By Rhonda Gowen
“I retired from nursing,” says Doris Fischer, veteran of twenty-six years as Bismarck Burleigh Public Health Nursing Director. “I never thought I’d have to keep on doing it. And caretaking is harder when it’s your own family.
Many women are faced with the need to care for elderly family members, spouses or neighbors, sometimes while tending their own children. They can feel overwhelmed. Problems such as caretaker stress, finding in-home care, deciding whether to take away the car, choosing an assisted living facility, or making a smooth transition to new living arrangements can loom large. Several local women have forged their own answers to these and other questions.
Twice a day, Doris had coffee with and “looked in” on her elderly neighbor Alma. She helped Alma with groceries and other tasks. They had a good relationship until Alma transitioned to assisted living farther away. Doris could no longer maintain the contact as closely as she would have liked. She felt badly but took comfort in the memory of the quality time they did enjoy together. Then recently, Doris’s husband developed medical problems resulting in many surgeries. Seeking specialized care, they traveled to Mayo Clinic in Rochester, MN. Even with a nursing background, it’s been a roller coaster ride for her, keeping up with the medical visits, travel and the home care of her husband. She relies on her family to lend a helping hand.
Joanne Swonger, married mother of two, shares her home with her 93-year-old mother Martha. Her mother enjoys doing her part to make the household run, such as food preparation, folding laundry and other practical matters. She also strives to preserve a zone of “personal space,” saying to Joanne’s family, “You go do that together as a family – I don’t need to go.” Joanne feels that a sense of mutual respect and a willingness to talk about concerns have made their live-in relationship work. Joanne is available to drive her mom, who no longer feels comfortable driving in the bustling city traffic. When the Minot flood overtook Martha’s house and she had to deal with recovery through FEMA, she gave her power of attorney to Joanne to help her bear the business end of the cleanup.
When meeting with agencies or health professionals, Joanne and her mother have found there is a temptation not to listen to an elderly person if a younger person is present to communicate for them. “It’s important that the younger companion focus the attention on the older individual so they can be genuinely heard,” said Joanne.
Juggling a distance care situation, Judy Nabben and her husband have increasingly been helping her 90+-year-old parents who live in Rugby. Her father has some hearing loss, making it difficult to arrange for Bismarck medical appointments over the phone. “Dad agreed to include my name on the ‘release of information’ form so I could make appointments on his behalf,” said Judy. “It is so much easier for me to call and arrange doctor visits and checkups so we can plan his travel.”
When it became necessary to select an assisted living facility for their mother, Cheryl Langei and her sister chose The Terrace, a 40-room Bismarck care center. Since her mother suffered from dementia, they thought she would have less trouble recognizing the modest number of staff and residents. She liked the way her mother was included in appropriate activities such as folding towels or decorating. It made her feel a part of the residence family. The staff was very understanding. “In one instance my mom thought the dining room was a restaurant, so she would leave a small tip after she finished eating,” said Cheryl. “The wait staff would place the tip money back in my mom’s purse for use the next time she came to eat.”
For Cheryl, placing her mother into assisted living was ultimately a great relief. She no longer worried about her mom’s safety around the stove and stairs, that she would take too many pills, or that she would wander out in the winter and get frostbite. Her mother realized she needed care because six months earlier she had become lost and frightened while driving. By living in the care facility, Cheryl’s mom eliminated the stress of tasks like mowing, shoveling, repairs and buying groceries. It was a simpler life. “The biggest thing for the family – they feel guilty, like they’re sending their child to school for the first time, into the unknown,” said Cheryl. “I think they should just try it. Placing Mom in assisted care turned out well for us. Loneliness can turn to depression. We all need companionship.”
Leslie Peterson’s brother would check in on their mother Geri who had lived on the family farm her whole life. One day their mother began cooking a hamburger, left to pay a bill, and forgot the hamburger. She realized something was not normal and the potential existed for danger. Together the family consulted a doctor and a neuropsychologist who conducted several vitamin deficiency and memory tests. Geri was already experiencing the moderate stages of Alzheimer’s disease.
When she entered assisted living, Geri made a big adjustment from living alone on the farm to the active social environment. As she lost memory capacity, even simple things she did to pass the time became difficult. She couldn’t remember the steps to her needlework and couldn’t remember the content of previous chapters she had read in her books.
Leslie’s mother had two long-term care insurance policies which together should have covered the cost of her assisted living. However, one of the companies did not want to cover her mother’s situation even though the doctor said she could not pass certain memory tests. After five or six months of struggling to get the company to cooperate, Leslie found out that if the insured person was unable to perform certain daily living tasks such as being able to feed, clothe and bathe herself, then the insurer would pay her assisted living bill. Even though her mother was able to bathe herself and wanted to be as independent as possible, Leslie waited for a moment when her mother was most cooperative and convinced her to let the nurses help her bathe. Only then, when Geri accepted help in that and one other area, would the insurance company pay for her residency. Leslie says, “Here was someone who had planned for long-term care, and yet when the time came, could not collect on the insurance because of a technicality. My advice is to double-check the criteria your long-term care insurers use for payment to dementia and Alzheimer’s patients.”
Leslie’s mom has passed on, but Leslie reflects, “I feel greatly relieved and glad that she no longer suffers. She left us before her body left us. Somehow she remembered we were her family, even if she didn’t remember our names.”
For further answers on assisted living facilities, qualified service providers for such needs as adult daycare and homemaker service, and for caregiver support, check the North Dakota Department of Human Services–Adult and Aging Services website. http://www.nd.gov/dhs/services/adultsaging/
Rhonda Gowen is a piano instructor at the University of Mary and a clarinetist with the Bismarck Mandan Symphony and the Missouri Valley Chamber Orchestras.