I began working in the senior living industry almost four years ago, and haven’t looked back since. I love everything about it. But like most professionals, I strive to maintain a well defined barrier between my home-life and work-life. But maintaining this barrier isn’t always possible in this field. For example, my grandmother, Lola, has lived at an assisted living community in the suburbs of Seattle for about a year and a half now.
On a rainy Saturday the weekend before Halloween, I visited her at her assisted living community for only the second time since she moved in. In fact, I hadn’t seen her in nearly a year. The reason for the lack of visits isn’t distance. Her community isn’t far from my home. Nor was my absence due to heartlessness or selfishness. Quite the opposite: I cherish my grandma and would have been eager to visit more. I stayed away for her own well-being. The staff at the facility, as well as the geriatrician my family hired to help my grandmother adjust, both stressed that family visits actually tended to upset my grandmother, create unpleasant episodes, and generally set back her adjustment. Until she had become acclimatized to assisted living, we were to keep visits brief, infrequent, and low-key.
Moving: No Easy Answers
My grandmother’s distress stemmed from her insistence on remaining independent, and an abhorrence of the concept of being put in an “old folk’s home.” This shouldn’t have come as a surprise. She’s fiercely independent by nature. For example, during the Second World War she was among the first women accepted into the military, volunteering to serve in the U.S. Navy as part of the WAVES division. After the War, she married another Navy sailor, my granddad, and started a long and successful career as a nurse. She raised three children, and later barely survived cancer as a young mother. But by her late 80’s she was widowed, with her three children scattered across North America. It was obvious to everyone except her that she could no longer live alone safely. Her memory loss, while not extreme, was becoming more alarming. She forgot appointments, fell prey to a few senior scams, and called an ambulance every time she didn’t feel well.
Her children had tried repeatedly persuade her to move, offering to host her in any one of their homes, or to find a nice senior community for her anywhere she’d like. After much debate, and invective directed at her children, she’d relent and agree to one of the many reasonable options presented, only to forget the next day and insist on staying put. These troubling skirmishes went on for months, with scorn portioned out equally to her three children, who she accused of betraying her, or scheming to collect her mostly imaginary fortune.
Sometimes my family, knowing I worked in senior care, would ask me for advice: “How do we get Grandma to move when she’s so resistant?” This is also one of the most common questions I was asked when I advised families for A Place for Mom. Unfortunately, there are no easy answers. There are no secret solutions. Ultimately it comes down to the art of persuasion, unless you’re willing to consider the last resort option, which is petitioning the court to declare your loved one incompetent and requesting that they grant a family member guardianship. But no one wants to do this. It’s an ugly and expensive process that no family pursues unless there truly are no other options. But thwarted and fearing for my grandmother’s safety, my family was nearing this point.
Tough Transitions and Heroic Efforts
Just when it had seemed that efforts to persuade my grandmother to make a change had utterly failed, and that an unhappy stalemate had been reached, an opportunity presented itself. My grandmother required a minor surgery, and would be rehabbing at a nursing home that offered assisted living on the same campus. Her children discreetly arranged for her to be moved from rehab to an assisted living apartment on the same grounds. A seamless transition was coordinated.
Exceptional efforts were made to ease her transition. For example, her home was practically replicated within her new assisted living apartment. The bedroom in her assisted living apartment was made to look just like her bedroom at home; her reading glasses and a Bible were on the nightstand, all the photos were in just the right places; it was a perfect reconstruction. The living room was similarly cloned.
Despite these exceptional efforts, my grandmother’s transition took time. As mentioned before, family visits would set her off. She also had issues with sundowning. For the first few months after my grandmother moved, my family had to pay someone to sit by her door in the evening keep her from wandering the halls at night. (This was necessary because she lived at a regular assisted living community rather than secured memory care.) Sometimes during her more lucid moments she’d call her children and accuse them of having abandoned her, frantically asking about her house, and when she would be moving back home. I still don’t know if she understands that her house was sold to pay for her care.
As the months passed by, my grandmother grew more accustomed to her new home. Her mood improved and her memory loss had, at least for now, stopped getting worse. The angry phone calls decreased. We no longer had to hire someone to keep her from leaving her room at night. We learned that she’s even made some friends, and is among the small, self-appointed committee of residents who welcome newcomers and try to help them feel at home. In short, she had become an assisted living success story. She had made excellent progress and was ready for a visit that was neither brief, nor low-key: her 90th birthday party.
Successful Celebration or Awkward Nightmare?
My Aunt Karolyn sent a chic looking invitation several weeks in advance, and I marked it on my calendar. October 27th, 4 pm at her assisted living facility: Lola’s 90th birthday party. I was certainly eager to see my grandma, but I was also a bit nervous. Despite the progress my grandma had made, what if she had some kind of episode? Would something or someone upset her? Would it be intolerably awkward? Would she ask about the house? Despite my fears, I realized all I could really do was maintain a positive attitude and hope for the best.
So October 27th came, my partner and our six-year-old daughter, Lola (who incidentally is named after her great-grandmother) arrived at the sprawling senior community on a dark drizzly Pacific Northwest afternoon. My daughter asked, “How old is Grandma Lola?” I told her she was 90.
Lola said, “Wow! That’s about as old as a person can get.”
We entered the community and were greeted by a friendly woman staffing the front desk. “Right down the hall and to the left,” she says. She directed us to a large event room with balloons, streamers, and about 25 relatives, many of whom had aged considerably since I saw them last. Some of them struck me as candidates for assisted living themselves. My parents were there too, of course, themselves in their mid-sixties, although not yet retired. And finally, there is the guest of honor: my grandmother, Lola. I can tell right away that my fears were unfounded. She’s simultaneously merry and composed, just as I always remember her.
After greeting my relatives, my Aunt Karolyn handed me a bag of candy, which I ripped open up and begin to eat from greedily. But between bites I notice that these were not ordinary M&Ms. My grandmother’s portrait, both as a young lady, and as an older woman, have been rendered into line drawings and printed on each and every candy. This strange gimmick was enough to amaze me, and just about everyone else there, and I quickly found it was much safer to chat with my various relatives about the novelty candy than the upcoming election.
“Nothing Like Those Old Nursing Homes”
My grandmother seemed to be enjoying herself, and genuinely pleased with the evening. She said with a smile on her face, “This is really great. I wonder who went to all the trouble to set this up?”
“Karolyn did, Mom,” my mother told her. My grandmother repeated the question throughout the evening, a subtle reminder of her memory loss, and an affirmation to the family that she did indeed need to live at assisted living.
I asked my grandmother how she liked the community, “Oh it’s very nice,” she said. “It’s nothing like those old nursing homes.”
Cake was served, although wine was conspicuously absent; someone had apparently decided there should be no alcohol. The evening passed happily and uneventfully. There were no episodes, and my grandmother only asked about her house once. As the evening passed, relatives gradually departed. Around eight it became apparent my grandmother was getting tired. We prepared to walk her back to her apartment. She had been given far too many flowers to bring back to her living space, so she picked a few favorites that we carried for her. Once back in her apartment, she sat on her sofa, yawned and said, “That was wonderful. Who went to all the trouble to set it up?”
“Karolyn did,” my mom told her.
Finally, the rest of us said goodnight and headed our respective ways into the rainy night. I think each of us was glad to see that my grandmother had a genuinely happy birthday, that her health is holding up, and that she’s finally feeling home at assisted living. I look forward to visiting again soon.