Friday, November 25, 2016
My mother is 85. There's plenty of variation in how vigorous and healthy people are at that age, but she's not at the top of the distribution. She has a problem with feeling unsteady on her feet, that doctors have been unable to diagnose for years. This limits her physical activity and that's bad both physically and psychologically. She also complains of chronic malaise, insomnia, frequent urination. Basically she doesn't do anything. She's also increasingly having difficulty finding words and otherwise showing strange cognitive lapses.
The thing is, I'm the closest child, and I live an hour away. My brother is a 2 1/2 hour drive away and my sister lives in Manhattan and doesn't own a car, meaning she has to rent one to get to deepest Connecticut. My father died about 8 years ago, BTW, but he'd been in a nursing home before then so she's been living alone for quite a while. His terminal illness depleted all of their money so she has nothing but her teacher's pension, which is basically equal to social security.
She also has a reverse mortgage, which means that if we sell the house she won't have enough money to last very many years in assisted living. So she's sitting around in an early 19th Century farmhouse with five bedrooms, just her and the cat.
In the old days, the family would still have been nearby, if not in the same house, and my mother's later years would have been much more manageable and probably far less unhappy. But nowadays a lot of people are in our situation. I only live out here in the last quiet corner because it's the only place that's reasonably accessible to both my mother's house and Providence, which means I'm spending two hours commuting to work and back every day and then doing it in the opposite direction many weekends. It's really bad for my carbon footprint. But I have to keep working or I won't be able to take care of myself, let alone my mother.
A lot of relatively affluent people end up in this sort of quandary. In fact it's a risk factor, I expect. Being really wealthy fixes it, and being low income means your family is probably not so dispersed. Public policy doesn't work properly here. Medicaid will pay for a nursing home, but not for long-term home care, even though it's cheaper. Here in Connecticut they have a hybrid policy whereby if you first go into a nursing home, you can then be returned to the community and get home based services. But my mother doesn't need institutional care, and in any case she'd have to sell the house meaning she'd wind up in some sort of a senior housing complex, which is not where she wants to be. And it would cost the state more in the long run. It's basically insane.