Caught in Between
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At some level, adult children know that their parents will die, but don’t want to think about what their parents’ life or theirs might look like leading up to the end. “It’s as if we live at the base of a mountain and know there are boulders at the top,” says Steve Tam, “but we’re too busy down below to think about the likelihood that those boulders will roll.” That inevitable fall from independence to dependence can either be incremental, as it is in the case of dementia, or fast, as it is with a stroke. Either way, there’s no blueprint or training manual.
“My dad was a carpenter for the federal government, so I thought he could fix anything,” reminisces Komeiji. Perhaps that’s why she and her siblings were slow to acknowledge what was happening, at least early on. It wasn’t until Komeiji found a pot on the stove that had turned black because the burner hadn’t been turned off that she knew her father was no longer safe by himself.
Suzuki started piecing together an unsettling picture when he noticed that the clocks in his mother’s home were set at different times and things were put away in strange places. More disturbing were the outdated canned goods he found in his mom’s pantry and the insects he found in her oatmeal. Worse still was learning she had depleted her bank account writing small checks to charities and lotteries.
The incremental decline in mental and physical capacity parallels the step-by-step relinquishing of one’s life to the care of another. It’s a series of losses that both the elderly and their adult children have trouble facing, according to Martha Wacker, RN, of Case Management Services. An elderly person might minimize a fall he or she took or try to fudge a lapse in memory, and an adult child wants to see them as the capable person they once knew.
Nearly half of people ages 65 and older will be incapacitated in their lifetime, and those that enter into a nursing home spend an average of 2.4 years there, according to the Kaiser Family Foundation.
The journey from living independently, to living at home with help, to living in a nursing or care home can happen in a matter of weeks. People are sent home from the hospital quicker and sicker to family members who are untrained and offered virtually no help from the government for long-term care at home. That’s where professional care managers come in, like Robert Nogami RN, MS, of Lokahi Case Management, who hears from families who need immediate help navigating the bureaucracy and finding a placement that feels like a good fit.
Many of the baby boomers now involved in caring for their elderly relatives can pinpoint the episode that led to an unraveling.
For Steve Tam, things “started to crumble” when his 82-year-old dad was diagnosed with Alzheimer’s and his father-in-law had a stroke. “I realized I needed to stabilize the family situation,” says 55-year-old Tam, who left his full-time job as VP of sales and broker-in-charge at Prudential Locations to do just that.
Things began to come apart for Beth Yos shortly after her mother died of ovarian cancer, when her dad fell and broke his arm at the Okinawan Festival. During the time he was recuperating at home, he fell again—this time, down uncarpeted stairs—and fractured his skull. Yos was eight months pregnant at the time and ended up giving birth to her third child at The Queen’s Medical Center, while her dad was downstairs in the intensive care unit with pneumonia.
It’s Not Cheap To Grow Old
At a cost of $123,000 a year (or $337 a day), Hawaii’s nursing homes are the fifth most expensive in the country, according to AARP state director Barbara Kim Stanton. “And worse,” she says, “not only are we expensive, we also have the country’s highest occupancy rate (95 percent).”
There may be a waiting list for nursing homes in our state, but most of those who need long-term care want to stay in their homes for as long as they can. In spite of the myth that contemporary Americans abandon their elderly, most seniors live in their own or family members’ homes.
Many costs are out of pocket for members of the Sandwich Generation, who don’t keep track of expenses as they meet the demands of the day: a shower chair, diapers, co-pays for medication, special diets, etc. A common refrain: “You don’t stop and calculate; you just buy what you have to buy.”