Tuesday, January 5, 2016

My "Granny Pad Rant" or Growing Old with Respect

As people grow older, and their personal needs, along with a desire to stay in their own home increases, there is a dynamic of a two-fold stress that arises. As we look from the outside in, (as those who are mere spectators) we often conclude that the best results that could be attained would be to dislodge our seniors from their homes and move them to a more acceptable situation, where both social and medical help would be more available. This may include more suitable surroundings, where consideration can be given to special needs with health and safety concerns as a basis of justification.

This stress can surface in at least two areas. We often disregard these two factors that arise in the aging process; It is the issues of convenience versus familiarity. There had been in the not so distant past, a tendency for both family and the care-giving sectors, to opt for convenience, as seniors were rushed into nursing homes and extended care facilities. This has changed somewhat, as governments have surveyed the cost of corporate care of elders, finding the growing economic limits of this type of housing to be prohibitively expensive, and so moves were made to aid in  keeping seniors in their homes longer. Now with the limitation on public resources once again being of concern, there seems to be a move now-a-days to promote alternate avenues of care for our aging population, among the private sector; that being the promotion of “Granny Pads” and “tiny home” provision for our seniors. This first area of stress is out of concern for the seniors themselves. Convenience is important to some extent, but as we consider convenience there must be the consideration of respect for the wishes of those who are our aged, what is measured as convenient for our senior family members themselves.

A certain or sure dynamic of stress arises when the only consideration is that of uni-directional convenience. As we evaluate both the environment and personal health of our aging seniors, there are two facets of care that must be considered. In this day and age, as family members are sometimes shipped off to a distant nursing home that may be of some distance away from their family. That sounds harsh… and it is. With the aging populations of North American society there are constant stresses placed on both health and geriatric care facilities. The Canadian dynamic is a bit different in some respects, as there are two levels of care available. The first line and most important to our citizens, is the state operated nursing and extended care facilities which have been our privilege for many decades. The alternate for some, are private facilities which may be a choice for those who can afford this style of exclusive care with extended options for socialization and exercise along with personal health care as a first line supplemental base. How is convenience measured then? Is it the convenience of those facing the decision process for others, or for the convenience of those being processed? What is most important is the convenience for our seniors, not the convenience of the family, or perhaps convenience for the care giving professionals and this fact causes much stress for all concerned. How does one evaluate fairly based upon all the factors involved and then make a decision based on both practicality and prudence?

I remember years ago my parents wishing to have us boys place them in a nursing home when the time came. They clearly, at that time, did not want to become a burden to us. We were both professional men and our lives were busy and complicated in many respects. There was no clear definition of timing or circumstance around which this decision process was to begin. As the years passed, a change took place as their view to the future was totally opposite to their original wishes. My parents now wanted to stay in their own home. My Dad had been instrumental in the providing of senior’s accommodations in our area, and had accomplished having two 2 bedroom apartments placed in the extended care housing facility, that was built during his years as Chair of the Housing Authority. His plan had been that he and Mom would live there, as their need for extended care increased. This was not to happen, as it was not coordinated with my mother’s plan.

My parents finally decided one day that they wanted to stay in their own home. This second dynamic of stress for both them and for us, as their children, was that we realized that there arose this problem of familiarity. How can familiarity be a problem one could ask? Human nature gets used to a certain flow throughout a lifetime. This is both more finely developed and accentuated as we age. Daily processes become a harbour of safety and routine, a fence to help keeping on track those mundane considerations of health and happiness, for seniors it is a familiar environment that lends itself to comfort. There is routine to make sure medications are taken, meals are prepared on time and the regimen of the day, through repetition, is comforting, as well as therapeutic, in most cases. While care must be taken to watch for signs of degeneration of mental capacity, we should not be too quick to identify a bit of momentary confusion with total senility. Consider how many times we have reached for something during the day and wondered what it was that we wanted, even in our young adulthood. There are signs of more deeply seated confusion that can be noted, to help us better evaluate, and it is our responsibility to help those we love by due diligence and research, as we assist and watch. without undue stress for either ourselves or our loved ones.

