 |
 |
I was looking thru some material I had taken off AOL and found an article that was printed in the San Jose Mercury. Without their permission, I will put it on the list server. ELDER CARE: THEY'RE AGING, AND YOU'RE WORRYING 8/26/94 When children grow up, and parents grow old Published: Aug. 22, 1994 By KATHLEEN DONNELLY Mercury News Staff Writer The worrying started last Christmas, when Lynn Anderson s mother picked her up at the airport. The car, Anderson noticed immediately, pulled violently to the right. It hadn t been driven in so long that the tires had decomposed in the Florida humidity. Anderson, whose 70-year-old mother usually comes to San Jose for their visits, was stunned. My mom, being a Navy nurse, is absolutely meticulous. You could bounce quart ers on the beds, she says. But I went home, and the priorities had completely changed. Worry edges into her voice. She s got books piled all around her. My brother s room has not been changed since he moved out in the 70s. She was a stickler about meals . . . and now she s using frozen hamburgers. There was dust on a lampshade. A curtain hung cockeyed. Plants withered in a once-thriving garden. Anderson, 36, pauses, as if still startled by her December discovery. I went home, she says, and I said to my brother, We ve got to start visitin g Mom. This is not safe. Stories like Anderson s have become routine for those who work with the elderl y. At some point, they say, nearly every family struggles to decide what kind of care its oldest members need, and where to find it. My consultation appointment book just skyrockets in January, says Mimi Goodrich, manager of social work services for the Senior Coordinating Council of the Palo Alto Area. After they all come home from Christmas. It s a matter of numbers. By 2020, projections put the number of Americans over 65 at one in five, up from one in nine today. In San Jose, the city s office on aging estimates the number of people over 60 will more than double in the next 20 years, and the number over 85, the old old, is growing even faster. Agencies, both public and private, have sprung up to serve them. But the array of choices is at once comforting and bewildering, especially for family members trying to judge the situation from far away. I don t know what I m going to do, says Anderson. I just don t know. We re going to have to move closer to Florida. She sighs. What am I going to find next time I go out there? Staff members at Senior Information & Referral Services in San Jose answer 13,000 to 15,000 telephone calls each year. About a third of them, says executive director Harryette Shuell, are from sons and daughters worried about their parents. About 25 percent of those callers, she says, are trying to deal with the situation long-distance. The most common question? Where do we start? Shuell answers. Sorting through the services, and the terminology, is daunting. Do you need telephone monitoring, adult day care, part-time or full-time home care? Meals on Wheels, residential care or a case manager? A friendly visitor, a peer counselor or a geriatric assessment? Throw in the question of who pays for which service some may be funded by government programs such as Medicare, some base their charges on sliding scales, some are private pay, meaning the client pays for it all and the process becomes overwhelming. A good place to start looking for help is at groups like Shuell s the local information and referral service. Looking for answers Eldercare Locator (800-677-1116), a national, toll-free telephone service administered by the National Association of Area Agencies on Aging, provides telephone numbers of information and referral services. We ask you some snoopy questions about the things you think may be the problem, says Shuell, whose group provides information and referral for Santa Clara County. Where does your grandmother live? Do you know about services she has already? What s her financial status? What can she afford? What can t she afford? Staff members comb through 17 thick binders filled with information on senior services in Santa Clara County and pass out phone numbers. The non-profit agency also annually publishes The Senior Handbook, filled with telephone numbers of local services. Family members take it from there. While the information and referral services can be very helpful, some who plan care for the elderly warn they vary in quality, depending on the amount of training given the person answerin g the phone. It helps to think about the kind of services you need before calling, and to know a few key elder care phrases, such as case management. Case, or care, managers assess the needs of older people and put together a plan for their long-term care. Federally funded case managers make home visits and assessments of people who are over 60 and in danger of being institutionalized. Mainly, we step in when the person is homebound, frail and doesn t have any support system in the area, says Telma Cramer, coordinator for older adult programs at Family Service of Santa Clara Valley. Case managers handle cases in South San Jose, Campbell, Los Gatos and Saratoga. Building a support system The Family Service case managers try to see clients within 10 days of hearing of them. They stay with cases until the person is stable, Cramer says, a time period that varies greatly. In the 14 years Cramer has been involved in case management in both California and New Jersey, she has seen startling changes. I am seeing that people are living longer, and I m seeing the support system is not there, she says. Families are all over the place and they are not able to be in the same place as their aging parents. My father, Steve Cain says with obvious pride, is Stanley A. Cain. He is 92 years old, and he was one of the original scientific ecologists in the country. Now, Stanley Cain has late stage Alzheimer s disease and lives in a Santa Cruz nursing home. Steve Cain is 52, a journalist with seven children living near Ann Arbor, Mich. It s the town he grew up in, the son of a University of Michigan professor who took a job at the University of California, Santa Cruz in 1969. Stanley Cain began to show symptoms of Alzheimer s around 1980, his son says. Meanwhile, Steve Cain s mother, Louise, was