My 94-year-old neighbor, Casey. is one of the most active people I know. She is up and in her garden early in the morning before I am even out of bed. She belongs to 4 bridge groups and plays many afternoons either at her home or one of her friends. She now lives in a 55-plus independent senior living community. Before that she lived in one of the nearby neighborhoods, so she has many friends all over the area.
Casey is not afraid to drive the freeways or neighborhoods on the other side of the city. She knows what she wants to do and she does it. In addition to her gardening and bridge activities, she also plays Euchre one evening a week and sometimes comes to afternoon dominoes games. She also serves as driver for others nearby when there is a community dinner or other activity.
In the past few months, however, Casey hadn’t been feeling well. She continued to garden and play bridge, but said she was often breathless when she took a walk or even after some shopping or gardening activities. She visited her doctor about this and he scheduled some tests. She had breathing tests and an angiogram and no cause could be found for her breathlessness.
A week ago she again called her physician because of breathlessness. He told her to check herself into the local hospital on Monday. “Oh, I can’t go in on Monday”, she said. “I have a bridge game here that afternoon.” So she cleaned her house and entertained her friends. Then she called her out-of-town daughter-in-law and told her she would check into the hospital on Tuesday.
Her daughter-in-law was here watching over Casey all week. Casey stayed in the hospital for 3 days and then discharged. The doctors tried more tests – upper and lower GI to see if she was bleeding – because she was severely anemic. She was given a transfusion and felt much better after that.
While Casey was hospitalized, her DIL stayed in her townhouse. We talked in the evenings and DIL told me how frustrated she and her husband were because Casey refused to move near them. DIL realized that since she and her husband lived in a rural area there was nothing for Casey to do there all day. They knew Casey was active with bridge and other activities and thought they might be able to find others for her to play with.
One evening Casey’s daughter-in-law told me that evening she would call Casey’s sons and they would have a family meeting by telephone. They would insist that she move to the rural area with her son and daughter-in-law. I wondered if Casey would be willing to go along with that.
When Casey was discharged from the hospital the doctors still didn’t know what was causing her problems. She was back to her own townhouse and her daughter in law returned home. Several days later her son came and took her to his home for a previously planned family reunion at his home. She plans to return to her townhouse tomorrow
I have been thinking a lot about this situation as it reminded me of when I wanted mom and dad to move by me. Before they suffered from dementia they had lived on their own for decades. I had no way to convince them to move near me and they stayed on their own, traveling from north to south with the seasons.
Although I wanted them closer to me when mom’s health began to deteriorate, I was never able to convince them to move. I believe in autonomy as long as the elder is mentally able to make their own decisions and physically safe in their own home. It wasn’t until mom’s health and mental capacity quickly deteriorated that I was able to convince both mom and dad to move to an assisted living facility. At that point I felt it was necessary because they were unsafe due to mom’s inability to tell dreams from reality, to count out their own pills and to stay out of the emergency room.
As I spoke with Casey’s daughter-in-law last week, I found myself thinking that they should not just have a family meeting and decide what Casey should do. They needed to include Casey because her mind was still healthy even though her physical health was deteriorating. She is aware that she is vulnerable all alone. However, she has many active friends who have been looking in on her and driving her to the hospital when necessary.
I don’t know what will happen next for Casey. I know the family feels like they need to do what is best for her and I see myself in their concern. But I also know what a strong woman Casey is and I wonder about how this decision will be made. If Casey insists on staying here, her family will be understandably concerned about her health. They know they would have to drop everything and come here again if things go terribly wrong.
At 94, Casey can’t expect to live independently forever. But I can’t help but wonder if they have explored all the alternatives. If she is financially able, she might be able to get some home health care or even move to a nearby assisted living facility. By staying nearby, Casey would be able to continue playing bridge with her local friends as long as her health allows.
Since no one knows if this is “the beginning of the end” as her daughter-in-law fears, this is a difficult decision for the family. I am hoping that Casey and her family can make arrangements that are satisfactory for the whole family. What decision do you think would work out best for Casey and her family?