Sunday, November 27, 2011

Greedy Children

I received the summons early on a Friday morning.  Although I had been involved as a bystander in other sibling disputes, this was the first time I was asked to testify in a custody case for a resident. The young ladies who were named as plaintiffs in the suit were sisters; daughters of a sweet, quiet, resident named Hazel.

Hazel lived at home with a caretaker, until coming to live in our community six months ago.  Her mobility and her memory had declined since her husband had died two years earlier.  For her safety, her daughters had hired a caretaker to attend to her shopping, bathing, medication, and nutritional needs five days a week from early morning until after dinner.

Not long after her husband’s death, Hazel had been awarded a large sum of money in a legal settlement.   The girls judiciously retained an attorney to disperse the money intended to subsidize Hazel’s care.  Of course, they were also the beneficiaries, each girl scrutinized how and why every penny was spent.

The sisters had been enemies for years, but they become possessive of Hazel once she became a widow with an inheritance. The argued ferociously and viciously with little or no consideration for the effect it had on their Mother.   They hired lawyers to petition for custody, each vying to act as her legal guardian.  The daughters spent thousands of dollars on legal fees and thousands of hours attending court hearings.  Eventually, an emergency temporary financial guardian had to be appointed from the Department of Elder affairs to protect Hazel during the painful on-going process.

While waiting for the courts to decide Hazel’s future, the younger daughter, who lived in New York decided independently of her sibling that her mother belonged in assisted living.  She implied that the current care- taker was stealing the money that was proportioned for Hazel’s incidentals, and she alleged the current arrangement was becoming too expensive.  She flew to Florida on the week ends to shop for places in local assisted living communities, and after several visits and numerous phone calls with our sales professionals, she agreed to move her to our community.    To save money, she insisted her mother could care for her daily needs, so she refused all services except for assistance with her Mother’s medication.

Rather than move her life-long possessions, Hazel’s daughter from New York purchased all new furniture and accessories to decorate the new apartment.  Although seeming to be kind to her mother in public, she verbally bullied her  behind closed doors.  She ruthlessly screamed at Hazel, not realizing her rants could be heard in the hallways.  She obsessively tried to control every aspect of her mother’s care; she badgered my staff daily with long distance phone calls from New York.

The older sister lived locally.   She begrudgingly agreed that her mother could try assisted living. Although she did not contribute her time or any furnishings to the move, she criticized everything her sister did from the color of the drapes to the size of the queen bed.  She visited infrequently, and made it clear she felt her Mom had been manipulated by her younger sister.

Hazel made small talk in the presence of her daughters.  She was in the middle of a family war zone, and she struggled to be impartial as her daughters continued to verbally assault one another.  She never seemed to take sides.  Occasionally she would visit my office and share her disparity.  Her daughters were making her life stressful and she was saddened by the conflict.

When the day came for me to appear at the hearing, I was both angry and nervous.  I refused to side with either of the young women; my only concern was for Hazel.  She had happily adjusted to the community.  She participated in many of the activities, and she had made several friends.  The staff appreciated her sweet nature; she soon became one of their favorites. I felt that her continued stay with us depended on which sister won.

The judge (who cleverly deciphered that the money was at the root of the turmoil) postponed his decision until the lawyers provided more financial information.   Not long after the hearing, Hazel’s older daughter convinced her mother that she would be happier at home.  Hazel left our community sharing tearful “goodbyes” with her new friends and moved back home.   The original caretaker was rehired.    As usual, Hazel did as she was told.

The last time I saw Hazel I was visiting a sister community not far from the home of her older daughter.  I recognized her eating lunch in the dining room.  Ironically, her daughter from New York was sitting with her.  She explained that Hazel had only been at the new community a couple of days; her older sister’s idea that she return home had been a huge mistake.  I smiled, but said not a word.  In less than 10 months Hazel had been bounced back and forth three times trying to please her avaricious daughters.   I silently wished she would outlive her money, and neither would be compensated for their selfish behavior.

Sunday, November 20, 2011

Grandpa is Nuts About Driving and Driving You Nuts

Last week an endearing gentleman came in to my independent living community looking for an apartment.  He was 88.  We talked for several minutes; I found him to be vibrant and spry, but also frail. He walked slowly with a cane because his balance was unsteady. Initially, he said he was looking for a new apartment in a place where he could make friends.  He appeared to be lonely.  After we talked for several minutes he confessed, “It is almost time for me to give up the car keys.  It would be helpful to live somewhere that provides transportation.”  I looked surprised, and misjudging the reason behind my surprise, he continued to explain, “ one eye is covered with a cataract, and the other is blurred with half a cataract.  It is becoming very difficult for me to see.” 
I kept my face expressionless, struggling not to react while he continued to describe his infirmities, although I was alarmed that he was still behind the wheel.  I agreed with him that he would benefit a great deal if he lived where transportation was provided, and thought to myself, “ and add to the safety of other drivers.”

