Octo Observations: “In Sickness and In Health”

A cautionary tale. This is a personal and poignant story to share, but it is true; it is revealing.  It is written for a reason. Hopefully, it will benefit those who are approaching older age as well as younger readers with older parents. I hope you are able to file away some useful information.

For centuries, traditional marriage vows have  included  the words, “In sickness and in health.” As young people blissfully in love, we tend to skim over that phrase. We believe we are Forever Young and Forever Healthy…..”sickness” won’t happen to us…..until it does.

A perfectly normal reaction. One that I entertained in September of 1957 when my husband John and I were married. Over a period of 63 years we have been richly blessed with good health……oh yes, periodic glitches and crises, but thankfully all treatable.

Now, however, life is very different. Age is taking its toll. I am my hubby’s chief caretaker and advocate. We do have outside help, which has become essential if I am to maintain my own health. Caretaking a beloved with physical and mental decline 24/7 is demanding, although the heart is willing to do whatever. Sadly, the 82 year-old body is not.  

Thus, may I emphasize the importance of  looking ahead and  researching the right help to suit your needs. There are many options available to elderly folks. Helping hands in the form of “at home” agencies that provide various skilled aids or sitters. There are also those who work for themselves, and some are quite reliable. However, try seeking the advice of friends who have used outside help. Even better is consulting the medical team in your long term health care facility, which is what I recently did.

In the “olden days,” as a family member aged, relatives automatically assumed the roll of caretakers. It was expected, because reliable home health care agencies simply did not exist. Now, however, times  and customs have changed, perhaps because so many families are separated by  geographic distance. 

Often young couples are both employed. Children to raise,  school schedules and day care to manage, etc etc. We Americans  are a very mobile society, because desirable jobs pop up all over the country. As I have written in previous WAT articles, our four married children live in four different cities, and each has his/her own families and careers to manage. Yet we are blessed as all hearts beat as one. Their long-distance support is the best of the best.

As a little girl I was exposed to the dedication of my father’s two oldest sisters, lovely, lovely women, whose life work was to care for their aging parents. And after their mother died, my grandfather moved in with both daughters, one of whom was married. According to Icelandic custom, my aunts were the sole caretakers for their father. They did it willingly and lovingly. My father supported them financially every month.  My sweet grandpa with his beneficent smile, trembling hand that patted my little head, his shock of snow-white hair thrived until his late nineties. Even after nearly 70 years of living in Wisconsin, he spoke just one language: his native tongue. It was not until after his death that Aunt Gert, the oldest of the family of nine children, gave herself permission to marry for the first time….at the age of 72! She and the local postman Ed who delivered daily mail fell in love and they lived happily for over a dozen years! 

Gradually perceptions of intergenerational living changed. Just as young folks wish to live independently so, too, do most seniors. Many older people prefer to stay in their own homes. Our mothers were classic examples. Their thinking was, “I survived the Depression, I can survive old age.” They both ran  into immutable snags….not easy.

John’s mother was at least persuaded in her eighties by Jim, his surgeon older brother, to move closer to him and his wife. The challenges that all three faced were innumerable, but my mother in-law did last until her late nineties in a nursing home, where Jim and Tommi kept a close eye.

However,  my mother, a widow of 30 years, was immutable. Not amenable to the idea of selling her home. Period. She had lived in Cleveland, Ohio her entire life, and she was 100% unwilling to change her mind or how she would lead her life. We tried to convince her, but she refused….adamantly. She was doing it her way, yet the fallout on my sister and me, both of us living a days’ drive away, was taxing, especially  during mother’s last two years. She died at age 94.

Naïve and inexperienced, we hired hospital recommended, smooth speaking, but unlicensed caregivers, with dire consequences. As a result, Judy and I  and our husbands made different choices. We each downsized at age 79, sold our homes and moved into highly accredited long-term health care facilities.

As a precursor to long term health care facilities, the over 55 communities offer certain advantages. The Villages in Florida is a huge over 55 attraction…..for a multiple of reasons….Many people, widowed or single, find companionship and even love with those in similar circumstances. Here in Richmond, one couple we know chose an over 55 community and love it…years ago they downsized, moved and happily participate in many activities offered to them. It is a less complicated way of life. Yet, it does not provide lifetime health services. But it is a step forward.

Caring for the elderly is a thriving industry. For years good long-term life care facilities were few and far between…..but in 2020 as our population lives longer than even a generation ago, endless choices are available to fit various budgets. In addition, supplemental at home health care is a viable option.

