Reading Time: 4-5 minutes

I just finished reading an interesting discussion about CCRC’s (continuing care retirement communities), on my favorite other blog, The New Old Age .  I did comment on that blog, but think I need to write an entire post on the subject.

CCRC’s allow people to move from independent living to assisted living, to skilled nursing within the same complex.  In my experience there are two big advantages to CCRC’s.

1. You will know where you want to move when you need more help.  By the time it happens you may be less mobile, less alert, and less able to decide.  Deciding for yourself while you are still sharp is a good thing.

2. Geographically, you are closer to your friends who may live in other parts of the complex.  Spouses visit every day.  As transportation becomes more of a challenge, being able to walk (or roll) to see your friends or spouse becomes very attractive.

The reality is not so easy or clear.

Several years ago I went to see my folks in their independent living apartment.  Mom shocked me when she answered the door.  She had broken glasses, a black eye, several cuts and scrapes on her face and hands, and a lump on her head.  Mom is pretty deaf and also has Parkinson’s Disease.  Her Parkinson’s seemed particularly bad that day.  She tried to fake “perky”, but it was obvious she felt awful.

My father used a walker or a wheel chair to move about the complex.  It turns out that when he moved about the apartment he just asked Mom to help him transfer.  On this occasion she was helping him to the toilet.  He lost his balance sitting down, grabbed for her, and fell on top of her to the hard bathroom floor.  My father was fine.  He had my mother for a cushion.  Not only was Mom hurt, but NEITHER of them had called to tell me or my siblings.  The fall had taken place two days earlier!

Many people who are aging will hide their diminishing capacity from themselves, their friends, their children, and even their doctors.  It is natural.  None of us want to admit to increasing frailty; but that is not the biggest problem.  The BIGGY is that we are all terrified of losing independence.

My father was perfectly happy to have my mother as his full-time caregiver.  He was like a big, greedy baby.  My mother had no ability to say “No” to him.  The five children were perfectly happy to allow Mom and Dad to take care of each other.  Boy! Was that convenient, or what?  My wakeup call came the day of that visit.

After much discussion between the siblings and with the parents, the children insisted that Dad move to the assisted living wing.  Mom told us privately that she could not support Dad physically any more.  She could not tell him this to his face.  The children became the tough guys and insisted on the move.  Mom cried with sadness, guilt, and relief.  Dad was furious with all of us, but truly enraged at Mom. I am sure he was also frightened.  Getting old is very complex.

After the move Dad was quite disoriented for a while.  The family learned, in time, that any move  was disorienting for both.  Mom spent all day, every day with him in the assisted living wing.  She hated it.  The residents were not good conversationalists and it was a very depressing place. She also ate her meals in the assisted living wing because residents were not allowed to eat in the dining rooms of the other wings. There were good reasons for that, but it meant that Mom, too, was separated from her friends in the independent living wing. In time, Mom did eat breakfast with her friends.

Things calmed down, eventually, but Dad never forgave us.

There is also a myth about being able to CHOOSE when you need to move to the next level of care in a CCRC.  About a year after Dad moved to assisted living, the administrator for the complex informed me that the assisted living caregivers could not cope with Dad any more.  He either had to move to the Alzheimer’s/Memory Impairment Wing or move away to a skilled nursing facility.  This particular complex did not give skilled nursing.  He moved to the Alzheimer’s wing for a while but required skilled nursing 24/7 within the year.  He refused to speak to my mother after the move to the Alzheimer’s wing.  She continued to spend her days and most meals with him there.  She remained in her independent living apartment after he moved away for skilled nursing.  She visited him daily for at least half of each day until he died.

My father received the best care and attention we could offer at each stage.  My mother went way beyond the call of duty.  She was the role model of a loving spouse.  I am sure she experienced many emotions besides love during this time, but she never showed it.

Knowing what I know about aging now, I would have provided different and better support for both my parents during this time.  I did the best I could then.  I wish I had understood more…sooner.

I digress.  This posting is about CCRC’s.  Logically, they make sense.  I might choose that route for myself or someone I care about.  CCRC’s solve the problem of the continuum of physical care.  They rarely address the emotional issues families face as an elder moves from one stage of need to the next.

Copyright TheNewElder 2012