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Tuesday, February 26, 2008

Middle-Agers, When You Need Elder Care Will The Market Offer The Shopping Choices That You Want?

After years of talk lagging behind the actual needs, even the most reclusive members of my own Baby Boomer generation are becoming aware that funding and services for the elderly have not kept up with the times. It is becoming increasing evident in a personal way to friends and acquaintances in my middle-aged circle who have been drawn into this area by the evolving needs of family members, friends and colleagues in our parent's age group that there are large gaps in the kind of resources offered and actual care available.

Much of this has occurred on our watch when the bulk of our time, energy and talents which ought to have been put to good use was frittered away while we were out dreaming about the purchases of bigger homes with faux French manor accents and gas guzzling SUV's in order to embrace all of what our generation has been conditioned to believe life had to offer.

And while many of those dreams did not pan out and not all of us uniformly embraced such dreams in the first place, the kind of thinking and long-range planning that would necessitate some dramatic changes in the area of elder care that we would like for our elders and certainly even demand for ourselves has not for the most part taken place.

As the years pass and our impending golden years come closer and closer this lack of attention and the intervening years of build-up neglect may very well bite us in the posterior in a very painful way!

Back in the late seventies I was introduced to some of the interesting developments in the area of elder resources as an intern for a editor who published a newspaper for senior citizens in Seattle. My editor was well aware of the gap in services then as a middle-aged only child of a senior mom well into her late eighties and nineties.

Just out of college myself, it was an eye opener to even be introduced to the world of elder care as like so many of those growing up in the 50's and 60's, older people were no longer always living at home with the family. Old folks homes were a part of the community in the areas where we grew up that youth in our age group seldom saw unless a family member or friend had been placed there.

Furthermore unlike the traditional Japanese immigrant family where my parents were raised, youth not the elderly, was the byword of society and the emphasis was on thinking and staying young which made it all the more easier to push gently aside or even forget all-together issues which affect all of us towards the close of our lives. Unfortunately, this behavior and mind-set does not make the challenges which go hand-in-hand with this era go away.

Is it realistic, for example, to expect a family which may not even entertained the idea of housing options for an older member of the family to find the ideal placement for their just discharged relative in assisted care in 24 hours or less?

This is exactly what happened to my brother and myself two years ago when our mother who had been going hale and strong for over 70 years, came to the point in her life's journey where she ran headlong into a full-blown health crisis.

While the home we were able to place her for the short period advised for by her physician, she was not pleased with the result. We had just received the news the recent signs of memory loss he had been investigating on her behalf could possibly be early onset Alzheimers.

The facility most nearby my brother was able to located for her in this narrow time frame specialized in caring for patients with memory losses more severe than Mom's. It appeared their afternoon activity time consisted largely of watching soap operas.

In her younger years, Mom never enjoyed this kind of programming and more often than not declared it a complete waste of time. She had not changed her opinion. When my family was able to visit her during this time period she greeted us on several occasions with a fully packed suitcase and firm request to be "let out of there right now" and go back home.

During one point she was in and out of the hospital three times in a month. Her medications were stopped then restarted. Somewhere along the line the balance was lost and her heart actually needed to be restarted. Subsequently, she made a decision with her doctor that in the future, she did not wish to be resuscitated for which my sibling had been informed.

Unfortunately, I was inadvertently left out of the loop and discovered only after the episode where mom's heart was re-started that had it happened a second time, I would have most likely learned of her choice after she died. And while mom is absolutely within her rights to make these decisions, it is a good example of the kind of emotional turmoil that can occur because one is not prepared.

How about finding yourself in a nursing care center while recuperating from a major stroke in your thirties or forties at the same time close family members just happen to be dealing with some personal and health issues of their own?

Just imagine no one is available for a short period to support you in the way family could and you have no Plan B. Unfortunately, the well-meaning but overworked staff at the center are not able to act upon your concerns with the rapidity that you desire and frustration soon becomes your best friend.

It's not a perfect world by any means, but so many of the difficulties encountered by patients, residents and families along the way did not have to happen if time, money, resources and personnel had been employed with the same enthusiasm that was dedicated to developing personal communication devices and increasingly portable packable entertainment centers.

We cannot undo the past. Indeed, the start-up time alone to effectively address many of the overflowing basket of needs has past for many of us. However, I would argue it is even of more pressing import that we and fellow members of society (who may well end up paying for our inattention) including our children and grandchildren spend at least 2 or three hours of our time each month boning up on what resources such as the Long Term Care Ombudman Program (LTCOP) discussed in my earlier blog entitled "Thinking About Accessibility & Resources For Our Elderly/Disabled Neighbors" are on hand while taking a good look at what the community might be able to do in the near future.

Readers - If you have any thoughts or experiences along these lines and would like to share them with me, I encourage you to do so by leaving your comments! We are only as strong individually as we are collectively.


Lorraine Hart said...

Edie Morgan's "Mustard Seed Project" on the Key Peninsula is growing very organically. It's a program working very hard for the Elders of our community to be able to stay here. Edie organized all kinds of people and research to start, first giving information of what was available. She's trying to help people 'age in place' and remain independent as long as possible. The News Tribune should really consider covering this story of a fledgling organization with large hopes and ideas. Before this, the only options for Key Pen. residents who didn't have family to care for them was to move to care facilities in Gig Harbor or Tacoma.

M. Sugimura said...

Lorraine -

What a great project and wonderful example of how small community organizations in our neighborhoods can offer critical services which address the needs of the people in smaller markets where big brand-name marketers will not venture!

Conversely, local organizations are often the only option for residents in areas where the same big, brand-name marketers (say, medical providers) have pulled-out.

I'm 100% in agreement with you that the "Mustard Seed Project" would be an excellent story in The News Tribune if they have not already done so.

Given the general avoidance of the topic in the mainstream population however, even if they had covered the story say, a few years ago (assuming the organization was around) this would be a good reason alone to repeat such information from a different angle once more.

THANK YOU so much for sharing this!


"The more we are aware of our options, the more control we will be able to exercise and enjoy in those areas where we will still enjoy the luxury of a choice. "

M. Sugimura said...

There is a sobering real-life look at online today: "Ailing Hearts Hard on Spouses," Thursday, March 6, 2008, posted by Heather Ross on the lifestyle-altering changes shared by partners of individuals in their 40's who have suffered a massive heart attack.

It is well-known that the stress of simply giving alone can lead to a debilitating health decline on the victim's spouse.

During my brief term as a volunteer for the LTCOP, it appeared due to their relative lack of numbers in those facilities visited, that the needs and preferences of residents under the age of fifty-five appeared to be sorely lacking in the minds of the facility administrators.

As the development of services often follows the build-up of a problem in our society, individuals and families so affected during the build-up to whatever critical mass is required to spur large enough market incentives to enter the area and widespread aids to be made available are too often left empty-handed and in the cold.