Elder Care Redux

It's hard for me to find the focus to write anything today. My in-laws are in the throes of their geriatric meltdown, much like the one my parents went through about 5 years ago.

I remember the shock of seeing my parents being incompetent. It was so strange that these people I had loved, respected, gotten angry with, rebelled against, sought out for advice, and bragged about were becoming helpless, incoherent, feeble, and irrationally argumentative. They were defiant, wanting to remain independent, as they sat there mismanaging their medications so badly that they were frequent patients at the hospital as a result.

They argued that they were doing just fine, but my stepmom, a proud, independent woman, lost the laundry room. The laundry room was in a closet in their apartment. She forgot how to use the stove, so the two of them were living on cold foods and frozen bits of things. She couldn't remember how to get to the bank, or how to give me directions to get there. She no longer read much, which was a profound tragedy as she had always been an avid reader.

My father had been becoming more and more feeble over a longer range of time. He had slowly lost the ability to walk for distances measured in tens of yards and was spending most of his time in a recliner. He would periodically use a walker to get to the bathroom, where he took care of his urine collection bag, sort of, but he often fell during transitions and needed help up.

The two of them had been quietly coping with declining abilities over a period of years. They didn't notice how badly they were doing, and it wasn't until my dear friend found them in such a state and called me that I saw with my own eyes the sad condition of their lives.

She saw, with objective yet loving eyes, that they needed help, and out of love and respect, she called all three of us -- my sister in California, my stepbrother in Tennessee, and me in the midwest. She told us what she had found and impressed us with her sense of urgency. I knew her to be a honest and honorable woman, someone I could trust to give me the truth.

She was right. I wanted to deny from afar that my parents were so old and so needy. I wanted to believe that they could care for themselves; that this was just a bad spell; that there was some medication or therapy that could make them "normal" again. What I didn't want to acknowledge was that my version of "normal" was selfish and childish. People grow old, and old people need care.

My siblings and I arranged to take two week spells to fly in and look after my dad and stepmom. I was the first one there. I felt like I had been thrown into an old-fashioned gauntlet and told to run for my life, but I was running for THEIR lives instead. They were not eating well, their bills were going unpaid or overpaid, and my stepmother's levelheadedness had deserted her. She was scrambling medications, having anxiety attacks, and living on too few calories. Both of my parents looked skeletal. All of this had been going on hundreds of miles away from me, with no word from either one of them because they didn't know that things were not right with them. They didn't realize, and no one who saw them on a regular basis knew what to do.

My folks were both just back from hospital stays brought on by frailty and medication problems. Home health was called in to help, and I liaised with them. They were adamant that my parents be given choices, even though their assessment tools showed that neither parent was completely cognitively fit.

I started looking into skilled care facilites and assisted living. The cost was staggering, thousands of dollars per month, and my parents insisted that they must stay together. Then there was another anxiety attack, heart palpitations, another trip to the hospital via midnight ambulance, another day of my father subconsciously trying to injure himself so he could be in the hospital with his wife in the only way he could manage to think of.

I was lucky -- I had had years of parenting small children to prepare me for the endurance race that dealing with my parents had become. I had to wake up before they did to make sure no one snuck medications they were not supposed to have, to prepare wholesome meals, to start making that days' worth of health care phone calls, phone calls to living facilities, phone calls to my own family, phone calls to my siblings to keep them up to date. They were still in denial, as I had been, but I knew that when their times came, they'd understand I was not panicking, I was just working as quickly as I could.

Then I had to help my folks toilet, dress, eat, all while treating them as reasonable adults, not as children, who could be safely put in a playpen or crib or entertained with toys. No, I couldn't treat my parents that way. I had to devise agreeable adult activities or sham "can-you-help-me" questions to keep them busy while I followed their trails and kept dangerous things from their paths. I sweat copiously for 20 out of every 24 hours from the relentless pace of caring for them.

The only way to deal with it was to detach in love and friendliness; to consider myself a home health aide who, just by strange coincidence, happened to be related to these needy elderly people. I charted med times, meals, doctor visits, home health visits, hair appointments, grocery shopping, etc. I threw out all medications that were not current (which I had to do when they weren't looking), and did what I could to get the bank to understand what problems were going on. I called creditors for current balances and paid bills. I prepped paperwork for my sister to read when we did the handoff. Reams and reams of paperwork.

As I had predicted, my siblings were quickly disabused of their illusions and denial when faced with the reality of my parents' lives. Within two months, my folks were established in a facility near me, their Powers of Attorney, living wills, and finances in my charge, their lives simplified to what they could truly handle and still feel good about themselves. The transition was easier than I had thought it would be physically -- but, oh, so much harder for me emotionally.

I know that my husband is going through the same things now. His brother and sister are in long-distance denial. They want to argue for things that cannot be, that will not be, that are no more. They want things to be "normal" again. They don't want to acknowledge that in order for their parents to live decently there will be no inheritances, there will be no more going home. It's going to be a fast trip to reality for both of them.

I am glad that I've already been through this, so that I can help my husband. It's a shock to the system to see one's childhood bedrock people become shifting sands of agedness and infirmity. I hope I can help him decompress, compartmentalize, stay focused, and stay real. And I hope his siblings will drop their selfish emotional needs and focus on their parents with the urgency and detached compassion necessary.

This is the part of middle-age no one ever told me about. It sure is tough.