Although most of us nearing old old age don’t often talk about it, even to each other, it’s a time of life that necessarily brings thoughts of what could come next. As prepared as we may feel ourselves to be, both emotionally and practically — such thoughts begin to impinge more and more frequently on our consciousness because of what we see happening to our contemporaries.
“I just never thought this would happen,” exclaims a woman I know. She is two years older than I am, with a husband nearing ninety, and two sons in their fifties not living in Princeton or anywhere near it who have children of their own still to educate. Both she and her husband had been professionals throughout their working lives and seemed to me somewhat better fixed than Bill and I are. When I met her about five years ago in a reading group, they were living in a free standing, well furnished house with three bedrooms, a study and a finished basement, as well as the requisite living and dining rooms and three full bathrooms. The house had an attached two-car garage for their two cars and was beautifully landscaped by the condo association to which they belonged.
But she was already losing her vision to macular degeneration that didn’t respond to drops. Soon after we met, she became legally blind and could no longer drive. They struggled on for about a year with the husband driving wherever they needed to go. Eventually, however, they had to move to a retirement community that provides transportation to doctors, hospitals, supermarkets, shopping centers and, on notice, elsewhere in town. This was a huge downsizing — to a one bedroom apartment with den.
However, she adjusted. The other residents were educated, many of them formerly affiliated with Princeton University, and there were activities within the main building to get her out of their small apartment and keep her occupied with lectures, movies (which she could still more or less see), and a small gym with physical trainer. As for reading, first she read with a magnifying glass, and then only books she could obtain on Kindle, where you can increase the type size to 16 or 18. (It slowed down the reading, but she was determined.) Finally she needed a machine under which you slid the Kindle or iPad to magnify it still further. She could no longer see well enough to review bills or write checks. It became hard to communicate with her by email.
A year later, his emphysema took a turn for the worse and he was put on oxygen. They gave up the remaining car to a grown granddaughter. He was willing to use the oxygen at night when he slept, but not the portable one to move about the main building — which made it more and more difficult for him to reach the dining room. He had to stop to catch his breath and rest on benches strategically placed along the corridors, sometimes falling asleep while he sat there.
One Sunday afternoon, when out to lunch with one of their sons, who was visiting, the wife tripped getting out of the car. She had a heart attack and a stroke which left her mind intact but resulted in a useless left arm and leg. They took her to Philadelphia for cardiac surgery; she then went to a rehabilitation clinic where with hard work, she has managed to recover sufficient use of the left leg to walk slowly (although not too far) and to hang light bags on her left arm but not do much else with it.
She’s now back in their retirement community apartment. Because of her incapacities, she has to have home help from 9 to 3 every day. It costs $25 an hour, or about $4,500 a month over and above all their other living expenses. After an initial period when it was covered, this cost has been coming out of pocket. Three months ago, her husband’s doctor put him under hospice care. This means it was then thought he would not survive more than another six months. Hospice pays for two hours a day of home care (as well as a visit every few days by a registered nurse). However, his doctor believes he needs round-the-clock assistance, because he keeps trying to get up to reach the commode every other hour of the night and falls. His wife, obviously, can provide no physical help at all. This means another sixteen hours of home care per day at $25 an hour.
She telephoned me in despair last week. Money has been flying away at a frightening rate. She’s had to authorize their broker to liquidate funds they never thought they’d need to touch for such a circumstance — including roll-over IRA funds that are taxed after being distributed (so you have to take out more than you need to keep the amount you want after paying taxes on the whole of the withdrawal).
And the scary part is that her husband is doing well!
“What does that mean?” I asked. “He’s getting better?”
“No,” she said. “But he’s stable. His vital signs are strong. He eats. His brain seems clear when he’s awake. Three months of the six are gone, and he’s not any sicker.”
She means he’s probably not going to die in the predicted three months. The round-the-clock care may go on, and on. She is looking into the possibility of saving some money by replacing the current system of hourly home care with a live-in person; it may be slightly cheaper, but not much. (Moreover, it might not work if he keeps waking so often at night; a single live-in person would get no sleep.) Bottom line: the longer he lives, the more his home care depletes their savings, and the less is left for her own survival afterwards.
Who ever thinks the time will come when you might have to worry someone with whom you’ve lived for sixty-four years won’t die before you run out of money?
ON BEING OLD 
Oh dear. And all that money as well. I am tempted to return to Finland as Helvi never relinquished her Finnish nationality. Most of the needs for the elderly are entitlements that society needs to pay for the same as for education.
Australia too is alright if you have the money, but if not…the urine scented retirement village, sleeping in a dormitory…
I know this is of no help,Nina. I hope all stays well and reasonable for both of you.
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Thank you, Gerard. I too hope all stays well for us. (But I’m sure my acquaintance did too.) However, you and Helvi are sufficiently far away from what I call “old” old age, not to have to worry about such stuff for a while.
