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level walkway, and reinforce a railing on the interior stairs. Virginia insisted that climbing the stairs to her bedroom each night was “good exercise,” and Mary was unable to convince her otherwise.

      As an alternative to more frequent visits, Mary has taught her mother to use Skype on her computer. Mary and her mother talk several times a week, and Skype allows Mary to monitor her mother’s facial expressions, general pallor, and get a glimpse of the kitchen where Virginia keeps her computer. Mary always asks to see the pill bottles and watches her mother take her medication.

      Though still mentally sharp, Virginia knows she doesn’t do as good a job managing her financial affairs as she once did, so she allows Mary to help her remotely once a month. They go online together and pay the bills on the bank’s website. This generally takes them about an hour because Virginia has lots of questions and tends to forget from one month to the next how the system works.

      Mary and Virginia share a financial advisor and Virginia has grudgingly given her consent to allow Mary to speak to the professional about both accounts. However, Virginia is still reluctant to give Mary full access to her finances, so there are aspects of Virginia’s life Mary knows nothing about.

      To Mary’s great relief, Virginia has remained active in her church and in her bridge club. Members of both groups visit her regularly and often bring her food she can heat and eat for several days. Mary has also arranged for a young woman to come in three times a week to do some light housekeeping.

      Similar stories are playing out everywhere today with parents who are aging in their homes and in retirement communities with limited services. Even in residential care communities, substantial involvement by adult children is evident. In 2010, a national study found 90 percent of men and women in nursing homes and assisted living communities experienced regular and frequent visits by loved ones.7 The casual observer in a nursing home or assisted living community can see immediately that these visits are overwhelmingly from children and grandchildren. Adult children play a significant role in the lives of their aging parents. In fact, adult children are sometimes the ONLY source of emotional support available to the aging parent, especially one who has isolated himself or herself from community contacts or has a life-limiting disease.

      Lisa’s mother, Alice, was diagnosed with Alzheimer’s disease when she was seventy-four. Since Lisa’s father had died two years earlier and her brother was a barely functioning alcoholic, Lisa was left to see her mother through the debilitating disease. For a couple of years, Alice lived on her own in a large, age-restricted mobile home park in Palm Springs. She had long-time friends and neighbors there who checked on her and reported back to Lisa if there was a problem. Lisa was a three-hour drive away, so she and her mother stayed in touch by phone.

      After those first two years, Lisa grew increasingly uneasy with her mother’s living alone, especially since Alice was no longer driving and had to depend on friends for rides to doctor appointments and shopping. Lisa found herself spending most weekends in Palm Springs. The six-hour round-trip was exhausting and took a toll on Lisa’s own family and job.

      The following spring, Lisa decided to move Alice into assisted living with memory care in Palm Springs. She used the proceeds from the sale of her mother’s mobile home to finance the move. Lisa chose to keep her mother in familiar surroundings and near her doctors rather than move her closer to her own home in suburban Los Angeles. However, the move further isolated Alice from her old friends and neighbors, which put Lisa front and center as the only support person in her mother’s life.

      Although she knew her mother was safe in assisted living, Lisa continued to spend most weekends in Palm Springs, taking Alice out for meals, supplying her with her favorite snacks, picking up medications, buying her clothing and shoes, and talking to her about things she was still able to remember from the past.

      After five years, the round-trip journey became too hard, both emotionally and physically. Lisa finally made the decision to move her mother once more, this time to an assisted living facility nearer to her own home.

      Today, Lisa is sixty-five and Alice is eighty-eight. After fourteen years with the disease, Alice no longer recognizes Lisa, but that hasn’t stopped Lisa from visiting, staying in touch with her doctors, and checking with the staff in the memory care unit to find out what her mother needs. Lisa has had her own health challenges to deal with, which have limited her ability to visit her mother as often as she used to, but she continues to act as her mother’s support system, staying in touch with the staff, and visiting as often as she is able.

      Lisa’s and Mary’s stories are being repeated all over the developed world, with boomers as the caregivers for their aging parents. The current cohort of aging parents—those living in their own homes as well as those occupying beds in nursing homes and apartments in assisted living communities—are composed of the two generations preceding the baby boomers. Will there be a different picture in 2040, when boomers are the ones in their eighties and nineties? One in five of them will not have adult children to provide the kind of emotional, physical, and logistical support that Lisa and hundreds of thousands of others are doing today.

      Intergenerational relationships are something people with children take for granted. This is less often the case for those without children, who may never have gotten close to anyone outside their own age group unless they come from large, tight-knit families.

      In order to fully understand what child-free people will need later in life, consider the variety of roles adult children play in their aging parents’ lives:

      No matter where parents reside, the adult children and grandchildren are usually the ones who visit, discuss family issues, share pictures, take the parent for an outing, and generally stay in close contact with parents as they age. They do this on a regular basis, in person, on the phone, via video conferencing, and in letters and emails, with the women in the family typically taking the lead.

      When an older parent has maintained ties to a strong social network (e.g., friends, a place of worship, a senior center, a health club, a bridge group, etc.), additional support may be available when they need help with transportation, a task, or simply need some companionship. This can ease the burden on the adult children, especially if they do not live close by.

      Very few childless adults reside in assisted living and continuous care communities today. Why? There were no adult children to convince them to make the move. Here is a typical scenario: The adult child or children become convinced mom and/or dad, typically in their late seventies or eighties, should no longer be driving or navigating the stairs in their multi-story home, and the time has come for them to live in a safer place. The adult children then help them “shop” for a new community—often closer to where they and the grandchildren live. Once the new home has been identified, the adult children assist in the difficult and emotional task of downsizing, which usually involves sorting through a lifetime of accumulated “stuff.” Once the cherished possessions and memorabilia have been given to family members, sold, or thrown away, adult children help their aging parents move what remains into the new, smaller space. Following the transition, the adult children often handle the real estate transaction to sell or rent the home in which the parents resided. Evelyn had to do all of these things for her mother:

      For five years, Evelyn had tried to convince her widowed mother, Jean, then eighty-seven, to move out of her multi-story home. Evelyn had been raised in the large, multi-story house near downtown Buffalo, New York, and her mother had been living there for fifty-six years. Jean was adamant about not moving until one night she became dizzy and disoriented, lost her balance and took a fall in the bathroom. She hit her head on the edge of the sink, passed out for a couple of hours and woke up in a pool of her own blood. She managed to make her way to a phone and call Evelyn, who lived several hours away. Evelyn called for an ambulance to take her mother to the nearest hospital, then quickly dressed and started the three-hour drive to the hospital. When she arrived in Buffalo, she found Jean in the emergency room where she had required nine stitches in her forehead and an elaborate bandage for a badly bruised knee and foot. Fortunately, she had no broken bones.

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