This morning I visited with my grandparents and their case worker.  My grandfather suffers from Alzheimer’s disease and has been on the wait list for a placement in a Long Term Care home for about a year now.  Both of my grandparents will turn 90 within the next six months, and I’ve watched the toll that caregiving has taken on my grandmother over the last couple of years.  Although they do have caregivers coming to the house to assist with some basic daily needs, the majority of the burden of looking after him all day (and night) falls on her, and you can see how it’s wearing her down.
At one month away from her ninetieth birthday, she’s just plain tired.

My grandfather still knows who my grandmother and his children are, but he’s long since lost understanding of who I am.  He seems to recognize my face as vaguely familiar, but he often confuses me with one particular niece of his.  This niece happens to be not only a generation older than me, but sadly passed away unexpectedly last spring, so the fact that he seems to think I’m her not only makes me empathetic toward the confusion he obviously feels when trying to place me and certain other people, it also makes me want to reconsider which anti-wrinkle cream I should be using…

But on a more serious note, I’m seeing first-hand the struggle of aging when one doesn’t have their health any longer.  My grandparents have lived in their current home for over forty years, and so I can completely understand the mixed emotions my grandmother is feeling at the prospect of sending her husband to live elsewhere for his last years.  I also understand her sadness at watching him deteriorate so slowly but so surely, and being helpless to do anything about it.  Having to keep an eye on him twenty-four hours a day (because he often gets up during the night) becomes much like having a baby in the house: she has to be on constant watch to keep him from hurting himself by trying to go down stairs he can no longer navigate, trying to step off the back porch to work in the yard as he did all his life, or trying to get in the car to go for a drive.  Sometimes, as commonly happens with this type of disease, he gets angry with her, insisting that she has no right to tell him what he can and can not do.

But it’s very clear he can no longer navigate through his life the way he used to.  Sometimes even following his own train of thought is too much of a challenge for him, and conversations with him are incongruent and incomplete as he moves from one train of thought to another, all within one sentence.  My grandfather, who used to be very active, still wants to get out and do things.  So even though it tires her, my grandmother generally takes him out to the coffee shop each day for a small “outing”.  She is also due to write her driver’s test next week, so is concerned for the possibility of what would happen if she’s no longer able to drive.  As a matter of safety for both them and others on the road, if she’s not able to pass then I agree it’s better for her not to be driving, but it would be just one more freedom taken away from them.

Of course as an “outsider”, I can see many advantages of placing my grandfather in a home:  ensuring he has round-the-clock care and supervision; activities and social contact which will help to engage him and keep his mind working; and of course the relief this would provide to my grandmother, not having to constantly keep her vigil over him to feed, clothe and otherwise care for him.  Even the simple luxury of her being able to get a full night’s sleep every night.  She’s barely able to keep up now and certainly won’t be able to continue a whole lot longer.

I can also see the sadness and heartache this same decision brings.  Putting him into a home and separating, even temporarily, from her life’s partner would no doubt be sad and frightening.  Coming to terms, face to face, with your own and each other’s mortality would also be difficult.  She knows that somehow moving to a Long Term Care facility is the “last stop”; it makes you come face to face with the idea that you’re nearing the end of the line.

In pitching to her the “plus side” of going into a home this morning, I made the statement that I think if it came to the point where my and/or my spouse’s health was such that we couldn’t look after ourselves or each other any longer, I would be glad for the opportunity to go into a home.  I said that I think I’d look forward to being someplace where all of my needs would be taken care of and where I’d have a social community to be part of, even if I couldn’t get around like I used to.  And I said I should write that down so that “mark my words”, I’ll remember it in the event that I find myself in their shoes one day.

So here it is.  My words, marked.  Written down in the voice of a thirty-something granddaughter who is still blessed with her health and all the rest of her faculties (relatively) intact.  Will my opinion stay the same, thirty or forty or more years down the road?  Only time will tell.