Elder Care: Tough Choices About Assisted Living

Posted by: Anne Newman on October 17, 2008

On the eve of their 62nd wedding anniversary, my 92- and 84-year-old parents are planning to move within their retirement community from a spacious two-bedroom apartment to much smaller quarters in assisted living. My frail father will get the professional care he needs, but my relatively healthy mother is ceding her last bit of ground as an independent homemaker. It’s not an easy decision, but judging from some of their fellow retirees, few have the luxury of wrestling with it: Many couples include a spouse whose health declines so rapidly that living together in assisted living is out of the question.

As more and more of our parents live within sight of their 100th year, families like ours face tough choices: Do couples break up so one can get the nursing the other doesn’t need? Do they stay together, with the healthier one sacrificing space, independence, and the company of a more agile community? Do children care for parents in their homes, or trust them to strangers better equipped to provide medical care? What kind of care can the family afford? What about the logistics of moving seniors? How do working parents juggle jobs, moving their elders, and kids’ lives back home? (Answer: laptops, cell phones, and weekend flights.) The blogosphere is brimming with stories on sites such as The New York Times’ The New Old Age blog. Organizations like the 12-year-old National Alliance for Caregiving provide everything from booklets to research to lobbying for family caregivers, companies like MetLife produce ongoing research and resources about aging, and the aging industry grows by the day.

Sorting through the icons of a life together—my parents’ marriage has spanned more than 15 moves across four continents—is not easy. For two people with vivid memories of the hardships of the Great Depression, they’ve come a long way—in no small part because of the frugality that shaped their childhood. Raised in Southern villages, they recall lives my 10- and 15-year-old kids can’t fathom: They each had only one birthday with presents during their entire childhood; my mother remembers gathering around a central stove to stay warm during the Depression, my dad recalls when his family’s only bathroom was a breezy outhouse near the chicken coop.

As a young couple with a fast-growing multinational, my parents became part of the postwar expansion of American industry that sent manufacturers to four corners of the earth in search of raw materials, energy, cheap labor, and local talent that could eventually run overseas operations. My parents’ retirement community is filled with ex-managers, executives, journalists, academics, clergy, and military types whose travels easily match my parents’. Each month a display case exhibits a different set of exquisite items from around the world on loan from residents.

But how do you decide what’s truly valuable when the time comes to radically downsize? My family of four seems to drown in the detritus of modern life—toys from McDonald’s, school papers and projects, far too many two-for-one girl’s Tees from the mall, enough Legos to build a village, junk mail that never seems to get junked—but I’ve always thought my parents efficiently handled the necessities, memorabilia, and treasures they’ve collected over the years. Now, however, as my mother and I sort through closets, drawers, and display cabinets, I too find the choices about what to keep and what to give away hard. My grandparents’ love letters? A no-brainer—they move with my mother. A favorite, huge carved elephant, nicknamed “Oswald,” from West Africa? Maybe. ALL the “Grandma” mugs? Not really. Family videos that become increasingly difficult for my father to see as his macular degeneration progresses? Hmmm. All the delicate china bought during years in Britain? Well, not all. And the list goes on… Meanwhile, doubts about the move are never far from the surface. Wouldn’t it just be easier to live apart, particularly as the ailing spouse retreats more and more from the world? Yet hasn’t some research suggested stable long-term relationships can prolong life?

Readers, do you find yourselves juggling worklife and elder care—and what advice do you have about some of the tough choices?

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