Elderly Crossings

Submitted by Jerry on Wed, 08/06/2008 - 01:56

A Path to Another Country Psychologists say that moving, divorce, and the death of a loved one are three of the most difficult life transitions. Have they measured the difficulty of moving to that other country, the land of the aged? The lucky ones have caring relatives and friends or can hire professionals to provide help and emotional support during the difficult transition. Others muddle through with help, if they are fortunate, from competent, caring professionals.

What about living in elderly housing on a restricted income? Surely that is in "another country," to borrow the title of Mary Pipher's insightful book that seeks to help elders and their children bridge the age divide. In that country, the pedestrian crossings are marked "Elderly Crossing." Not that the drivers pay heed. They are too busy texting or talking on the cell phone, driving along without looking where they are going. They claim surprise when they run down an elderly person in a crosswalk (as quoted in a news report, the driver looked up and suddenly the pedestrian appeared). Survivors have learned to wait for the cars to stop and while walking across they watch the eyes of the drivers.

Home for the elderly

Families based on Old World traditions used to have three generations living under one roof. The new adult generation would become masters of the home and farm or business, and the seniors would gradually do less of the work but be assured of a home.

Modern life has created a variety of new lifestyles, with children often living quite far from parents, unless they return home during times of adversity. But for many years most parents in the United States have been unable to count on their children for a place to live.

People with money for retirement have a wide range of options, including facilities providing comfortable and even elegant styles of independent living, assisted living, and more. Not everyone is so lucky, however, and indications are that many of the baby boomers are not well prepared for their old age.

Whether by choice or by circumstance, the elderly couple or individual who must leave their home and relocate is faced with emotional as well as financial challenges. Many of the options are like a return to a student dorm. The treasured belongings and memorabilia of a lifetime that may fill perhaps a Victorian home with an attic, a cellar, and a garage will not fit into a one- or two- bedroom or a studio apartment. Can a loved pet be accepted in the new residence?

Subsidies

For people lacking in financial resources, or unable to maintain a home of their own or live with family or friends, they may find shelter in subsidized elderly housing. Many towns maintain a stock of housing for the elderly; rents are often reasonable but the wait times can be months or years. Private market-rent apartments are a possibility, but often too expensive for the retired person. Some elderly housing is a mix of market-rate and subsidized apartments.

In theory, government subsidies such as the so-called "section 8" are available to pay a cooperating landlord two-thirds of the market rent. In practice, however, the waiting lists are extremely long--measured in years--and funding does not keep pace with demand. Again, in theory, an individual could qualify for a personal "section 8" subsidy that could be applied toward the mortgage of a home. This method is even harder to realize in practice. And finally, some nonprofit and for-profit organizations build, own, and manage elderly apartments for rent at below-market rates. These are based on "section 8" as well as on various tax benefits that encourage investment in such housing. At least the rich investor can profit from poverty, although support for management and staff may be parsimonious.

Adjusting to new situations

Those low-income elders who are lucky enough to get subsidized and/or "section 8" apartments, and who have been in control of their lives suddenly find themselves having to adopt to rules set forth by others. If they need advice, emotional support, or financial help they are suddenly beholden to young people who may or may not have appropriate training. Social agencies charged with helping the elderly are severely underfunded, with insufficient resources to meet the needs of their clients. And the elderly are underfunded: Social Security alone is not enough to support a decent life in the U.S. today.

The people who have cars and can afford the upkeep, and are still capable of driving, can carry out errands and activities on their own schedule: shopping, a museum, a trip to the park, a doctor's appointment. Where help is provided, it must be sought and scheduled. The town may have a fleet of cars and vans to provide rides. However, one must shop on the day the van is scheduled and at only one of several possible shopping centers. One must schedule a doctor's visit at least three days in advance. To use public transportation--where it exists--one has to research the routes and schedules and work out connections. Suddenly, an errand that might have taken 40 minutes round trip by car, becomes a three-hour trip including waiting outdoors. Taxis are prohibitive in cost on a senior's budget.

