My job is to plan for catastrophe, yet Jane’s story was an echo of my own. My mother, a fiercely seniors independent and proud woman, worked until she was 86 years old; but after she was forced into a senior nursing home care at age 93, she died within weeks. Ethel enjoyed a long life. Its end was certainly not a direct result of the loss of independence and personal dignity she experienced in the nursing home. But if I had helped her plan for her very old age, she might have spent her last months surrounded by neighbors and friends, instead of professional caretakers.
Ethel knew what she was worth. She returned to Filene’s department store, the employer of her teen years, when she was widowed at 59. She broke sales records, but the store’s management retired her when she was 67. Not ready for television and afternoon bridge, Ethel applied to Lord & Taylor. “Ma,” I warned her, “you’re wasting your time. You’re going to be demeaned and then rejected by some kid who could be your grandchild.”
Ethel was undeterred. “Ben, I’m not going to listen to you. I’m going to have my hair done, and I am going to apply for the job.”
My mother sold handbags at Lord & Taylor until she was 86, never missing a day. Or wasting a dollar. When, on a steamy August day, I sent a prepaid taxi to bring her home, she expressed her disapproval to the driver. “You tell my son not to waste his money.” Her work ethic as well as her life ethic prescribed independence coupled with frugality.
Ethel had her first extended experience with nursing home care after abdominal surgery at age 86. We negotiated with her: “Please, Ma, promise to stay just one week in the recuperative senior independent care center, and then we’ll get you back to your own place.” Convinced that recuperative care was a one-way ticket to the nursing home residents, Ethel outsmarted us. Against medical advice, despite jeopardizing her Medicare coverage, she called an ambulance and left the care center after staying one night. The center’s social worker officially scolded her, but privately admitted that the entire staff stood “behind the plants and cheered her as she climbed into the ambulance.”
My mother maintained that freedom until she was 93. In many respects, she was lucky. She stayed in her own apartment. Her neighbors loved her home- made cookies, showering her in return with flowers, candy, and Mother’s Day gifts. She refused to consider long-term care, even when we suggested a live-in companion. “Let me understand this,” Ethel said with disdain. “You want to have someone come to live here, watch my television, eat my food, and still pay her?” Pointing her finger at me, she cried: “Shame on you!”
I didn’t feel shame, but I certainly felt guilt when she finally moved to a adult foster nursing home. The placement was a good one, but no senior home care services nursing home has the staff to provide sensitive care 24 hours a day, seven days a week. Inevitably, patients are at risk, left occasionally untended, sometimes unsupervised, and always deteriorating. My mother’s worst fears came true. She lost her independence, her dignity, her privacy, her days in the warm sun, and, worst of all, her contact with the world outside the home. From the first minute of her confinement, my mother and I each mourned her loss.
Despite struggling with the pain of losing two of my three daughters, the end of my mother’s life is still one of my saddest memories. I feel guilty that al- though I am an expert in insurance, I did not do more to explore ways to keep her at home until she died.