In Richmond, one major retirement center offers fellowship programs, wherein a person or couple of limited means can move into a nice one-bedroom apartment, and become eligible for excellent health care services. This is especially appealing for those unable to afford the hefty entrance fee often demanded, in addition to the monthly service costs that are significant. 

For those of you who have a loved one suffering from any declining condition even though living in a comprehensive facility, you need to know that private duty help is an additional expense. Rather than move yourself or your spouse to the health care or memory care section, you may have private duty home health assistance. Unless covered by long term health insurance, the costs can mount up rather fast. 

During this Covid-19 pandemic, no one really wants to put a loved one into any facility’s special needs areas. As careful as facilities are, the risk of contracting the virus is greater than remaining in one‘s own apartment or cottage. Everyone, employee and resident, is required daily temperature checks when entering the gates of my facility, Cedarfield. Visitors are limited to family members, and employees are supposed to work at one facility. For several months, not even family was allowed on campus. We were virtually locked down.

It has now been nearly two years since my John was diagnosed with dementia/Alzheimer’s. We moved to Cedarfield in the nick of time. We are grateful for so many things…mostly for the ability to live here and to have shared a wonderful marriage of 63 years. I remind myself not to feel greedy. This is a daily rejoinder…

However, needing extra help from outside sources presents a challenging chapter of life.

For several months we had the assistance of an able independent CNA. While it worked, it was great, but when our helper decided to make a change, it left me tossing and turning at night. It also left John more confused. Change of any sort is difficult for people suffering from dementia/Alzheimer’s. And abrupt change is a jolt. It should be avoided if at all possible.

Mega thanks to the immediate intervention of our dedicated nursing and social worker team, I was quickly connected to one of Richmond’s top home health agencies, fully licensed, rated, and insured. Now we are working with HOME INSTEAD agency. Employees are selected to fit a family’s special needs. If one person is not a “fit,” then the agency chooses another helper. Flexibility of hours is accommodated. Punctuality is assured by clocking in and out with agency. Any issue that arises for family is handled by agency manager or assistants. And after an hour-long interview with the competent manager, our needs were thoroughly assessed. May this be the optimum solution to a very emotional and difficult situation. 

In my heart there is nothing I won’t or cannot do for my husband. How hard it is to realize that the endless energy I have always prided myself to have, does have limits. Our nurses say they worry more about 24/7 spousal caretakers than they do patients. Too many stories of spouses falling sick  from trying to do everything. It simply does not work at age 82! As the old saying goes, “The spirit is willing but the body is not.” I thank our lucky stars we moved when we did, not waiting until “the wheels started coming off our bus.”

For those with elderly parents or relatives, may I suggest that your best gift to them is to encourage/help them seek available options to assist them through these difficult years. Your love is wonderful, essential and vital to their well-being, but you cannot live their lives for them. For sure, you cannot stop living your own lives to assume the duties of long-term care. To me, it is neither wise nor fair. We do not live in the olden days of aunts who cared for their father. We do not want loved ones to postpone marriage until 72! 

Ask any of our children, and they will confirm my mantra, “Let Go, Let God: God helps those who help themselves.” Strangely enough, this idea was firmly implanted by my own beloved mother. However, in her nineties, she did not follow her own advice. Instead, she sadly, but archly asserted her independence until it was impossible to extricate herself from an untenable end of life situation.

Daily I am reminded we can never stop trying to improve ourselves or our capacity to adjust. One would suppose that after living eight decades, one would be facile enough to understand all bumps in the road. But I know I am never smart or knowledgeable enough to manage successfully every twist and turn. I keep trying to do better. And  I must freely admit when help is needed.

Watching anyone you love suffer is indescribably painful, but living the decline with that person is a grieving process unique unto itself. It hurts. My humble advice is to drop the heroics, instead, reach out, get help, adjust and by all means, trust that in every city we are surrounded by professionals willing to guide our paths….and relieve our angst.

I wish you all long and happy marriages, and I wish that with each day you take a second or two to recall your wedding vows. Be happy and healthy as long as possible, but realize we are all vulnerable to inevitability of “in sickness and in health.”

The Dalia Lama words:
“Love and compassion are necessities, not luxuries. Without them humanity cannot survive.”

And Mother Teresa said:
“Do small things with great love.”

I leave you with these words from great minds as I share  fervent hopes that my humble observations will ease whatever rough patches you encounter. God Bless.

Joy Nevin is the author of Joy of Retirement – Live, Love, and Learn. Click to buy on Amazon.

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