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  • July 11, 2014 - Reflections

    By Jean S. Horner
    The other day while walking down a corridor in a public building, I saw what appeared to be someone walking toward me. On coming closer, I found it was my own reflection in a huge mirror. For a moment it frightened me. Somehow a full-length reflection of one’s self is a startling thing. ...

The Good Old Days

By John W. Kennedy
Feb. 19, 2012

Octogenarian Luella “Blue” Koelling gradually required more and more attention in her Sullivan, Mo., home from younger daughter Christine Williams, who lived only two miles away. For two years, Williams hired 24-hour private care during the week, usually people she knew from the church she attended, First Assembly of God in Sullivan. Typically, two helpers took 12-hour shifts each day.

Williams often dropped by before going off to manage a furniture store. After work, Williams devotedly stopped by to hear what new pains her mother wanted to talk about.

“Mother really enjoyed the attention,” says Williams, 64. “She would get irritated if I only visited once a day.”

On Friday evenings, Williams went to her mother’s home and stayed until Sunday evening, leaving Barry — her husband of 47 years — to fend for himself. Barry came over for breakfast on Saturday mornings.

“It’s hard to get anyone to work weekends,” Williams says. “And you’ve got to have a very understanding spouse.”

Barry understood. His mother lived in a care facility for five years before she died. Koelling’s other child, Arlene Allen, who lived 21/2 hours away in Nixa, Mo., tried to relieve Williams in caring for their mother one weekend a month, but she often traveled for her job as director of the Assemblies of God National Women’s Department.

With old age, Koelling’s medical problems — Parkinson’s disease, osteoarthritis and knee replacements among them — intensified. In the past three years she has endured spinal surgery, a shoulder operation and a stroke. She can no longer stand up without assistance or cut her own food.

“I never felt used or mistreated,” says Williams, who taught Sunday School to fourth-grade girls, as well as girls’ programs on Wednesday nights, during the ordeal. “I felt no resentment. The hardest thing was I felt like I should be with my husband a lot.”

The final decline

There are myriad examples of people living on their own into their 90s and functioning quite well. But a decline usually begins by no longer being able to drive a car, balance a checkbook, or keep prescription medications straight.

Commonly, an aging parent will be fine living alone until a life-changing event occurs, such as a broken hip. That can ignite a descent into less-active and more-dependent living, many times rapidly transitioning from cane to walker to wheelchair.

Virtually all who live long enough will need help at the end of their lives, whether that’s at 85 or 100. Relatively few among the aged die in good health, peacefully and unexpectedly at home.

“Our parents may have escaped earlier threats to their health — strokes, cardiac events, cancer — and lived longer than any generation before them, but eventually some things are just going to wear out,” writes Jane Gross in her book, A Bittersweet Season: Caring for Our Aging Parents — and Ourselves.

A drop in infant mortality, eradication of certain diseases, improved medical care, healthier diets, a decrease in smoking rates, and increased exercise all have played a role in boosting longevity to record levels. Yet the “oldest old,” who retired 20 years ago or longer, are apt to have multiple chronic illnesses, particularly Parkinson’s and Alzheimer’s diseases. According to the U.S. Census Bureau, those 85 and older are the nation’s fastest-growing demographic segment, accounting for 1.5 percent of the population.

If a person lives into his or her 80s or early 90s, more often than not that life will end in an assisted-living facility, nursing home or some other type of specialized group care setting. While middle-aged people may eat nutritiously, eschew tobacco, and exercise regularly, it is no guarantee their later years are going to be pleasant and free of pain. Contrary to rosy propaganda, 85 is not the new 65.

Upon someone reaching 85, it likely falls upon their offspring to make decisions on where the parent will dwell during that sometimes long, gradual decline in health of mind and body.

James M. Houston and Michael Parker, in their book A Vision for the Aging Church, say adult children and aging parents usually wait until a health emergency to devise a caregiving plan.

“In most cases, caregiving requires considerable preparation because people are living much longer with a variety of health challenges,” Houston and Parker write. “Most people spend less time planning the last season of their life than they do organizing their next two-week vacation.”

Experts agree there are multiple benefits to an elderly person staying in his or her residence. Children must negotiate the proper time to exert more authority in the role reversal of caring for their parents, who may need to be spoon-fed pureed food and have their disposable briefs changed.

“If you take charge too soon, you will patronize and humiliate your parents, but if you step in too late, their manageable problems will have turned unmanageable,” Gross writes.

It’s nearly always a daughter, granddaughter or niece who assumes the role of caregiver. The female relative who provides caregiving for an older loved one isn’t necessarily a best friend. As with Christine Williams, the daughter dutifully complies because she believes it is expected, taking whatever extra time is required and shoehorning the care into her schedule without complaining.

However, an unpaid relative quickly faces burnout if daily tasks include helping the parent dress, bathe, eat and make it to the toilet. When shopping, housekeeping and laundering are added, the experience can prove stressful or even injurious to the health of the caregiver — especially if the person is in the workforce full time. Many such middle-aged daughters are still supporting their own children at home.

When home care is no longer feasible, the elderly sometimes move into one of America’s 39,000 assisted-living facilities. Here a resident has a modicum of independence, residing in an individual apartment but eating meals in a common dining room.

If a person lives long enough, moving to one of the nation’s 16,100 nursing homes may become inevitable when the family simply doesn’t have the financial means or the physical strength to care for the increasingly ailing parent.