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Dear Helvi and Gerard
“Kiitokset Gerulle mielenkiintoisista artikkeleista. Helvi, sinulle
haluan ilmoittaa Laina-tädin poismenosta.
Hän nukkui pois 6. pnä helmikuuta aamulla aikaisin. 16.4.2016 olisi
tullut sata vuotta täyteen.
Terveisin Sirkka”
This we received last night,Nina, telling us Helvi’ eldest aunt (her mother’s youngest sister) has died, two months short of 100 years.
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This is quite the thoughtful piece, Nina. I guess life continues to throw us curves no matter how well we think we’ve adjusted to each “new normal”.
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It certainly does, Isabelle. Thanks so much for commenting.
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Nina, yes, scary! The what ifs are scary enough, but the real medical stuff is even scarier! It’s happening already in my family, and it’s going to get worse. Looking ahead too far is depressing. It comes down to a hope and a prayer to hang on to good health as long as possible! Good health to you! Happy Valentine’s Day! 💝 Elizabeth
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You said it, Elizabeth! Happy Valentine’s Day to you, too. ❤
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Declining health is my biggest nightmare. It doesn’t run in my family except for one aunt with Alzheimer’s. Most everyone else died instantly or within months of onset of whatever. There is more opportunity to prolong life these days. That is both comforting and scary. My husband’s mother died a few months before she would have run out of her money (she’s the one who lived at Penn’s Woods). The last eight years of her life (after her major stroke) were confined to a wheelchair, blindness from macular degeneration and an increasing dowager’s hump. She was close to 100 when she passed. I wish your friend well.
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It is a nightmare. I was depressed all the next day after writing it, and only Scalia’s death has distracted me. (As a retired lawyer, I am perhaps particularly interested in the forthcoming Senate battle between Republicans and Democrats over his seat.)
Your husband’s mother was fortunate in having enough money to live out the last years of her life, however disabled, at Pennswood. It is extremely expensive — not so much so in the cost of moving in, but in the monthly charges. Even if Pennswood were our choice, Bill and I would not be able to afford it for more than a couple of years, which means we wouldn’t pass their financial means test for acceptance.
Thank you for your good wishes for my acquaintance. Unfortunately, and paradoxically, the best long-term outcome for her may be that her husband pass away sooner rather than later.
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Well dear friend, this was quite a CHEERY blog for Valentine’s Day…and a real heavy dose of reality! As a member of
the approaching old old club (I’m just turned 84) I also
have been thinking about the end approaching. Many of my
friends in the 80’s club are still fairly OK, with a large sprinkle of ailments to go around, but still moving and doing. Being diagnosed a year ago with a serious illness did bring
reality right up to my nose…but I am doing fine at the moment. So what do we do??? Drink the hemlock? This is the dilemma–so we all trudge on in our various stages of losing many of the abilities we took for granted. Amazing, thinking of your friends in your blog, how many of us struggle and
work at overcoming “stuff”…its inspiring and rather moving.
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Nothing particularly cheery to report from the land of the old old, Rita, which you obviously already know. But as I broached the blog topic of “The Year of Crossing Over” (YOKO) a couple of posts ago, it seemed I ought now and then to acknowledge the darker motifs beginning to color my life as I age. Sorry if you found it depressing. It depressed me to write it, too.
Yes, the desire to live, despite increasingly crippling obstacles, is indeed moving. So let’s lock up the hemlock and continue to trudge, if not exactly skip, towards wherever we’re going. Maybe we’ll be so lucky as to pass away in our sleep after a pleasant convivial dinner, like Scalia, with our hands laid neatly on top of the coverlet — not causing undue trouble and worry for our immediate families.
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You articulated many people’s fears. And the younger generation’s who try to care for their parents as well. Declining health and the ridiculous amount of money needed for home care (in the U.S.) must be planned for. We want to sweep our silent fears under the rug. Thank you for talking so specifically about this issue.
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And thank you, Barb, for your thoughtful comment.
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A difficult post to read, as much as to write – but from the heart and tackling a subject which is of increasing concern to those getting older, and particularly those already alone (ie, without partner) and getting older. As you so often do, Nina, with such spirit, you force us – in a good way – to see the realities.
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Thanks, Julie. For most of us, the end of life promises to be no picnic. Best not to look too long in that direction, though. It’s like staring at the sun blinding you. Focussing on dying can blind us to the pleasures remaining in however much life is left to us.
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Yes, this is what we need to talk about. This is real. I’m 20 years behind it but I see it with my parents. And I see it waiting for me. It is scary.
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It is both scary and real. It’s also a political question, which doesn’t seem to get covered with any specificity, even in this crazy heated election year.
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Very scary indeed!
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Yes, Hilary. Not much more to say….
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