The social life of the benches

An apartment building full of elderly people--all capable of independent living--becomes a strange kind of village. Think a thought and everyone knows what is on your mind. Sit with companions and hear the same stories of long-ago events told with relish, time and time again. Hear the gossip, too. Over, and over, and over. Recall the friends, neighbors, and family who have all died.

Sit on the benches at the front of the building, enjoy the sun and the shade and the breeze, try to stay upwind of the smokers, and enjoy the benefits of international travel without moving. By this I mean, listen to the babel of languages from people who are from immigrant origins: Finnish, Greek, Italian, French, Canadian, Dutch, Palestinian, Israeli, Portuguese and more. Nearby are restaurants, take-out shops, and bakeries: Greek, Portuguese, Italian, Brazilian, Chinese, and more.

Money and health

And then there are the financial realities. Sitting on a bench, enjoying a warm summer's afternoon, one learns that a companion is planning on popcorn for supper, another is planning bread and water. Hard to tell is this some kind of reverse snobbery, or an honest sharing? Some of the residents have a repertoire of one-liners and comic routines, they feed each other straight lines like aspiring professional comics. Most likely "eating popcorn" is a joke that plays on the worries of many elderly. What is behind the joke (if it is only a joke) is a painful reality. The social security checks haven't yet arrived. People don't have enough money to make it through the month, literally. They may take advantage of lunches provided at nominal or no cost, receive "Meals on Wheels," but still be unable to eat well. Or their food stamps have been cut and they haven't figured out a new strategy. Or they may not know their options, may not want to be "dependent"...who knows?

Given the state of health care, is it any wonder that even the apparently healthy have problems? One man mentioned that his doctor sent the results of his tests and marked the cholesterol results as "Bad." The man said, "I don't even know what cholesterol is! What kind of food is that?" Clearly, his doctor is not taking the time to educate him or refer him for nutritional counselling. His friends ask, "Well, what do you eat usually?" He answers, "Oh, a cheese omelette for one meal and eggs for another." And popcorn for supper.

Fears

One of the worst parts of living alone is the fear of injury and not being able to summon help. Several residents have had strokes or fallen in the tub or when getting out of the tub. One lady tells of lying in the tub, helpless, for two days, before friends missed her and rescued her. Some people wear an emergency call button.

The building has a kind of social history, with stories about events and people, old friends and antagonists that have moved away or passed away. And so many other rumors and fears bordering on a collective paranoia, reinforced by the telling and retelling of anecdotes. One wonders why there are TV cameras covering all the public areas including hallways, is it only for security? You worry what will happen if your pet were to violate one of many rules. Worry that a neighbor will be convinced that YOU are moving furniture in the middle of the night in order to disturb his rest---and that you will be written up by the management office.

Living together

Residents also have a number of other centers for activity. For example, one room has a small library and tables on which are laid out one or more large puzzles. Several people spend hours each day assembling the puzzles. The coin-operated laundries are another social center. A weekly meal in the large social hall is served by staff and volunteers. A large new TV may provide a common interest focus, although residents anticipate the possibility of conflict and disagreement about what to watch. One evening a week there is a Bingo game that is well-attended.

Some residents have developed close and supportive relationships with friends who live in the building. They may visit back and forth, cook for each other, and gallivant together, going into town for a restaurant meal or a shopping expedition. Some people have close relations with their families, and frequently receive visits by their children and grandchildren, and the residents may go out to visit their families. Nurses and home health aides are also regular visitors to people with health problems and disabilities. Although the apartments are for independent living, several people use wheelchairs or walkers. And a social worker is available once a week. So it is likely that some people can delay moving to an assisted living facility because of the available support; or there may be no assisted living option available for them.

Difficult times

Regardless of age, these are difficult times, reminiscent of the Depression years of the 1930s. Even healthy, successful people in middle age can find their lives in turmoil. Buy a home at the top of an inflated market and watch as values fall and foreclosures rise. Be a middle-aged, successful family and have your home hit by an explosion and a flood, be bankrupt, and unable to get a car to drive to work. How much more perilous the situation of an elderly person unable to sell their home or without adequate savings.

