice, I have to end it. I get one freebie.

I worked in a nursing home, changing diapers, feeding, bathing, turning, dressing, undressing, etc. I made a whopping $10 an hour. It was physically demanding, disgusting, and soul-crushing.

I see in some of the comments there people talk about being vigilant asking questions of the staff about their elderly relative's care. There's only so much you can expect from an overworked aide making a pittance who has to care for many different patients all at once. It was a mixed blessing seeing someone's relative visit. It was nice to know that our patients got to enjoy a visit, but often the visitor would hassle us, demanding a level of care we just could not provide. We'd be attentive while the visitor was there, but then go back to normal when they left. There were just too many people to care for. We did our best but we had a heavy patient load. I couldn't check every diaper on my hall every hour, or even every two. I didn't take notes on exactly how many times I changed people as I did it, I just sort of summed up in the log books as best I could at the end of my shift. Reports of what they ate were similarly estimated, but I think drastic changes were picked up when they happened.

Two patients stood out to me as having no quality of life, yet they were kept going since the money kept coming in. They were both in late-stage alzheimer's. Neither one opened her eyes, or wore anything but a scowl of pain and unhappiness on her face. One could at least stand and walk (well, shuffle), but this caused problems as if she got out of her room she faced the possibility of serious injury, since she couldn't see obstacles. Once when I was helping her, I went to the cabinet to get a fresh diaper and accidentally left the door open for a few seconds. She shuffled her way into the edge of it with her face. Luckily she was very slow so she didn't get a bruise or anything serious.

The other one did nothing but mutter something unintelligible occasionally, and fight like mad when I needed to change her clothes or get her into her wheelchair to go to meals.

Both of these ladies would eat when spoon-fed, which is a laborious and tedious process but I guess it's less bad than tube-feeding. Tube-feeding is a place where many people draw the line with their advance directives.

Ending up like one of those ladies is my worst nightmare. I cannot begin to fathom the amount of pain their families felt. Any chance of any kind of acknowledgement or recognition of the people they love is long gone. What's left is just a husk. It's just prolonging the agony for the families.

I think the baby boomers are going to bleed the country dry with their medical care needs as they age. Face it, the level of care available nowadays is a luxury, and we won't be seeing it by the time I and my fellow Gen-Xers age. I foresee assisted suicide becoming legalized and used regularly.
posted by marble at 5:45 PM on July 11, 2008 [5 favorites]

marble writes "I foresee assisted suicide becoming legalized and used regularly."

We already have assisted suicide thanks to cheap and freely available firearms. It's just the dignity that's illegal.
posted by mullingitover at 6:01 PM on July 11, 2008 [1 favorite]

Gerontology takes an even thicker skin and greater reserve of empathy than probably any other healthcare field. I know that when I was in social work school at Columbia absolutely nobody wanted gerontology internships, it was the bane of probably 90% of the class. Columbia has this thing about expanding horizons and challenging comfort zones so I was told not to expect to get assigned a first year internship that covered any ground I already tread on. I arrived there having done a pretty solid cross section of social research and clinical internships as an undergrad (child abuse, substance abuse, mental health, etc.) so I knew I would wind up doing gerontology.

They placed me in the city's Department for the Aging and I had to staff a hotline phone for their elder abuse division. Holy shit, talk about a suicide inducing job; I spent like four hours a day talking to elderly women whose children and husbands were either beating the shit out of them or robbing them blind. I dropped out at the end of the year and never finished my MSW, it was that harrowing.
posted by The Straightener at 7:45 PM on July 11, 2008 [1 favorite]

It's somewhat depressing that I find this link useful. Thank you mygothlaundry.
posted by caddis at 8:11 PM on July 11, 2008

What caddis said. I can't say anything else that won't turn into a pity party. I'm facing this right now -- my mother and I -- with my dad.
posted by dhartung at 12:56 AM on July 12, 2008

My parents were egomaniacal boomers who lived like there was no tomorrow. Tomorrow's here and now me and my siblings are trying to figure out how to make up for their lack of planning and employment. We're working very hard to keep it from getting ugly for any of us.

I'm glad people are writing and talking about the challenges of this inter-generational obstacle course. Although I've already got it bookmarked from when it showed up on some other site, this post provides a better intro. Thank you!
posted by batmonkey at 3:50 AM on July 12, 2008

As I watch my Mother slide daily into a madness borne of dementia, I thank you for this link and all that it leads to. It is a goldmine of useful and helpful comments and experiences. It is the hardest thing I have had to do: I can only imagine what it must be like for my Mother who is fearful at every turn, has lost any sense of others, no longer cares what she looks like, or has any sense of propriety or female decency. This can't be right: I used to think that we suffered so we could know the Love of God. I am not so sure now.
posted by vac2003 at 4:28 AM on July 12, 2008

Thank you for the post- I have a mpther-in-law who is 92, still living in her home and a stepmother-in-law living in a nonprofit assisted living center.

This post is a gold mine of practical information.
posted by francesca too at 7:41 AM on July 12, 2008

Egomaniacal boomer here. batmonkey I wanted to be offended by your characterization, but I can't be. I can only say in our defense that we really believed that we were the last best hope of mankind, and that as such we would change the world. That the bright horizon was in reach and all problems would be solved. We would all live forever, drinking and dancing and screwing and creating peace and beauty in a grand unity of race, creed, and gender. That our legacy is instead the cynical and disillusioned generations of our children and our grandchildren is such an indictment of how badly we let our own youthful optimism down. I weep for us all.