The hardest of all judgment calls during the process of aging is to give up the car keys.  It is devastating to loose the autonomy to come and go at whim.  As one gets older, doctor appointments are vital, the liberty of shopping at Wal-Mart is not merely an activity, but an outing, and going out to dinner is a special occasion.  Once that independence is lost, there are few alternatives. Public transportation is limited, and children and friends try to be accommodating, but they have busy lives, and we cringe at the idea of becoming a burden. 

Several years ago, I received a phone call from the Seven Eleven gas station across the street from my community.  The owner was frantic.  One of our residents had backed into a car as he was pulling away from the pump, then edged forward and rammed into the side of another car.  He panicked, shifted into reverse, and hit the original car a second time. “Please come get your resident,” the distraught proprietor pleaded over the phone. My maintenance director rushed to  rescue my eighty year old before he could slam into another vehicle, and a family came later in the day to claim the bruised sedan. 

In one city, the windows in my office faced the parking lot.  Every day I watched residents with walkers teeter toward their cars, pull themselves up, sturdy themselves with their hands against the top of the passenger door, and panting and rasping, manipulate their frail bodies behind the wheel. In their minds, they felt cognizant, alert and physically able to drive, but our minds can paint a brighter picture than our bodies can accommodate.  I knew if push came to shove, there would be disastrous consequences if they had react quickly to prevent an accident. 

 One afternoon I glanced outside to see a resident back into a “no parking” sign.  He did not realize he had hit it, and continued to back up until the sign arched backward.   He pulled forward, vigorously turning the wheel to clear the curb, reversed, hit the sign a second time, and the battered metal leaned sadly just inches from the ground. I ran to warn him, but he'd already given it a third try, and by the time I got there, his tail lights were trailing down the street, too late for me to save the sign from another blow. 

Not long afterward a family member rushed into my office to report, " A white haired older woman just rammed into the car in the space behind her. Then she pulled forward and drove away as if nothing had happened." Keeping the benefit of the doubt in mind, it is possible that the driver didn’t realize there had been a fender bender, but more than likely, she did. She panicked; because if someone discovered her mishap, there was a strong possibility her kids would confiscate her car keys.  The young woman who saw the accident couldn’t (or wouldn’t) identify the driver, but in the meantime, I had to locate the owner of the damaged car, and with my cheeks blushing from embarrassment, report the hit and run.

A person must eventually admit that driving is a privilege.    As kids, we can't wait until we are sixteen to receive our driver’s license, but there are no guidelines for relinquishing it when age works against us. "The Muffin Lady” (profiled 11/13/11) had been injured in an accident in which she was at fault.  After that she was afraid to drive and would say, “One should quit driving when one becomes timid and hesitates before pulling into traffic.” Not long after her recovery from some minor injuries, she opted to move into our community.

I have been the tattletale more than once and called a son or daughter to suggest a discussion with a loved one about driving may be imminent. I cannot 
imagine how difficult it must be for a person to be told they are no longer able to drive safely. I am independent as long as I can come and go as I please, and I'll admit that I take for granted the freedom that it allows me.   One of the lessons I have learned from my residents is to plan for the future, and sometime within the next few years I will be obliged to realistically access my own driving skills.   Luckily, it hasn't caught up with me yet, but one dreadful day, I will have to admit, "I'm too old to drive" and as hard as it may be, willingly present the keys to my son.  

Sunday, November 13, 2011

The Muffin Lady

I had been at my new community only a couple of days.  I arrived early that morning knowing I needed extra time to organize my office.  I was bent over alphabetizing the folders in the lower drawer of my desk, when I heard a noise that sounded like someone clearing their throat.  I looked up to see a resident standing at my open door. She was not smiling. 

I rose to meet her, intending to introduce myself.  I had taken only one step when I caught a glimpse of her right arm cocked and locked like a major league pitcher ready to throw.  A mille-second later, I felt an object whiz by my head. I ducked.  I heard a dull thud on the window. Then, I turned to watch a food like substance slide down the glass and plop on the floor.

