The bad consciousness and feeling of inadequacy is for many of us reality when we are called upon to care for ailing, older parents. We are savages, hacking our way through often unchartered territory. It is difficult. We live far apart, are busy copying with our own challenges and have a hard time fitting yet another one into our lives. Our society allows for very little ‘spare’ time for emergency calls or care taking. Hollywood has made a film on the topic, ‘The Savages’. In it, two siblings played by Phillip Seymour Hoffman and Laurie Linney learn that their estranged father is in trouble, with bouts of dementia and aggression with nobody else to decide about his care, but them. Hollywood confirmed it – how to take care of older parents and the future of our own care has become a societal topic that needs to be addressed on many levels, from the social/political support for family care giving to long-term care insurance to the training and retention of elder care staff to the quality of residential care facilities.

AHWGO screened the ‘Savages’ at the last meeting in November. Donna Schempp, former director of the Family Care Giver Alliance in San Francisco led the discussion. Hollywood has gotten a lot right in this movie but could not resist making the period of care giving unrealistically short and making the siblings professionally successful in the end. Inspired by the movie the discussion touched on the following issues.

Planning Ahead:

Advance Health Care Directives are not a standard. It should be promoted by a concerted effort between government and health care providers. The general economic crisis has also impacted the financial health of Continuing Care Retirement Communities (CCRC).  Residents have lost money in the financial crisis and people postpone their entry into CCRC’s because they cannot sell their houses at the expected price. It is not clear if this will affect future contracts and fees. Ideas 42, a Harvard group is currently studying why people in the US do not buy life annuities, an insurance against the financial risk of longevity.

Having the ‘Conversation’:

The conversation about health care directives and wishes for burial services was triggered in the movie by the nursing home requirements for such information. There is never a right time for this conversation and it is easy to never have it. Yet with medical advancements it is more important than ever to clarify wishes at the end of life. Baby boomers having experienced the effect of such missed conversations with their parents should be more aware of the responsibility to be clear.

Nursing Homes and Care Facilities:

‘Green Manor’, ‘Valley View’ and the like are names that conjure up beautiful settings and serene surroundings. Many nursing homes and assisted living facilities borrow such names to assuage the bad conscience of children whose parents move there. Money is poured into the landscaped surroundings and outward appearance. Often it is only that and the name which distinguishes them from each other, the actual living units or rooms are standardized.  They are not designed for delight and other features that could alleviate the day to day challenges of aging.

Being Inside Life – Being Outside Life:

Scenes in the movie drove home how older adults tend to become invisible. Often it is about doing it ‘to’ them not with them. One incident can trigger moving from being inside life to being outside life. Caregivers routinely lack the training to recognize states of dementia and related needs of treatment.

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