We often hear people say, “There is no place like home!” and yet a normal reaction for those on the outside quite frequently is to come to the conclusion that something else, in the way of surroundings and environment, would far better serve their loved ones, in their later years. This is not a total misjudgment, if the circumstances warrant it. There does come a time, if personal care is of great concern and the availability of caregivers, to meet the personal needs of our loved ones, is lacking. I will not argue that. I would suggest, and perhaps I may be seen as naive here, that first and foremost we need to continue to do evaluations based on the desire of our aging seniors. I have seen in the past too many evaluations done by professionals, who with well-meant consideration for their clients, made their decision to report a need for relocation based solely on a 45 minute practical and verbal tests, focused on physical response times and acuity of understanding. While these tests or benchmark forms of evaluation have their purpose, there is the problem of false positives or false negative factors that must be considered. To have a stranger come into your home asking questions, and often being perceived as “demanding” responses, to both oral inquiry along with physical capability, can be daunting for seniors. Seniors do not always react well to external stresses created around such evaluations. There may be formulas in the process that allow for client’s (this is the term used by the health care-givers) state of mind, but far too often, it seems like results are calculated only using standard forms, reflecting basically the actual responses given and abilities shown, as time needed for such evaluations is an element of concern within the process itself.

I have been there and I have noted those stressed seniors personally over a 40 year period, working with not only family members but community members, as they faced this overwhelming process. I helped care for both of my parents, hands on, and I know that there are easier ways to both try to help and assure our seniors, who are our family members… yet sometimes alternate methods and foreign environments, are not the best way to go. I realize that not everyone is capable of caring for aging family members. Not everyone is in a situation that allows them to perhaps stop their own lives, to assist an aging parent, or parents, through their final days. But out of respect for our seniors, I pray that this hands-on course of care will not become a “last considered” option, as our society seemingly devalues our seniors in many respects.

 I am writing today in response to an ad found on social media for the proposing and promotion of “Granny Pods” or housing for our family members in the backyards of our homes. In this scenario they are near, but out from under foot. Seniors in this scenario are given the opportunity for personal space and privacy, but are also near enough to be cared for when care is needed. That “when needed” has always bothered me. My sick mother looked after parents and her aging in-laws until their deaths. No one knew how many times she cleaned up the messes made when their body functions failed them, the meals shared, clothes laundered and a hand was held when losses meant tears being shed and company was needed. That was “hands on”, and it was not just a chore to be grudgingly completed, it was a privilege. Years later, there were moments of exhaustion for my brother and I, as we experienced what our parents years before, had taken on as responsibility for their own parent’s care. There were times when embarrassment had to take second place, as the needs of our parents overshadowed any preconceived idea of how things would work themselves out, when the latter years of our parent’s lives came to confront us, and their care was now of prime concern, now to be a privilege and not just a necessity.

This is not meant to be a chastising of those who have made other choices for their own family members or parents. I helped my aunt get a bed in a nursing home because that is what “she” wanted at that point in her life. It was not a matter of outside evaluation and decision process… it was her decision and I was merely the convener within that process. How we perceive our seniors, and how we deal with their needs, should be made solely on their desire first wherever possible, and where that is not possible, great care in acknowledgement of their presence and importance in our lives should be taken, so that perceived alienation does not become a factor of daily life later on, for those we love.

Granny pods…. Well, if that is a consideration on the part of the senior themselves… OK! But, let’s not rush to tuck away our seniors and parents in our backyards too soon… their homes are their castles and as we evaluate the dynamic of familiarity over convenience, we must not leave out that dimension of human need that states that what is familiar to us brings comfort beyond most external supplemental care in life. If I choose to move… and I may very well do so at some point in my later years, then I pray that it may be near some family member who will choose to help care for me, not from guilt, pressure or perhaps only out of a fear for my safety. I pray that it might be with a heart of love that remembers that as a parent, I helped nurture them, as best I could through life, and that they would now do so for me, until I depart in death. That may include at some point, a decision to place me in extended care somewhere, when I am no longer manageable and their personal care for me is no longer tenable… That could be a reality, but one faced with God’s Grace.

That is what living near the edge sometimes comes to. It is not always about exploring new ground or meeting challenges that are all about our skill sets in life; one day it will be our ability to face the unwanted changes that are normal for advancing years, but foreign to us in your youth. We must prepare ourselves to walk near that edge as well. Is there a need to rush things? Perhaps not. But, like anything in life, the more homework we finish on time, and with due diligence, the more prepared we are for the test when it comes. As we walk near the edge in this respect... take time to answer some of the gnawing questions about what you want, versus what may be expected. No need to walk there alone! Walk with God at whatever level you might be in your understanding of His guidance and direction for your life. But remember this... we will all face that reality at some point ... ready or not! Personally, I do not fear what the future holds as I am too busy just celebrating the present, but I do keep in mind and practice the reality of my place before God.

May you be blessed, as you consider some of my odd rant today. Now don't go getting all depressed... I will be taken care of I am sure, even if I don't deserve it! That can be your smile for today!