Bernard’s physical difficulties began slowly and subtly at first. Knee and hip soreness, sciatic pain, neck pain, arthritis in the hands and fingers, circulatory issues in the legs and feet – all common ailments among individuals entering old age – were among the challenges Bernard began to gradually face… all at once. Tough and stoic as many men of his generation are, it wasn’t until about five years after the onset of his symptoms (not to mention two or three surgical procedures) that Bernard finally began to admit a change of pace and living situation might be warranted.
In 2007, Bernard and his companion Carol, already well into their eighties, decided to move together into a new home, where they could still care for one another and enjoy the independence to which they’d become so accustomed, but where their gradually growing needs could also be better met. After some months of disagreement, they settled upon a one-story, two-bedroom apartment in an Independent Living center – they insisted on calling it a retirement home. The complex offered many of the social outlets and activity opportunities that Carol craved while affording Bernard the privacy and control (over schedules and physical space) upon which he had insisted.
These new accommodations cost roughly $4,000 per month in rent – not unusual.
It was during the second year of this safer, more supportive yet more expensive living situation that Bernard’s health took another turn for the worse.
While he insisted emphatically on remaining with Carol in their home – determined to perpetuate the autonomy and dignity and continuity of their living situation – he eventually conceded that he indeed needed additional care, of a kind beyond what Carol could reasonably provide not to mention the toll his care was taking, physically and emotionally, on his beloved longtime partner.
So the couple agreed to hire a part-time in-home caregiver. The caregiver arrived every weekday early in the morning and handled everything from cleaning linens and the home interior to helping Bernard dress and groom himself and perform his daily exercises. Some difficulties ensued as Bernard was wary of the company, unwelcoming of instruction and irritable to begin with. Cultural and generational divides – as they so often do – also caused some confusing and combative moments.
Within that same year, they’d hired two additional caregivers at an out-of-pocket expense to the couple of nearly $80,000 per year, on top of the $48,000 they were already paying annually in rent.
At first they were fortunate to have the resources to pay these mounting expenses and didn’t concern themselves too much with their inevitable depletion. This went on for two years.
And it was merely twenty months later that lo and behold, Nursing Home care became necessary, for both Bernard (at first) and then for his long-devoted companion Carol (within that same year). Falling, over a dozen times, in the year thereafter, his mood increasingly depressive and erratic, and his body increasingly fragile, there was no choice but to again ramp up care. Both the proprietors of the facility and the primary caregiver at the time had been contacted separately by paramedics (who had responded to multiple calls) who were threatening to contactAdult Protective Services over the frequency of the falls.
This news sparked action, the dreaded (but in this case mercifully anticipated) move to a Nursing Home, where Medi-Cal, would pay the bill. Carol soon joined him as her health had been compromised caring for him. Had it not been for the help they received with Medi-Cal, the nursing home bill for both of them would have been $18,000 per month.
Make no mistake: while their fiscal resources were all but depleted at that point, the initiative that they had taken – not then, but over two years prior – to prepare for the likelihood of Nursing Home care for one or both of them, ensured their well- being at that point, and going forward.
The point of the story is this – two individuals who were active and collaborative about shaping their future together were able to provide excellent care for themselves on their own terms, at levels that were appropriate to their evolving needs and finances, as well as optimal for their comfort every step of the way. It’s amazing and sad how few are similarly realistic.
Due to their pre-planning and initiative their respective estates were preserved, and are not at risk of State recovery.
The intended implication here is not that they have achieved some sort of reward or prize for good work and all will live happily ever after. In truth, at their age, their situation is messy and challenging and frankly rather dire, but that will be true for us all near the very end of life. No, the intended implication here is that Carol and Bernard are a shining example, on paper and in practice, of what preparation and action and realistic expectations can achieve. Both have enjoyed as comfortable and as autonomous and as dignified an old age as either could have possibly hoped for, and, notably in this case, they have only themselves to thank.