AUSTRALIA: Taking Care Of Mum - Three Families Speak Of Their Choices

By Bernadette Clohesy Australia's aged population has more than doubled in the past 20 years and caring for elderly family members is an issue many face. Is it better for Mum and Dad to stay at home, move in with the children or shift to a nursing facility? Bernadette Clohesy talks to three families about their choices. MELBOURNE (The Age), February 4, 2008: My mother is 87 and still of very sound mind. She lives on her own and mainly cares for herself with a little bit of help from her large extended family (she has six children). We often tell her how lucky she is but she doesn't always see it quite that way She becomes frustrated by her increasing frailty; about all the physical things she can no longer do and the places she can no longer go. No matter the circumstances in which the elderly are living, this time of life is still extremely frustrating - and often very painful. Baby boomers (of which I'm one) are the sandwich generation, caught in the middle: juggling careers, caring for their own teenage children or even grandchildren, and trying to help their elderly parents as best they can. The most common emotion expressed here is guilt, as in, "I don't think I do enough for them." It's a problem that won't go away - thanks to improvements in medical care, people are going to live longer. The scary thing is, soon we (the baby boomers) will be joining the ranks of the elderly. While trying to make things better for our parents, we're looking ahead to what we'd like for ourselves. Leonie Toohey is 60. When she gave up work to help care for her mother, Ruby Coad (who died last month aged 94), she was a family support worker with the Department of Community Services. It nearly broke her heart when three years ago she placed her mother in a nursing home in Sydney's south-west. Then 85, Ruby's health had started to deteriorate and she could no longer walk because of the pain in her leg, associated with polio as a child. ``As I wheeled her away from the house she'd lived in for 60 years, I kept thinking: 'This is the last time she's going to see this house,'" Leonie recalls. "But I couldn't tell her that. Over the next two years, I can't tell you how many times she said to me, 'But how long am I going to be here?''' For the first four months, Leonie visited the nursing home every day in an effort to assuage her mother's grief at losing her old life. She gradually eased her visits back to three times a week and spent about four hours each time helping the nursing staff. Leonie knows the cost of such devotion: she quit work and has used all of her superannuation. She leased Ruby's house (because she knew her mother would hate her to sell it). But there was very little rent left after she had paid her mother's chemist, telephone and hairdressing bills, plus the $16.50 a day required - in addition to her mother's pension - to cover the accommodation fees. Leonie thinks the staff at her mother's nursing home did a wonderful job, but she is adamant she'd never want to go into a nursing home herself. "The level of care that is needed for the aged now will be just blown out with us baby boomers," she says. "I do not see how things can get better. My children will not be able to do what I did. I would like to see a raising of community awareness to a level that governments can see that funding needs to be higher and aged-care nurses need to be more adequately paid - and valued." Mary O'Mara, a counsellor and educator with Carers Victoria, helps people like Toohey cope with the trauma of placing a parent into residential aged care. She says it's not always as bad as we think it will be. "Our perspective is not the same as the elderly person's," she says. "Some people thrive in aged care facilities; they may have been lonely on their own; they might like the activities or to have a meal cooked for them. We can't take away the pain and frustration - no matter what choices we make. You want to fix things for your parents and you can't." The ideal for everyone seems to be to stay in their own home as long as possible. This is what Marie Owen, 87, is doing. Marie, whose husband Dudley died 19 years ago, has lived on her own in Melbourne since her youngest daughter moved out 12 years ago. About five years ago, life became more difficult for Marie, an intelligent, independent woman with a great sense of humour. She has a heart fibrillation problem and had a pacemaker fitted. She also has high blood pressure and problems with her legs, which limits her mobility. Marie's five children ­- Anthona, 65, Dennis, 63, Loretta, 56, Veronica, 53, and Theresa, 48 - contribute towards her wellbeing but most have full-time careers and some live more than 45 minutes away. So Marie arranged some extra services: home help from Southern Cross Care (a community-based non-profit organisation), which includes a carer; Ameda, who does house cleaning on a Friday (Marie affectionately calls her "my girl Friday"); food shopping on a Tuesday; and on Monday, someone brings in the bins for her. Frozen meals are delivered twice weekly from a gourmet food service. "They're lovely," she says. Marie also wears a medical alert around her neck in case she