 “Would you eat that?” the woman shrieked still standing in the doorway.
“Eat what?” I asked, afraid to move for fear she would hurl another projectile my way.
“The muffin. Would you eat that?”  
“I didn’t know it was a muffin,” I answered timidly.
“Exactly my point,” she answered arrogantly. “That’s the worse excuse for a muffin I have ever had on my plate.”
I bent to pick up the smashed, but somewhat in tact muffin.  I turned it in my hand, “Looks like a muffin to me,” I thought to myself, knowing that was not the answer she wanted to hear.

I smiled politely, trying to defuse the moment.  “My name is Karen.  What’s yours?”
“I know your name is Karen.  Everyone in this place knows your name is Karen. We all got the memo. “I’m Mildred.”
Still holding the muffin, I turned to walk back to my desk.  “Come sit down Mildred,” I offered.  “Let’s talk for a minute.”

My conversation with Mildred lasted for almost an hour. She was in her early 80’s, dressed in expensive brown wool slacks, a red silk-like Nehru collared blouse, and a long, chain stitched, ecru jacket sweater.  She didn’t have on make-up, but her earrings, traditional slim hoops, looked expensive.  Her face had sharp features, her eyes were small and narrow, and the wrinkles around her mouth curved downward suggesting that she didn’t smile often.

She talked in bursts - short angry sentences.  She had only been at the community for a month.  Her husband had died on Christmas Day less than a year ago; she had lost her son in a jeep accident less than 5 years ago.  Her daughter, a lawyer, lived near by.

Mildred made it clear that she came to live here of her own accord, but she was also convinced it was the worst decision she had ever made.  She found the food  intolerable. The meat was tough and the vegetables were overcooked.  Coming from California, she preferred al dente. She was not used to eating on a schedule.  Dinner at 5 was annoying.   Furthermore, she was frustrated that the bus driver refused to take her on her personal errands when it was convenient for her.
 As she talked, her voice grew louder with each complaint.  She threatened to write the owner, and she threatened to call the movers to take her elsewhere.   Then, after a pause, and without preface, she became very emotional. “I have nowhere else to go.”   I saw the tears slowly filling her eyes. I was not surprised when she began to cry, but I was not prepared for the, long, heavy, painful sobs. 

Mildred was not angry with me, she wasn’t angry about the muffin, but she was angry about the turn her life had taken.  She left a four-bedroom house with a pool and tennis courts, and she now felt cramped and imprisoned.  She had made no friends, because she wasn’t friendly.  Her relationship with her daughter was tenuous, but Mildred made few gestures to mend it. 

When she was younger, Mildred was the president of her own accounting firm.  She was always the boss and she was always in control. People did what she told them to do.   When she retired, she frequently traveled with her husband.  Mildred had been an active, engaged and energetic person.   At eighty plus, that had changed.  Now she had nothing purposeful to do, she was lonely, and she wasn’t in control of anything – not even the time she ate dinner
Mildred’s self image was worsening, as was her cognitive ability. She could feel her memory slipping, and she hated that.  She was not ready to be old; she felt helpless.  There are no alternatives to growing old, and she, like many of our seniors found it difficult to cope when age compromises both the body and the mind and the future appears bleak.

 Mildred and I became close friends, although she continually tested our friendship with her feisty disposition and forceful manner.   In time, Mildred came to love living in our community, but it was a tough transition for her. I made her chairman of the food committee, and she took ownership of the chair like a drill sergeant.

 I was devastated when two years later she had a stroke.  She recovered and returned to live with us, but the assertive, aggressive CEO personality never returned with her. I sorely missed that lively, spirited, strong willed person I now fondly remember as “the muffin lady.”


Wednesday, November 9, 2011

Walk the Talk and Talk the Walker

Raleigh (my miniature schnauzer that I profiled in my first Post) and I were taking our afternoon walk when I recognized a familiar sound in the driveway near a house we had just passed.  It was the grating of metal on concrete accompanied with a clatter of rocking wheels. Turning to look back, I was not surprised to see an older man using an aluminum mobility walker.   He was pushing it clumsily and incorrectly.  The sound was the legs scraping across the pavement. 

The man looked frightened and moved timidly. The lightweight walker barely supported him. He shuffled his feet as if he didn’t trust it to prevent him from falling.  He wasn’t using it correctly –picking the walker up and placing it a short distance ahead of him, then walking into it; he instead shoved it forward as he walked with it.  I recognized the walker as the generic brand I had seen a hundred times before. l guessed that it was donated, purchased on line, or acquired secondhand, and I suspected that he had not received professional training on how to use it.

