Have you ever walked into a nursing home and thought “Gee, I cannot wait to move in to one of these places”? Or, perhaps, you’ve been overwhelmed by all the happy faces around you, seen the overflow of family members and relatives who visit, secretly envied its residents? Yeah . . . I didn’t think so.
Despite the undesirability of nursing-home life, more and more parents and grandparents are being admitted (or committed, depending on your perspective) into nursing homes or assisted-living facilities. According to a 2012 report, a reported 1.4 million Americans live in nursing homes and 735,000 in assisted-living facilities. With an aging population of baby boomers, and longer life expectancy for both males and females, these numbers will only increase.
When I first moved to the United States almost 15 years ago, this shocked me. So many nursing homes. So many people in them.
Don’t get me wrong; there were homes for the elderly in my country of Romania as well. But these asylums (literally translated from “azile” in Romanian) were usually for people who had no family left to care for them. Those who had sons, daughters, siblings, nieces, or nephews were taken into their care. It was the way of life. Families made whatever adjustments they needed to their finances and lifestyle to balance care for both their children and elders. Need to fit grandma in? Kids can now share a room. One more mouth to feed? We’ll make it work. No elder left behind.
So I couldn't help but wonder—in a country where income per capita is significantly higher than in mine was, and where the standard of living is among the highest in the world—why are over 2 million people living away from their families, institutionalized in nursing facilities? Sure, some have medical conditions that may require around-the-clock medical attention, but is that truly the case for all 2+ million? And how many of those with medical conditions could, with the right supplies and training, be treated at a family member’s home?
These questions continue to linger in my mind. Every so often, I happen to chat with someone who mentions having parents in nursing homes and I ask (every so delicately) how the decision was reached. I’ve heard anything from “it is difficult for her to get around without a walker and cook her own meals” to “we thought it would be best for her to be around her peers," to “my father developed end-stage-renal-disease, now needs hemodialysis 3 times/week and we just had to put him in a home." Others, more direct, confess to being too busy with work and the kids’ athletics, or situations where the spouse did not feel comfortable with a long-term arrangement of caring for an elderly in-law.
I wonder how many of these individuals had candid conversations when the now elderly family member was in his or her prime, about how they wished to spend their elder years. And of those who did have those conversations, how many of these family members fought tooth and nail to be put in a nursing home? I suspect very few.
Is there truly no more room in our homes? Is staying after hours at work or our kids’ multiple athletic commitments so important that we cannot make time for those who raised us? Are we so attached to our current way of life, that we would rather drastically alter another’s lifestyle than make adjustments to our own? Are these not the same parents who did their very best to raise us and build us into the adults we are today?
Of course not every parent has lived in such a manner to earn them a “World’s Best Mom/Dad” medal, but many have done their best. In my case, I was fortunate to be blessed with two amazing parents who have moved mountains to keep me alive (despite health issues I experienced as a child), to provide me and my sister with a good education, a warm home, a solid moral foundation, and later on, a chance for a better future by immigrating to the United States.
Now it is my turn to move mountains when it is time to care for them in their later years. And I am up to the challenge.
This isn’t meant as a manifesto against nursing homes. Neither is it a criticism of those who have made the choice to house their parents in one of these facilities. Rather, this is a call for our generation to rethink the way we make these choices. Instead of this being a decision you and your spouse make upon on your parents’ behalf, at a time when they are beyond a phase where they can make their own choices, make it something you discuss with them and your siblings early on. What are your parents’ wishes? Do they wish to continue to be an active part of your and your children’s lives? Or would they rather spend those days surrounded by people their own age, away from the hustle and bustle of band practice and sleep-overs? Or perhaps in their own home with an on-site caregiver? While they’re far from your average, light-hearted coffee chats, these talks are crucial to ensuring that your parents have a voice when these plans are made and that their wishes are respected when they no longer have the physical/mental ability or financial independence to do so themselves.
If it is already too late to have these conversations, it never hurts to do a thought experiment. Think of the adjustments that would need to be made to welcome your parent(s) into your own home. Write everything down, do the math, compare scenarios. Perhaps it is not as difficult as you initially thought. Yes, your children may whine about having to share a room, but eventually they will get used to it. And they will learn a very valuable lesson as well.
So, what about Mom? Are you ready to take the challenge of offering her as much care, attention and dedication in her later years as she offered you in your early ones?
Photo by Nima Salimi