has a fall. All this assistance costs a total of $90 a week, deducted from her pension. "I know a lot of women my age who carry on, saying, 'I'm not having anyone doing my cleaning or shopping,'" she says. "And I think, 'Well, you're silly; your kids would have more time to spend with you.'" They do - her eldest daughter, Anthona Wall, 65, agrees. "She's pretty lucky with her family, really; we all visit often, bring extra food, do anything else she needs done around the house, and take her out. We all love her dearly and want her to keep going." "The worst thing about old age is that you are so restricted," Marie says. "You try to go down the road and get on the tram and it's just too hard." Although housebound, Marie has many interests. She reads The Age newspaper every day, does the crossword, has a huge collection of movies and reads everything - from classics to newly released novels and biographies. She's determined not to be a burden on her children, either. Anthona laughs as she recalls her mother's reaction when she told her about a three-week trip to Europe. "Mum said, 'If anything happens to me, I don't want you to come running back.' We laughed. It was an absolute reality but we weren't going to not come back if anything happened to her." Anthona and her siblings want to keep their mother at home as long as they can. Anthona is a volunteer with Meals on Wheels and has observed that people seem happier if they are in their own homes. Her mother agrees: "One of my friends was in a nursing home," she says, "but she died in July. It was very desolate in the outer suburbs; she had a nice room but [she said] to me, 'I'm here until I die.' I realise how lucky I am." It's not guilt that keeps Helen Johnson awake at night. The 45-year-old mother, who juggles three part-time jobs, is often still up, working. Helen lives in Traralgon, in country Victoria, with her husband, Peter, 48, an instrument fitter electrician, and their two sons, Jayden, 17, and Ben, 14. Ben was born with a rare syndrome called Rubinstein-Taybi; he has an intellectual disability and very high medical needs. But when Ben reached school age, he was bussed to school every day and Helen was able to go back to a much-loved three-days-a-week job. Then, 18 months ago, Helen's 79-year-old dad, Horrie Skinner, who used to live 90 minutes away on Raymond Island, moved in with the family. "Dad's emphysema was worse and he had to go on bottled oxygen on the island," Helen explains. "Then he had a fall and the television landed on him; he cracked a rib, and developed pneumonia. Finally, the doctor said, 'Horrie, I think it's time to consider a nursing home.'" Helen's dad turned to her, pleading, "You'll kill me if you put me somewhere like that. Can I come to live with you?" The family have made a lot of adjustments. "I used to be quite fussy with my housework," Helen says. "I liked things to be in their place. That's not possible now. We have a nebuliser and Dad's big chair in the lounge room, an oxygen tube running through the house and a ventilator in the dining room." Horrie qualifies for a federal government Extended Age Care at Home package (EACH), which funds his oxygen, pays for some house cleaning and entitles him to a personal carer three times a week and a range of extra services such as podiatry. Late last year Helen qualified for the National Respite Carer Program, which enables Horrie to have a worker call in each weekday, while Helen is at work, to check on him, make him a cup of tea and have a chat. Horrie enjoys living with the family. "Peter and I get on extra well," he says. "We're on different sides in politics and we have our little debates but we enjoy those." Peter is Helen's greatest ally in helping her manage her three jobs, her social welfare studies and family life. Peter does a lot of cooking and shares the washing. Jayden likes having his granddad around. "I see him every day now," he says, "and we always have a good chat. He keeps me up-to-date on the footy. Every now and then I have to stay home if Mum and Dad are going out, to keep an eye on Granddad if he's not feeling well." Helen says she can cope on four hours' sleep if she has to and doesn't regret her decision. She says it's in return for everything Helen's parents did for her (her mother died 10 years ago). "My mum and dad were great parents to me and my four brothers," she says. "They lived in NSW when Ben was born and moved back to give us a hand. I'll never forget that." Helen admits there may come a time when her dad will need to go into a nursing home. "I said to him, 'If you ever become incontinent, I don't think I could do this,'" she says. "I already care for one incontinent person [her disabled son], I couldn't do two. He said, 'Oh God, I wouldn't expect you to. Hopefully by then I won't know who or where I am.'" Growing older: the statistics of ageing in Australia * In 1986, there were 129,300 Australians aged over 85 years old. In June 2007, there were 344,900 Australians aged over 85. * In 2003, 167,000 people aged over 60 were in cared accommodation, while 506,500 aged over 60 received assistance from a friend or family member other than their partner. Source: Australian Bureau of Statistics Source: The Sun-Herald