Walkers are a way of life in a senior community, and without them, residents would be more apt to fall and injure themselves. According to the Center for Disease Control, one out of three age 65 or older falls each year, and among the oldest segment of that group, falls are the leading cause of injury death.  Therefore, those with weak legs and uncertain balance depend on sturdy, properly adjusted walkers to retain their independence and mobility; few people realize that a walker has to be sized and adjusted, just like a pair of corrective shoes, if it is to be effective.

I recall a resident, Frank, who attached himself to me as his literary mentor.  He fancied that he was a poet, and every day he banged on my office door with a new creation for me to critique.  He was a small, thin man, somewhat frail, and he had recently fallen on two occasions.  His fear of a broken limb or displaced hip had prompted him to became attached to a walker that he had inherited from a former roommate, and he used it faithfully even for short distances. 

Frank was unaware that his walker wasn’t properly adjusted.  The railings on the walker were set so low that he was looking at his feet when he walked, and because he couldn’t see where he was going, he often scraped furniture or ran into people.  He had a bad habit of pushing the walker forward and rambling with it. No one had ever trained him to place it ahead of himself and then walk into it to catch up. To make matters worse, he had attached two lime green tennis balls to the feet.  Temporarily, the balls made the walker’s feet slide easier, but after prolonged use, the bottom of the balls will wear away leaving the metal exposed to the floor. The metal becomes slippery and once weight is applied, the legs will slide like skates on ice.

I pointed out Frank’s problem to Lisa, our physical therapist. She called his doctor asking for an order for Frank to receive training. She discovered that Frank was eligible for a new walker from Medicare, and she arranged to have a shiny new one delivered to him within days.  She adjusted the height so that he would stand more erect, and encouraged him to: “Pick up the frame, place it ahead of yourself, walk into the frame and repeat”.  Finally, she attached the specially designed slides on the legs to facilitate propelling a walker smoothly, and she discouraged him from exchanging them for the lime green tennis balls.

After his training, Frank still came to my office every day.  In fact, he felt so good about himself he often came twice a day. He was more mobile and more self confident, and he appeared stronger and happier

Walkers come in all shapes and sizes and their styles range from what I refer to as the Chevy model to the Mercedes upgrade. Most residents choose to use walkers, especially if their neighbors do. They quickly lose any self –consciousness; they are no longer embarrassed  – even at the age of eighty plus, people like to emulate their peers.


Saturday, November 5, 2011

Taking the Time to Find the Right Time

Late one Friday afternoon, I had to say my final goodbyes to Debbie and Gary when they moved the last of Harold’s belongings from the apartment. Gary was Harold’s father, and Debbie Harold’s daughter-in-law. Harold had lived at our community for 6 months and had passed away earlier in the week while under the care of Hospice. It was not unusual for me to become close to a resident’s family, and I was saddened to realize that, despite our connection, our paths would probably never cross again. 

Prior to his death, Harold, spent weeks in a rehab center receiving intense physical therapy, struggling to regain his strength, hoping to return to his own home. His therapist determined he had reached his maximum physical capacity; his doctor told him that his health would not improve. They concluded that it would be dangerous for him to live alone. Therefore, his dream of returning home was no longer a viable option.

Son Gary lived in New York; his father Harold lived in South Florida. Harold’s moving to New York to live with Gary and his wife was not an option. New York weather would not be Harold’s friend. To complicate things further, Harold lived with a “significant other” that he was not willing to leave behind. Gary had to make other arrangements quickly, because the 90 days of facility care covered by Medicare were coming to an end. Harold’s discharge day from Rehab was pending.

Gary found our community on one of the senior housing search engines on the Internet, and came to us distraught. He was frustrated, anxious, and desperate for a solution although he felt “putting” his dad in a facility was an intolerable remedy. He, like his dad, equated an Assisted Living Facility with a nursing home, envisioning lonely hospital beds, sterile rooms, and bedridden patients. 

As I gave them a tour, I could feel Gary slowly relaxing. I showed him the carpeted dining room with linen tablecloths, the huge circular living room with a large 3D TV, the cozy conversational settings, and the pristine care station where nurses and aids were busy interacting with our residents.  In one of the alcoves, we saw a group of residents contentedly playing dominoes, and fortuitously, in another, we saw one of our Jewish Volunteers leading a chorus of traditional Hebrew songs with some of our large population of Jewish residents. When I explained to Gary that sharing Yiddish folksongs was a regular Friday event, he smiled for the first time. “Dad would enjoy that,” he said softly. “He’s Jewish.”