Ministry opportunity

Nursing homes are required by Medicare to provide unspecified “spiritual care” to residents. Thus, few administrators object to church volunteers coming in to conduct worship services or Bible studies; it relieves the facility from having to pay someone to do it.

Nursing home ministry isn’t a natural outreach for churches, according to Bill Goodrich, 52, executive director of God Cares Ministry in Avon Lake, Ohio.

“It’s not glamorous, there’s no financial gain, and it won’t build membership,” Goodrich says. “But the fact that this people group does not have the ability to fill pews, give funds or serve in a ministry does not disqualify them from the body of Christ.”

In a diminished physical and mental capacity, nursing home residents frequently believe they have outlived their usefulness and that they are a burden to their children.

Yet living in a nursing home doesn’t necessarily need to be a time of withdrawal for frail residents. Socialization opportunities are more abundant than if a person remained in the family home. Games, cooking demonstrations and musical events all can be enriching. The structure and activities of the nursing home schedule actually may bring comfort to an elderly person whose health seems out of control.

Apart from interaction at a church service or Bible study, Goodrich says an astounding 85 percent of nursing home residents never receive personal one-on-one visits.

Ward Tanneberg, 73, executive director of the CASA Network (Christian Association Serving Adult Ministries) based in Bellevue, Wash., says Christians need to show the same respect for the feeble aged as they do for wounded veterans returning from the battlefield.

“We need to take care of the veterans of the Christian faith out of respect for what they have given,” Tanneberg says. “We don’t simply push them off in a corner and say, ‘You don’t count anymore because you can’t produce anything.’”

The elderly have hard-earned wisdom to pass along to younger generations because of life experiences, Tanneberg says, and their integration is essential to the well-being of the church.

Hospice care

Compassion for the helpless elderly is often best expressed by hospice workers. Hospice care isn’t necessarily just for the final days or hours at home. Doctors authorize hospice care if they determine a patient has six months or less to live.

Yet sometimes with increased nutritional and nursing attention available through hospice, the patient — who frequently resides in a nursing home — may live much longer. Hospice care includes regular visits from a registered nurse case manager, certified nurse’s aide, social worker and chaplain.

Valerie Alfano, 43, a Christian hospice social worker based in Springfield, Mo., believes everyone who is close to death still has a purpose in God’s plan.

“It is my goal for any of my folks on hospice to continue living life — to the fullest extent possible — down to their last breath,” Alfano says.

Christian hospice workers can pray and read the Bible to patients. According to Alfano, who attends Nixa (Mo.) First Assembly, hospice workers can be the bridge between the patient and mourning family members who see a parent’s demise approaching.

Hospice workers engage family members by prompting meaningful reminiscences about the one who is near death. When children are at a loss for words, hospice workers can lead prayers and offer comforting assurances of eternal life in Christ — or give the plan of salvation.

In hospice care, there is a recognition that expensive medical intervention is not going to restore health. The hospice method is to provide palliative care to make the patient comfortable, not postpone the dying process.

“At some point the family must release their loved one to God,” Alfano says. “It can be a blessing to see people pass.”

John Heide, Assemblies of God U.S. missionary to the second-half generation, encourages congregations to organize SWAT — Seniors With a Testimony — teams to share with the aged who are near death in hospice care, long-term care, hospitals, nursing homes or homebound. Virtually everyone who is about to leave this earth is open to prayer, says Heide, 61.

“It’s a real opportunity for the church to share words of comfort, peace and joy at this point,” says Heide, who is based in Conway, Ark. Too often, Heide says, Christians ignore visiting the weak elderly and discussing the inevitability of death.

“Jesus’ primary purpose in coming to earth was to prepare us for eternity, because every soul matters to God,” Heide says. “We will either live forever with Jesus or forever without Jesus. The church needs to help those who are ready to cross over to run the race successfully.”

Dutiful daughters

Siblings, especially daughters, often share in the care of declining parents. If the parent moves to a nursing home, the daughter realizes it may be up to her to provide nurturing care because the transition can be an emotionally jarring experience for someone accustomed to independence.

All of one’s possessions are reduced to what fits into a single bedroom. Residents are thrust into an institutional atmosphere where they have no friends or relatives. Meal times and dining companions are regimented by the edict of strangers.

In the case of Blue Koelling, older daughter Arlene Allen, 67, now handles more of her mother’s care.

Last April, Koelling, now 85, moved to a nursing home in Nixa, 11/2 miles from Allen, who recently retired. Even in tandem, Williams and Allen are unable to lift their 180-pound mother to take her to the bathroom.

“I had feelings of guilt that my sister was carrying the load,” says Allen, who, similar to her sister, cared for her father-in-law at her home for five years before his death. “I feel good that I’m able to do it now.”

Today, Allen helps feed her mother at least one meal a day at the nursing home, washes her mother’s face, combs her hair, and puts moisturizer on her hands and arms. Her mother inevitably wants the stays to last longer. Allen says she believes her mother approved the move to the new nursing home because it meant a new physician would be examining her, and somehow that would provide marked improvement.

Allen says her mother hopes there will be a medical cure for her weakened condition. But in the overwhelming number of such cases, advancing age only hastens deterioration in a body that already carries a host of ailments.

JOHN W. KENNEDY is news editor of the Pentecostal Evangel. His 93-year-old mother has been in hospice care for more than a year.

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