We Need to Talk About the Elderly

It’s coming. Are you ready?

We don’t talk enough about the elderly.

In the crevices deep in the back of our minds, we know that in the future there’s a good chance that our grandparents or parents (or maybe even we ourselves) will need assistance of some sort. The front of our minds, however, is occupied with the here and now, and what little thought we give to elderly assistance is typically relegated to: We’ll deal with it when it becomes apparent that we have to.

Obviously, there are many problems with this approach. But maybe the biggest concern is how astonishingly quick a problem can go from a small concern to a dangerous situation.

My mom was a miracle. In her eighties, she was dynamic and independent and somehow younger in spirit, energy and focus than her friends who were 10-15 years her junior. Living on her own, she was a social, bright grandma and the designated driver for her friends. At the center of her life and health was the daily ritual of back-to-back water aerobics classes at the YMCA. She would leave the house at 6:30 a.m. and be in the pool by 8:00 a.m. Usually, she would socialize with her YMCA friends afterward. Those classes kept her young, independent and vibrant.

And then COVID hit. The YMCA closed and the socializing stopped. The fear of contraction, particularly for the elderly, was such that my mom barely left the house for three months. And in those three months, she went from miraculous, senior athlete to convalescent patient. Gone was the independence. Instead, she wobbled precariously on a cane.

I called a meeting with my brother and sister and explained that the fear of COVID was significant, but the reality of quarantine and isolation was worse. We agreed and kicked into high gear, walking her daily and breaking quarantine by including her in family meals and outings. Things got better, but the damage was done.

She still lived alone and was surviving, but it wasn’t long before her short-term memory lapses became the rule and not just an occasional mishap. On one occasion she couldn’t remember where she had parked her car at a supermarket and broke down in tears, calling us to help. At that point, we realized not only was driving hazardous; so was living alone.

Every morning my siblings and I woke up fearful that my mom hadn’t made it through the night. I had mental images of my mother fallen, stuck in a bathtub and not being discovered for hours, or worse. So every morning, we would call. And on more than one occasion when she did not answer the phone, I jumped in my car only to discover that her ringer was off. The situation was dangerous for our mother and it was oppressive for her kids.

My mother is not a wealthy woman. The reality of assistance was going to fall on us and we were all concerned how this would play out. At the mere mention of getting a live-in or a nurse, my mother was adamant. She would not have it. And stupidly, we had not had this conversation until the circumstances were acute. There were so many years before this moment when we could have had a gentle, theoretical conversation about a time in the distant future when a situation like this might occur. What would mom prefer? Unfortunately, we did not take any of those moments to create a plan, and the consequence was that now we were engaging in a combative assessment of mom’s situation and how to remedy it.

Unfortunately, we did not take any of those moments to create a plan, and the consequence was that now we were engaging in a combative assessment of mom’s situation and how to remedy it.

Mom stated with complete clarity, “I will not have an aid or nurse here and that is final … but I would consider moving into a living facility.” She would? My mother’s condo was a source of great pride for her. She had bought it after my father’s passing and paid for it herself with her wages earned as a public schoolteacher. To think she would give it up was incredible to us.

Of course, that was all we needed to hear. I kicked into high gear and checked out 15 independent and assisted living facilities. One of the places towered above the others. It was only a few blocks from her condo and very near to my brother and me. It was lovely and airy and friendly and they also had a memory care facility—something that we hope to avoid as long as possible, but knowing it is there is a relief. Within three weeks of the initial conversation, my mom was safely moved and happy in her new life.

Assisted living is expensive. In Los Angeles, costs range from $5,000 to $15,000 per month. My mom’s facility costs her about $8,000 per month. Living on a small schoolteacher’s pension and a smaller social security check, the increased costs were going to impact all of us. But thankfully, my mother had LTCI—Long Term Care Insurance.

The LTCI was not without drama either. My mother had paid into the LTCI for 28 years. In the beginning it cost around $100 per month, but it had gone up to $480 per month. And then in the last two years, the insurance was nearing insolvency and the premiums went first to $900, then to $1,200 and finally to $1,900 per month. It was outrageous. We were about to join a class action lawsuit when we realized that mom needed to move into assisted living. So instead, we paid the premium and applied for the support and thankfully it has paid out.

The good news is that my mom loves her new place. She has friends and assistance and daily activities, and my siblings and I are enormously relieved.

If I may be so bold as to give some advice based on my experience: Have the conversation sooner rather than later. Find out what the person prefers. Look at the options. Visit facilities and check out prices. It worked out for us, but I hate to think if there had been no room at that ideal facility. None of the other places were nearly as good for her. I suggest choosing a facility that is convenient not only for the children, but also for any friends that are nearby. Maybe there is a way to incorporate elements of the previous life into the new life (in the beginning, my mom went back to the YMCA for a few classes). Or maybe, the better choice is to stay in the house with a helper. There are options. But just know, at some point, this is coming; and the sooner you are prepared for it, the better.

A week before she moved in to the facility I had a tearful conversation with my mom. She confided, “Danny, I had a nightmare last night.” I leaned in, concerned. “I saw myself walking into the dining room and nobody would eat with me.” I hugged my mom and cried with her. It dawned on me in that moment, no matter how old we are, there is a part of all of us that is still in 3rd grade.

I am happy to report that my mom is incredibly popular and every time I show up at mealtime, she is surrounded by five to eight of her friends all squeezing into a table to eat with her and laugh at her jokes.

Daniel Kaufman is a filmmaker and writer. You can follow his blog “Confessions of an Orthodox Sinner” at: https://www.facebook.com/orthodoxsinner