Wednesday, February 08, 2006

Getting Old...and then Older

I'm learning these days about getting older. I don't like it one bit. And it's not even about me. It's about my father-in-law who is 88 and not well, and my mother-in-law (Mil) who is facing some serious decisions. She can no longer care for her husband alone. She wants to, but physically can't. Mil keeps hoping she'll wake up from this nightmare, but that's not going to happen. All we can hope for is a loving, humane and well-considered solution. We want a clean, attractive space for my father-in-law with conscientious care-giving, a healthy quality of life, good food, and physical and mental stimulation. So we visited some Board and Cares. A Board and Care is a house for assisted living in a residential area of single family homes. The idea is to eliminate the feeling of nursing home sterility and to have the residents and caregivers create a community. We'd heard good things about them, so Mil sought out referrals.

Our first experience with B&C last week was mixed. On a beautiful street in a nice neighborhood, the house was large, open, and clean, and the residents seemed happy. We liked the B&C, but the manager made us feel as if we were shopping for a used car. She was constantly chattering away about adhering to the law, how residents always improve under her care, what a wonderful alternative a B&C is, and how costly all other choices (private in-home care and assisted living facilities) would be. Unfortunately she exaggerated these costs. We knew because we'd done our research. We'd been told this B&C would cost around $2500, so when the saleswoman popped the price at $4500, we felt conned. It was like taking a spin in a new car, wanting to buy, then having the manager say you have to pay over sticker price. But she was willing to deal. Just make an offer. The dickering was a turnoff.

Yesterday we gave Board and Cares another shot, but it didn't start off well. I noticed how all B&C are behind iron fences with locked gates. I understand there's a good reason for this, but it felt off-putting, jail-like. Second, I've never seen so much cement landscaping in my life. At the first house, the entire lot was encased in concrete. And not necessarily safe concrete. The wheel chair ramp inclined toward the steps, but dropped off on either side to more cement with no railing. When Mil and I were leaving, she almost stumbled over the edge of the ramp. If she'd fallen, it would have been smack onto the concrete.

Inside, however, it was open, bright, and clean with leather or vinyl couches lining three walls, a big screen TV on the fourth. The two residents watching TV seemed comfortable and well-cared for, but the place was sterile. No knickknacks, no pillows, no personal touches, even in the bedrooms. When I asked the attendants, a young girl and guy who seemed personable and kind, where they stayed, they said they lived at the Board and Care, but had no rooms of their own. They are on duty 24/7 and take turns napping on a narrow bed in the office. This room had nothing personal in it either. How long can a person care for others if he has nothing for himself? Isn't this exploitation of the care-givers and wouldn't this at some point spill into resentment?
Something about it bugged me.

The second place was worse. It was in a questionable neighborhood where almost every house had a wrought iron or chain link fence. Inside, the house was dirty. The couches looked as if they'd been found on the curb. The rooms were spare and the kitchen remodeled sometime in 1975. Everything had a worn-out look to it. The residents were sleeping in their rooms, except for one who was on the deck with a family member. Only one attendant was on duty. When Mil sat down on the couch at the invitation of the caretaker, I hesitated. She has a more generous heart than I and couldn't hurt the caretaker's feelings by refusing to sit, but when we left, she said she wouldn't put a dog in that place. The private room here had a whopping $3000 per month price tag.

Lest you think it was all bad, the last two B&C were clean and homy. One had a white picket fence (no wrought-iron, thank goodness) and a large grassy back yard with fruit trees. It felt as if we were walking into grandma's house, warm and cozy with magazines tucked neatly away in magazine stands, figurines in a book case, and a stuffed toy Labrador alert under the coffee table. The residents sat contented in the family room watching reruns of "Wheel of Fortune."

The last place had some of the charm of the "grandma's" house, but was smaller and felt more crowded with the same number of residents. But it had large light bedrooms and a pretty backyard. A wife visiting her husband told us they loved the place and a resident grinned that the caretakers were the best. We liked the director (she manages the last two places we saw) and the caregivers. The prices were reasonable, but the distances far from both of our homes.

We added the last two B&Cs to our list of possibilities with that of larger assisted living choices. Since his fall on January 18, we've been searching for solutions and hopefully we'll be able to decide today. There's much to consider: quality of life, distance, peace of mind, cost. It is a nightmare as my mother-in-law says, but it's one most of us eventually have to deal with.

1 comment:

Secret Sister said...

This has really become the best way to keep informed, hasn't it? I didn't know about the fall, but I am glad that she is learning that she can't do it all. What if they both fell? It's scary. Let me know how the search goes...