also having health problems. Steve Cain suggested one or both of them move back to Ann Arbor. His mother declined. By 1988, Louise Cain s ailments had become so severe that she could no longer care for her husband. Stanley Cain moved into the nursing home that year. Not long afterward, Louise Cain was diagnosed with bone and lung cancer, a condition her son calls immediately terminal. The diagnosis forced both of them to think again about Stanley Cain s future. We were talking about it right along, Steve Cain says. What do we do with my dad? My father has not spoken two words of understandable language in three or four years, and it s been at least that long since he recognized me, his only child. He takes a long breath. If you rub his hand, he ll smile. That s really the extent of it. Louise Cain died Oct. 22, 1993. For a number of reasons, Steve Cain has decided to keep his father in Santa Cruz. He visits a couple of times a year and believes his father is getting good care. But he still wants someone to be his eyes and ears at the nursing home. So he hired a private care manager. For $60 a month, registered nurse Becky Peters, co-founder of Capitola-based Lifespan Care Management Agency, gives Stanley Cain a physical check, talks with the nursing home staff, and mails a report to Ann Arbor. Lifespan, which Peters started 12 years ago with another nurse, Pam Goodman, is one of a growing number of private geriatric care management companies that arrange for everything from 24-hour home care to daily telephone monitoring. We realized if people had a problem, there was nowhere to turn for advice or consultation on that problem, says Peters, who, along with Goodman, worked with elderly clients in the public sector first. The company has now grown to 140 employees, about 120 of them providing in-home care. A good proportion of the firm s clients are grown children like Steve Cain, who live thousands of miles away from their parents. Lifespan charges $50 for an initial consultation (the fee is waived if the client signs up for home care services) and $75 per hour for an assessment of a client s health and financial situation. There is a 2-hour minimum for that assessment, which leads to recommendations for care. Fees vary depending on the kind of care needed. Care management which includes telephone consultations, home or institutional visits, assistance in placing clients in institutions and after-hours management, is $60 an hour. A live-in care provider is $150 per 24-hour shift. Getting old is expensive. There s no doubt about it, Peters acknowledges. Some employers, recognizing that caring for elderly relatives is becoming a topic almost as hot with employees as child care, have begun to help out. Those companies offer elder-care consultation as a corporate benefit. It s really having someone to brainstorm with and help you identify what services you might need, says Robbie Smith, elder care program coordinator at Senior Information & Referral Services, which has a contract with several local companies to provide consultation. If company benefits aren t available, family members can meet to discuss options with someone like the Senior Coordinating Council s Goodrich, a licensed clinical social worker. A 50-minute consultation with Goodrich is $40. It s worth it, says Meredith Loring. Loring, 49, is a technical writer in Las Cruces, New Mexico. Her 86-year-old mother lives in Palo Alto. For the last few years, Loring says she s watched a slow decline in her mother s ability to care for herself. Gradually, Loring and her mother have sought help a roommate who gets room and board in exchange for shopping, fixing dinner, checking the mail and making sure Loring s mother takes her medication; a bookkeeping service to take care of monthly bills. But before coming to visit this month, Loring felt her mother needed to move. When I came out here, I was all stoked to start pressuring her to move out of the house and move to New Mexico, Loring says. But after talking to the social workers and to the people who know (my mother), I started to change my mind. Instead, Loring has arranged for her mother to spend the day twice a week at the Senior Day Health Program in Palo Alto, where she ll get some medical supervision as well as social and recreational programs. She plans to start visiting every few months, instead of a couple times a year. As long as she can keep these familiar surroundings, I think it s much better for her, Loring says. I m just afraid it might precipitate a total decline if we move her. Rebuilding a home Ten years ago, Sara Goldstein and her husband Ernie tried moving to Palo Alto to be closer to their two sons one in Palo Alto and one in Berkeley. Nine months later, they moved back to their native New York. It wasn t absolutely great, Goldstein, now 76, says of moving to the West Coast. I had retired from a job that I just loved. And my unhappiness, I realized after awhile, was grieving. I was actually grieving. After the Goldsteins moved back to New York, Ernie Goldstein s health began to decline. He was diagnosed with Parkinson s disease, and Sara Goldstein became his caretaker. Then, in 1990, arthritis forced her to have a hip replacement. The Goldsteins Sara walking with a cane and Ernie hooked up to oxygen moved back to Palo Alto, this time for good. I think it was easier, because the situation was more than I could handle, she says. Even though my friends were (in New York), there is something about family support. I can t explain it, but it s very profound. The Goldsteins have lived in Palo Alto four years now, and bought a condominium two years ago. They have a mortgage for the first time in their lives, Sara Goldstein says, laughing. It s for 30 years. Sometimes, she admits, they still miss New York and old friends. But Sara Goldstein, who volunteers as a peer counselor at the Senior Center of Palo Alto, is adamant that moving closer to their sons was the right thing. Now, she advises people to think about their options before they re forced to. I guess, in a way, you live in a dream world, she muses. You always think life is going to be this way. You re always going to be well. You re never going to get old. =================================================