Time was running out quickly for Harold. Gary and Debbie worked quickly to obtain the necessary paperwork and prepare for the move-in.  Once the furniture was delivered, Gary and Debbie were fastidious in decorating Harold’s new apartment with familiar pictures, a large king sized bed, and a stately antique dresser.  Debbie hung curtains over the generic blinds, and Gary installed a big screen TV.

I wish I could say, “it was love at first sight,” when Harold saw his new home, but that wasn’t the case.  Initially, Harold hated everything; he disliked the community, his room was too small, the food was tasteless, and for several days he resented his girlfriend.  Determined to make him happy, my team of caring professionals befriended him, the care staff overlooked his angry outbursts, and his friend, Roberta, remained loyal as we slowly worked to crumble Harold’s hard wall of anger.

Although he remained essentially a loner, he gradually began to smile.  He occasionally appeared in the common living room, and often joined the Jewish sing-along.  His “significant other” Roberta visited frequently, sometimes spending the night, and she became as much a member of our family as he was. I knew we had succeeded with Harold about two months into his stay. I was circling the dining room sharing my daily breakfast conversations with our residents.  When I reached his table to speak to him, he secretly confided in me, that he was content and glad to be with us. I thanked him, pleased, but suspected, if anyone else questioned him that he would deny it.

Four months later, I was standing nearby as Debbie was putting the last of Harold’s things into the van following his death. Debbie and I reminisced about her experiences with her father-in-law.  She enumerated for me the difficulties of caring for an aging parent, and the decisions, not always pleasant, that an adult child is forced to make. She thanked me, “We didn’t know what to do. Your guidance was invaluable.” 

Then as she turned to leave, giving me one long last hug, she smiled. “I have only one regret.” I looked at her questioningly. “I regret that he didn’t come here sooner.” I watched her car, lost in thought, as she slowly drove away.

Tuesday, November 1, 2011

Truly Sad and Sadly True...

As an only child, I was the focus of my parent’s existence. I lived my life to enhance theirs; I was on the honor role in high school, made Dean’s List in college, married, and gave them a brilliant grandson.  Once they got older, I moved to Florida to continue my role as the perfect daughter, but everything changed when I was forced to reverse our roles, and suddenly I became the parent.

As my Dad became mentally and physically weaker, my mother made herself his primary caretaker with a martyr’s diligence.  My proposals to hire outside assistance to lighten her load fell on deaf ears, and despite her complaints of fatigue and a lack of freedom, she persevered in her mission to manage his care. Then, after he died, left without a sense of purpose, she suddenly became needy, depressed, belligerent, and extremely defensive.

Although I desperately tried to help her, she rejected every idea or suggestion. During this time, I had my own set of problems; I was going through a divorce, owned a flower business, and held down a second job to make ends meet. She lived three hours away on Florida’s opposite coast. I found myself rushing across Alligator Alley at least twice a month to respond to her pleas for assistance.

Finally, I packed her possessions and moved her, despite her protests, to the West Coast to live with my son and me. Although she pouted and cried, I continued to harbor an unrealistic expectation that moving her would change her attitude, and that her new surroundings would encourage her to appreciate my company as well as that of her only grandchild.

Oh, how wrong I was! During our final two years together she resented the arrangement I had forced on her and never hesitated to remind me. She withdrew from my son, from both her friends and mine, and she declined rapidly, as much from her attitude as from her physical decline. Nothing I tried seemed to satisfy her. She even hated our dog. In turn, I became resentful, and often failed to hide my feelings. I verbally lashed out at her and she lashed out at me.  There ensued an unhappy dance between the two of us that made both our lives miserable and unhappy. It finally ended when we shared a pitiful "I love you" hours before she died.

 Years later a series of unpredictable events has led me to a career in senior housing, and now, as a manager of an assisted living community, I have discovered that conflict between adult children and their parents is not uncommon. Ironically, I spend my days consoling others, who are just as confused as I was, and gently guide them in making decisions and finding viable solutions.

I am now aware that the Mother, who so resented me and was critical and verbally abusive, suffered her own sense of bewilderment. She experienced the loss of her independence, a diminishing physical presence, and a failing memory. She needed me to understand; I didn’t, and regretfully, I was unable to empathize.

Those needing assistance will increase as our population ages, as will the number of children sandwiched between simultaneously taking care of their kids and their parents.  I am grateful that I have been given the opportunity to help to turn a sad, hurtful episode between my mother and myself into a useful and positive legacy of service to others in a similar situation.