The challenges with caring for the elderly

I read this blog recently and forwarded it to my sisters. On second thoughts I think I should forward it to my usual list of people that I mail interesting articles to, because this is something every one has to face - either themselves when they grow older or if they have aging parents or relatives to take care of now. The astounding number of comments from readers is a reflection of a real issue that both care takers and the elderly face in their old age.

My father passed away Jan'07. As the youngest child in a family of six siblings, the first five close in age to each other, I was in the unique position of seeing my parents in their old age when I was still fairly young compared to my siblings or even a lot of my friends. Even my sister who is the fifth in the family is seven years older than me. Yeah, I was clearly an accident. My mother is sweet enough to tell me that it is probably my luck that my father led such a good life until the day he died - this is when I tell her how good their life would have been had they not had me at all. Five kids would have been settled and they could have relaxed in their old age much sooner.

"At least he didn't suffer...just two days of pneumonia and he passed away", my mother says to console herself and us when she talks about my father's passing away. I too thank heavens for that. It would have been unbearable to see my independent, active, confident father become totally dependent had he come back home with lung complications with an oxygen tank. My parents were staying with my brother and sister-in-law at that time. They (and us visiting them) would have surely taken good care of him - but every one would have been stretched to the limits particularly my mother. And my father would not have coped well emotionally if he had to depend on any one for his basic functioning. In that sense, I think we were blessed that we did not have to see him suffer and that he passed away with dignity. I wish for my mother a long and healthy life. If my father was active, she is super active. And super emotional. And can spiral into absolute negativity on the rare occasion that she is even down for a couple of days with fever. I pray to God that she should never suffer or become physically dependent on any one in her old age.

My mother-in-law was a heart patient - she had a congenital heart defect that was diagnosed only at age 50 or so by when it was too late to operate on her and be sure of fixing it. She too had phenomenal energy and has really awed many cardiologists with her energy despite her weak heart. She became physically weak in the last month before her death. She was very exhausted physically and at that point I used to have sleepless nights wondering what we should do - should we move right away back to India or should we wait for a month or two to see if she gets back to normal and is able to travel to the US in which case they were both willing to be with us and get a Green card? But before we could even get to such decisions, she suddenly passed away. My FIL too talks in the same vein and says that he is just glad that she passed away rather than come back home physically incapacitated.

My FIL is a diabetic patient but is quite active and self sufficient thus far. He will be moving to the US - he just got his GC - with plans of eventually getting his citizenship since both his children (my husband and his sister) are in the US. He will be living with us for the most part. I have two very young children and coping with all the work including cooking meals on time is just barely manageable. Nearest family for us is a five hour drive. Some friends yes, but all have two young children, so can't even imagine asking them for any help unless absolutely necessary during an emergency. It gives me the shivers to think how we would cope if there was a dire emergency. Not just my FIL, for that matter none of us can afford to be in anything less than the best of health at this point. Even on rare occasions when B has sprained his shoulder, it was hard because that meant at night I would have to attend to both kids all night.

Back to the main point, caring for an older person is something that requires patience - almost like caring for a child. But caring for an older person who is physically dependent requires patience, courage, stamina and will. A strong will and a sense of duty - for even love falters if there is no will during tough times. I have seen even young couples where one person had to go through cancer therapy where the marriage was really tested. No wonder they say "In sickness and in health" during wedding vows.

Some of the comments in this post are really sad and heart breaking. A few of them may come across as heartless. But mostly you can see that the children/siblings of these elderly people are trying their very best with their heart and soul to provide them with good care. Still it can stretch a person to the limits. Especially in this country where there is no neighbor walking in randomly to check on you and give a few minutes of break. Even when I take care of the two kids, if I need to quickly go out and get some milk, I will have to take both kids along. It would be no different with an older person who needs constant care and attention.

I wonder how many of us have thought about our own old age. I tell B that I never want to be dependent on our children financially. But what if our health fails? That thought then brings me closer to the reality of how it might feel to be in a totally different world of assisted living. Not that that is bad. But somehow I have this mental image of living in a bread and breakfast inn except that that would be home, not a vacation stay. Breakfast at set times, living by rules set by the nurses. All reasonable, yet so different from the feeling of home.

I saw my friend and her two siblings struggle horribly in taking care of their father who deteriorated from Alzheimer's. She with her two very young children, her sibling on the other coast and one in the UK, all with relatively young children - together struggled to give him good care. Her mother once called me when I actually did not have much time to talk. But I could not hang up on her at all. It was heart breaking. At some point, she did not really care if I was even listening. She just wanted the feeling of someone who had the time to listen to her. I just forgot about what I had to do and just listened. I did not utter a word other than "Uhm, Uhm" for a whole hour if you can believe it. She was like a prisoner in a foreign world. There was no world outside of caring for her husband for her. Holding him back from running out of the house in the middle of the night, waking up in panic hearing him turn on the stove in the kitchen or hearing him shower in the middle of the night or soil his clothes quite unaware of what he was doing. It was wrenching to even hear of all this from her. In some ways, much as she terribly misses her husband, and the children their father, there is a feeling of liberation from the stress they were all going through at that point. Having to provide care in such situations especially when you have your own dependent children to take care of can really make or break relationships. Between the spouse of the caregiver, between siblings. One can only hope that through it all, you come out stronger and not broken in spirit.

I think of my father and again feel a sense of relief as I write about what my friend's father went through. And I realize it is a blessing to have a good life and as much of a blessing to have a good death. I only wish people were at least spared the unfairness of physically debilitating illness in their old age. These days if I hear of someone old who went to bed and never woke up, I can't help but think of that person as truly blessed.