And it is better than living in a spare bedroom through the decency of a friend. Imagine a person who has moved to a new area and is unable to find work. He bought a beautiful loft apartment in a downtown area being gentrified, at the top of the market, and just before the bubble burst. He has worked at national levels in a couple of careers, but was unable to find work and at the same time had some health problems. He lost the apartment (which had become worth about half of what he paid), found a friend who let him store his furniture, and at least has a roof over his head. Now he works, without pay, for his landlord; almost an indentured servant.

Perhaps placed just where it is to remind you of your luck, not 100 yards away from the elder apartment building is parked a van in which a middle-aged woman lives year-round with her cats. She uses bottled water, seems cheerful, and well-nourished, and is well-dressed but she rarely leaves the van, although the van sometimes goes away for a few hours. One doesn't know what she uses for personal hygiene (toilet, showers). How does she register the car or get mail in a world that insists you have a fixed address? At least the local police don't harrass her.

Thus, whatever the issues, an apartment building for the elderly is still a godsend; clean, dry, well-maintained, surrounded by lawns, trees, and flower beds.

Romance

Most of the residents are living alone, and it seems that many of them have dreams of romance. As one woman put it, "This is like Junior High, everyone thinks and talks about having a relationship." The hunger for a connection, and for sex, is a constant topic. Often masked by irony and jokes, this need is always coming up. People retire to their rooms with a wry invitation, "I'll leave my door open." Talk to a person of the opposite sex more than once and you are said to have a boyfriend or girlfriend. It really shows the truth in the joke making the rounds: It seems that Jack and Jill were sitting on a bench at their retirement home. Jill asks Jack, "Don't I know you?" "Yes," Jack says, "I used to live in this town but I have been away for 20 years." "Where have you been?, Jill asks. "Well," replies Jack, "I was in state prison for 20 years for killing my wife, and I just got out." "Aha," says Jill, "that's great--that means you're single!"

More Transitions

It really is another world, and most people are OK once they manage to get past the initial stages--the "elderly crossing" transition that is a bit risky to go over.

There are other transitions and crossings to come. People who have lived in the building for some time have established a network of relations in the building. Others have lost a spouse, perhaps after 50 years of marriage, either in a moment or over a lingering several months; and they turn to their friends as well as family for support. Some who could live in their own home or an apartment in a mixed-age setting, instead choose to live in an elderly apartment building precisely to be close to others.

One afternoon (alternately sunny and dark with lightning and downpours) there is a flurry of activity as police cars, emergency medical response vehicles, and a fire engine arrive. I chat with two people sitting outside--perhaps they are residents I haven't met. My dog realizes at once that they are upset although they are quiet and tell me about the dogs they used to have. The dog repeatedly nuzzles them, but it takes me a while to realise they are related to the resident responsible for all the emergency vehicles. One says, "Why are they taking so long?" The other, "She has gone to a better place." It seems that one of the residents didn't answer her phone. She is found. She is taken away by black-suited funeral home staff, a small figure wrapped in a black bag, in a black hearse. Several residents sit together quietly for mutual support in a common room. The small, independent person who used to be a good companion at the weekly dinner is gone. May her memory be a blessing. Death is always so close but a surprise when it comes.

Death is the hardest transition for those who remain in life. The pain never ends, with time it becomes easier to tolerate. The death of a neighbor, or their move to another facility like assisted living or a nursing home, leaves a void. Their faces and their voices are gone. There is an empty space where before there was a person and a relationship. Do we remember the person who is gone? If one photographs everyone, will that help to remember the ones who are gone? "Get used to this," my friend tells me, "they move on and never come back." So the voids and the spaces begin to define life in the building. The longer one lives in an elderly building, the more we live in awareness of the ones who are absent. Those who are present are defined by those who are not.

With age comes an awareness of death, the constant frustration of physical ailments, the loss of mobility, and restrictions on activity. Some people accept that they are waiting to die, but seem to enjoy each hour as it passes. Others seem determined to live until they die.

It is a strange world, living with dozens of other elderly people. What makes it bearable? A small child with curly ringlets and a cheery disposition whose grandmother, a resident, cares for her during the day. And sharing with others. Making new friends. And keeping busy with one's own life.

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Photos ELDERLY CROSSINGS
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