God, what a way to start the day.
posted by nax at 7:48 AM on July 12, 2008

Nax I like to joke that you boomers are going to retro fit senior living to be really awesome places (some of them are kind of on their way already with the current generation). Then the hubby and I can move in when we're in our 70's, bring our XBox10,000, and ride the community van to baseball games, attend sr. yoga classes, our apartment already set up with excellent wireless.

Thanks for this wonderful post. It is a wealth of information. The Straightener and Marble, you comments make me so sad and reflect what I see in my own line of work. This is a public conversation that needs to be had frequently. The loss of physicality and mental awareness that sometimes comes with aging is terrifying and we as a community need to know what our resources are and what to fix if and when we can.

It's a little old and I'm sure I've posted the link before - but here's a wonderful positive approach to aging: Surfing for Life, a documentary about aging in surf culture and celebrating the sprit of life.
posted by dog food sugar at 8:21 AM on July 12, 2008

I echo this sentiment. I have family history of alzheimer's and my criteria is that if I get lost on the way to the grocery store twice, I have to end it. I get one freebie.

You get lost because the memory goes. You don't remember that you have a problem. It's maddening talking to suffers. The mind naturally makes up something likely for things that you don't remember. You ask "what'd you have for breakfast this morning?" and they respond "eggs and some grapefruit." Meanwhile the daughter is in the corner pulling her hair out whispering "OATMEAL! SHE HAD OATMEAL EVERY DAY FOR A YEAR!"
posted by a robot made out of meat at 8:25 AM on July 12, 2008

My mefite brother actually emailed me these links - because we are finding ourselves rather suddenly in this situation. Every day is like a new journey and it's not going to be a short trip. It's all kind of overwhelming; even though I've been sort of involved in eldercare with my mother for some years now, it just got exponentially more complicated when my mother's sister, who has no other relatives, suffered a thankfully mild stroke. Even a mild stroke is pretty debilitating. I get so frustrated because it seems like this is a huge national problem and I guess I'm still naive enough to think that when there is a huge national problem, someone will step in to fix it. You know, like they did with health insurance. Ha.

Instead, it's just a huge chaotic mess that has to be carefully navigated, from the crazy complexities of Medicare to home health aides to housing - where and how? Have you ever tried to get a normal landlord to rent to a person who has occasional lapses of memory and speech? - to shifting social security payments and powers of attorney from one state to another and all of this done with a person who is suddenly unable to sign her own name and is understandably frightened and frustrated. The switch from independent adult to, basically, a return of childhood is really hard to watch and I can only imagine how terrible it must be to go through. Sometimes I leave my mother's continuing care - and she's one of the lucky ones - and I think, keep smoking, MGL, die young.
posted by mygothlaundry at 10:09 AM on July 12, 2008

These links so hit home with me... My beloved mother-in-law,who is only 69,was recently moved to an assisted living facility (we'd thought she'd had Alzheimer's Disease, now the latest specialist says it's Lewy Body Dementia). My father-in-law is in an obvious state of depression/denial and Mr. Adams and I are trying our best to help him (he's in Georgia, we live in Michigan but go down for one- or two-week stays frequently). My own parents are in their late 70s/mid 80s and are in sound mind (so far) but deteriorating body (heart attacks, minor strokes, breast cancer, yada yada). My youngest brother (early 40s) has moved back in with my parents in order to help "take care" of them (trying to do so without their knowledge, as they're stubborn and "don't need any help")...he mows their lawn, shovels their snow, arranges for necessary repairs on their house, etc, but gets easily frustrated with their "ways." Dad really shouldn't be driving (he is so easily distracted, and frequently goes well below the speed limit or doesn't notice stop signs) but gets antagonistic when it's suggested that someone else should take the wheel.

So Mr. Adams and I are currently in a state of constant worry/dilemma...father-in-law lives in a rural area with almost 1,000 acres of land and an aging house in dire need of repairs. He's also a packrat and has lots (and I mean LOTS) of collectibles stashed not only in his house, but in various sheds on his property. He doesn't want to move, of course, but we're trying to decide whether it's more economical to just move him elsewhere rather than pay for the new plumbing, roof, heating, cooling, etc, necessary on his current house. But if he did agree to move, what in the world to do with all his collectibles? Meanwhile, he lives in a pitiable state of depression, with his only reason for getting out of bed in the morning being to go visit his wife at the "home" and maybe take her to lunch or to church. He perks up noticably when Mr. Adams and I come to visit - we take him out to eat, go to antique malls (no, he doesn't really need more junk, but it's his passion) or simply sit and watch TV with him, and he's like his old self. It breaks my heart when we have to leave...his face is so very sad. My own parents (who live near us) are similar - they visibly perk up when we stop by and do something as simple as watch TV with them or take them out to Cracker Barrel for lunch. Again, it makes me sad every time we bid them farewell, because they are just so grateful for our company. (Even though my brother lives with them and takes care of their basic creature comforts, he's not very patient and avoids "socializing" with them.)

Sorry to have rambled on and on, but thanks to the OP for the post. I appreciate the opportunity to vent.
posted by Oriole Adams at 1:09 PM on July 12, 2008

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