Monday, February 15, 2010

Baby Boom Delusions and Solutions (Chap.1, Part 2)

See previous posts for background.

Deb’s daughter and stepdaughter arranged for a series of private duty in-home helpers. The first woman was good for the first few months and then began to skip days, show up late or leave early; but, she was always sweet to “Miz Chase” and Deborah liked her. The woman asked Deborah for a loan of $10,000, claiming that her husband “needed emergency surgery”. Deborah wrote her a check. The woman cashed the check but never returned.

The second woman lasted one week. The third, referred by an employment agency, turned out to be in the country illegally, had a drug habit--which she partially funded by fencing Deborah’s jewelry--and left the country before she could be arrested. Frustrated, the family hired bonded help through an in- home companion service agency. As Deborah’s confusion mounted and her memory slipped, the tag-team of companions had to be with her nearly 24/7 and the monthly bill exceeded $15,000. Because Deborah’s care needs were not directly related to medical treatment, Medicare paid not a penny. While well-to-do by most standards, Deborah’s nest egg could not stand a nearly $200,000 per year tab for trustworthy in-home assistance.

Her children might have pooled resources to keep her at home but they were already paying over 22% of their incomes to fund Social Security, Medicare and Medicaid. Their generation was financially struggling to fulfill the government’s entitlement program promises now that the entire living Baby Boom was over 65. It was rumored that FICA would increase another 2% in 2030.

After much rancorous family discussion, Deborah moved to an Atlanta assisted living facility. She left behind her spacious home with its beloved art collection, her craft studio, beautiful kitchen and peaceful screened deck. She gave her cat to her granddaughter because pets were not allowed at Heritage Gardens. She moved into her new small apartment an unhappy camper.

She hated the community dining room with its cliques of “ins” and “outs”, social butterflies and overly attentive gentlemen. She despised the cafeteria-style food. She wanted nothing to do with the group outings to local attractions, all of which she had seen before and several for which she had served on the boards or fund-raising committees. She only admitted it to herself, but the thought of returning to those local attractions as just another senior citizen shuffling off of the van was humiliating.

She made one or two friends, was attended to by the facility’s health and daily care staff and life for her scattered family returned to nearly normal. It wasn’t normal for Deborah and she developed clinical depression, a condition that went undiagnosed for over a year. Her doctor had no training in geriatrics. He mistook her symptoms as the natural state of the elderly. The woman that her children, grandchildren and friends visited and phoned during this time was a heart- breaking shadow of the vibrant woman Deb had been for nearly eight decades.

In March of 2030, Deborah’s daughter, by then living in Santa Fe, received a call from Deborah’s tax attorney. The attorney, a long-time friend was in the process of preparing Deborah’s 2029 return and had come across some banking transactions that were problematic and of no small consequence, nearly $80,000. She suggested that the daughter come to Atlanta right away.

Within the week it came to light that Deborah had been contacted via untraceable wireless phone by “Dr. Someone” (she just couldn’t remember his name) in Nigeria. He claimed to have gotten her name from the director of Deborah’s favorite charity, one that indeed did good work in Nigeria. The ”Dr.” indicated that there was a very large pool of money—Deborah thought it was $4 or $5 million, or maybe he said $45 million--available there, left over from an unfulfilled Nigerian government contract. If Deborah would just help free up this money he promised to give one quarter of the millions to the favorite charity.

Over the course of the next four months, Deborah wired $5,000, then $12,000, followed by $8,000, $35,000 and finally, $19,000. Each transfer was preceded by a call from the friendly “Dr. Someone” who assured Deborah that these additional payments were needed to take care of unforeseen bribes, a bureaucratic snafu or tax payment and that soon the charity would have its grand gift, thanks to her. He also assured her that she would soon get all of her money back with interest. Deb told her trust officer that these large checks were cash gifts for her grandchildren and children. Deborah had once been one of the most respected financial executives in Atlanta.

The money was never recovered; Deborah continued to insist that “Dr. Someone” was “such a nice man” and would never cheat her and she was livid when her daughter had Deborah’s phone number changed. For security reasons, the tax attorney was added to her checking account and did a daily on-line review of transactions. This trusted professional charged a pro-rated $250 hourly fee for this service. None of the government entitlement programs paid for this type of oversight or could provide someone who could do it cheaper.

The brain aneurysm did its damage late in 2030, just before the holidays. By this time, only one of her children remained in Atlanta. After the initial hospitalization, Deborah’s daughter and stepdaughter searched for a skilled nursing facility (nursing home). Deborah was now almost totally dependent. She could no longer communicate clearly, dress herself, go to the toilet on her own or transfer from wheelchair to bed. She was once a woman who ran 10Ks in support of local charities.

After a sobering tour of several facilities, the daughters selected the one that didn’t smell of disinfectant and urine. This “home” had the fewest residents aimlessly parked in front of common area TVs. The institution was pleasant looking from the street with well-maintained grounds and walking paths. Inside there were live plants in the sun rooms and common areas and the semi-private rooms had floor to ceiling windows that looked out onto small patios and gardens. Deborah’s roommate was bedridden and talked to unseen visitors while awake and even during her dreams. She had no idea who Deborah was day-to-day.

A nurse’s aide awakened Deborah each morning at 6:30. With nearly 100% of the nursing home’s aide staff turning over every year, the person who woke Deborah was often a new face with a new accent. Some aides were more patient with Deb’s physical deficits than others. All of them called her “Debbie” or “Darlin’” or “Honey” or “Suga”. None of them called her Ms. Chase and they spoke to her as if talking to a child. When they were angry, like when she soiled herself after they had just changed her into something clean, they spoke harshly. On these occasions, Deborah was frightened and cried. Some of the aides called her a “big baby”. During her career, Deborah had a reputation for speaking truth to power, it was one of the attributes that made her successful, but none of the aides knew of her personal history and they had all the power now.

In her one-piece shift with Velcro fasteners and her skid-grip socks, Deborah was wheeled to the dining room every morning at 7:00 a.m. She sat beside another woman in a wheelchair and both were fed oatmeal, always oatmeal, by one aide who spooned first to one and then the other. There were not enough aides to feed the residents who needed eating assistance one-on-one. Deborah hated the oatmeal. It was tasteless, always nearly cold and nothing like the delicious oatmeal that she used to make with a touch of brown sugar, wheat germ, fresh berries and a splash of half and half.

The aide who fed them talked to the aide at the next table and Deborah ate very little. Most of the gruel slid out the side of her mouth that drooped. Nevertheless, the aide was instructed to feed [them] “all of the oatmeal” and so the feeding charade continued until the bowl was empty. Much of the food slipped down the neck of Deborah’s shapeless dress. She had once been a superb cook and she still knew what good food was. What was shoveled at her three times a day in this fluorescent-lit, loud and confusing place was certainly not it.

On Tuesdays, Fridays and Sundays, Deb was wheeled to the shower room where someone would remove her skid grip socks, help her stand, strip off her dress and underwear and ease her onto a wet plastic bench where she steadied herself as the aide shampooed her snow white hair and washed her down. There was no dignity in this routine but it was efficient. Once, many years ago, Deb had redone her master bath with a large walk-in shower. She could still recall the pleasure of the slate tiles under her feet and the hot water coursing from two shower heads. In those years, showering efficiency was not a goal.


To be continued.


Observoid of the day: A nursing home bears little resemblance to your home.

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