The Way You Play It

Life is like a game of cards.  The hand that is dealt you represents determinism; the way you play it is free will.

Jawaharal Nehru,

Former Prime Minister of India

Casually tossing the stack of mail on the seat beside me, I continued on with my day unaware of the personal letter lumped in with the invoices, sales pitches and bank statements which usually await me at the post office.  Later that evening, getting back to business after dinner was served, the table cleared and the dishwasher loaded, I returned to my desk to review my next day’s agenda and sort through the mail I picked up earlier. 

It was only then that I noticed the hand-addressed envelope.  The words it contained were simple and sweet, but powerful enough to settle the unsettled feeling I had been dragging around with me for weeks. 

She teaches me and I really enjoy her company were among the written words, but it was what was written between the lines that made me feel so much better.  Written there, in invisible ink, but large bold-face type, was a message reconfirming there is always meaning and purpose to human life no matter what a causal observer may think. Thank you, Ashley.  I knew it was there, I just needed a short, straight-forward example to wrap my mind around …  She teaches me and I really enjoy her company.

About a month earlier, while making idle chitchat with another visitor at the memory care unit, the woman with whom I was conversing  unexpectedly blurted out, “I would rather take a bullet to the head, than land up like this.” Given that we were in the company of a half dozen dementia patients, her comment was inappropriate and insensitive.  Most would agree, her comment would be inappropriate and insensitive no matter what the setting.  As I gathered my belongings and prepared to quickly move Maggie down the hall, I suggested to Chatty Cathy that nobody wishes to suffer from dementia, and perhaps she should choose her words more carefully.

I confess I don’t have much of a poker face, and although I tried to hide my irritation brought on by the insensitive comment, Maggie picked up on it.  She suffers from advanced dementia and usually doesn’t seem to comprehend most conversations.  Sometimes though, she surprises me with a spot-on interpretation of what is going on around her.  A few minutes passed and as we settled into a quiet corner to watch the birds feed outside the window, she said, “Well, my dad always told me, we’ve got to make the best of it.”  She is fond of common sayings, and I have heard her repeat this one many times before.  Never in such an appropriate situation though.  I wasn’t certain whether she was directing her comment at my mood, or addressing the careless words of the other visitor.    Maybe neither.  I couldn’t be sure.  Just as I did the other times she said this, I replied, “Sometimes, that’s all we can do.”

Copyright 2012 Carol M.W. Bagazinski.  All rights reserved.

Home Sweet Home?

Years ago, I participated in a funeral procession that drove to and paused in front of the deceased man’s home before continuing on to his final resting place at a nearby cemetery.  I was told this was customary to his family heritage.  The tradition honored all he had worked for throughout his life – his home.  It was a safe haven for his children while they were young, and for him and his wife in their old age.   Both he and his wife died in that house. 

Living and dying are different now.  In earlier times, people who were lucky enough to live well into old age, got sick and died rather quickly from a stroke, cancer or heart attack.  Not so much anymore.  Medical advances are keeping people alive much longer, and as a result, we are often living with a number of disabilities. 

As we age, our sight and hearing abilities diminish, arthritis limits our mobility, cognitive disorders impair our minds and the list goes on.  As Claire Berman put it in her book, Caring for Yourself While Caring for Your Aging Parents, (Henry Holt and Company, LLC 2006) “Nowadays, we lose our parents bit by bit.”  For many, it is not plausible to age in place, or in other words, to remain in their longtime home until they die.  This does not mean, however, they have any intention of leaving it before that happens.  Most of us have heard an older person exclaim, “The only way I’m leaving here is feet first!” 

As life expectancy increases, more of us struggle with caring for our aging parents while trying to maintain the fragile balance of life’s other obligations.  Difficult economic times are forcing many to consider just how much time can be spent away from their jobs.  During recent months, I have heard from two men, both without siblings, who lost their jobs as a result of spending long hours tending to the needs of their elderly parents.  Both sets of parents were determined to remain in their own home, but had not developed nor put into action a plan outlining how they intended to do that.  Time moved on and one day they found themselves engulfed in a world of chaos brought on by old age and illness.  The situation worsened when financial problems emerged as life savings were quickly depleted by medical bills.

Aging in Place is possible for some, but requires a bit of good fortune relating to one’s health, and extensive and realistic planning for support services.  Access to specialized services such as transportation, home health care, non-medical home care and home updates and maintenance is critical to remaining comfortable and safe.  Of course, even with the best laid plans, life situations can change in an instant. 

There may come a time when “accepting an alternative lifestyle” takes on new meaning for your parents.  For any number of reasons, their home may no longer be suitable for their changing needs, and it will become necessary to secure other living arrangements.  This could mean moving in with you or another family member, or residing at an assisted living facility.  Take time to consider and learn about the various options.  Hospital social workers can help locate available beds for a discharged patient in need of ongoing nursing care or rehabilitation services.  However, space is sometimes unavailable at the more desirable facilities, thus forcing them to place the patient in a facility with a less than stellar service rating.  Public and private ratings of nursing homes are available for review.  Familiarize yourself with alternative living options before they may become necessary.   At least you will know what to expect if you find yourself facing this situation.

Also, don’t be blindsided by financial problems as they relate to your parents’ living arrangements.     Encourage them to seek professional advice to protect their assets.  Financial planners, accountants and attorneys can be of tremendous assistance in helping them to manage their financial resources, including Medicare and Medicaid information.  There are also many services available, such as the Area Agency on Aging which can offer assistance as well. 

Oftentimes, in an effort to preserve their independence and privacy, the elderly resist assistance offered family members.  Keep trying.  Tread carefully and be respectful, but remain persistent.  In the meantime, gather as much information as you can.  Developing a plan of action may be hard work, but is much easier than crisis management.  One day, it may even save your job. 

Copyright 2012 Carol M.W. Bagazinski All rights reserved.