The large workshop located at the back of the property was where Dad had enjoyed the best days of his life. Now he would dream of the things he had made there; he visualized his tools, the workbench, the chair he sat in when friends would come to visit and look at the wonderful things he made. He would have been so rejuvinated at being able to go out to the workshop, maybe stand at the workbench and do a few of the things he could still do. It would have provided him stimulation, occupation, made him feel like a normal person for a while. But to get out there would have required opening a door in the wall of the den, building a ramp down to the ground and then a walk way to the door of the workshop. Actually this would have been a very simple thing to do – but it would have upset the house and so it was not done. The doorways were not widened either because that would have upset the house and so Dad couldn’t get into any rooms other than his bedroom and the kitchen and living room. The bathroom was off limits unless he walked and that was difficult for him. So Mother had him use a commode. This was humiliating for him but he had no choice, she was in charge of his care and claimed she didn’t mind.

They had arranged for a nurse to come in the morning to help Dad get up, dress and to the table. At night he came to help him undress and into bed. Every few days he was given a bath and once a week a physical therapist came in to work with him. Every six weeks he went back to the hospital to give mother respite from his care and during that time he was given a full battery of tests, all the therapy he needed and counsel. However the therapy stopped when he went home; it was just so much easier for Dad to sit at the kitchen table keeping Mother company while she puttered around with her cooking. I bought them a small tv to mount on the wall so they could watch their soaps; Dad had a small radio by his side and he read the paper, read his books – and sat there all day.

As time went on Dad because less and less fun to be around. He had always been a man of humour and people were attracted to him for his wonderful stories and his gentle, elegant manner. He spent more and more time alone as his mood darkened and he was depressed much of the time. He was ashamed to be seen in a wheelchair so refused to be taken for rides around the neighbourhood. His life had become reduced to 2 rooms and what he could see out the window. Mother had refused to allow them to take part in any stroke counseling so they never knew how much help and support was available to them. Dad could have learned this feeling of helpless despair was natural for someone in his condition. that there was hope and things they could do to make their lives easier.

It broke my heart to visit my parents and see Dad deteriorating. I tried everything I could think of; the medic alert for when Mom had to leave him alone to go shopping, a reclining chair so he could relax and watch tv in the living room. I tried to move furniture around so he could get around in his wheelchair; I moved stuff off the shelves near where he sat so there would be room there for his books and his cup of coffee. Nothing worked. By the time my plane had left the ground the medic alert had been cancelled, the recliner was used for something else, the shelves were jammed with trinkets again and the little table of nick nacks was back against the wall where the wheelchair would hit it. So I gave up.

This went on for 7 years and in 1998 my Dad decided he had had enough; he died in his sleep one night in August. He had been running a high temperature but Mother had decided it would go away, she could take care of it herself. When she wakened to find him cold beside her she refused to believe it and waited, as she had when she first saw his stroke symptoms. When they finally took Dad away that morning something broke in my mother and she could no longer create her own reality as she had done for so many years. Two months after he was buried she was diagnosed with 4th stage ovarian cancer and was gone 6 months later.

I have written of many other aspects here of how to address aging. This has been a very personal exercise. It has been so very clear to me how different my parent’s lives could have been; how much happier, lighter, joyful those last years could have been for them. Instead they were burdened, isolated, fearful and defensive. Fear and suspicion were what had moved and controlled my mother all her life and that affected very negatively how they lived their final years together.

In Palo Alto and Menlo Park we have a fabulous non profit called Shelter Network which helps people who have lost their homes to tragedy, illness or fire. They are assisted in getting established in new housing and they need all the stuff you don’t want, need or can use anymore to help them set up homes for their families. For items that are questionable there is Good Will, Salvation Army etc. If tackling the mountain of stuff ahead of you is too daunting, you can always call Tom Anderson in Palo Alto who has a fabulous operation called Clutterboy. He and an assistant come to your house and inject humour and energy into a dour task and tease you into considering your things from a different perspective. He then hauls things away to either the shelters or the dump then helps you put back in place the stuff you are going to keep.

Now that the house has been lightened you can consider making some repairs. Get a home inspection done. A licensed contractor will go through the house from top to bottom and draw your attention to items that may need immediate or future work. Now is the time to know what’s going on in the house; is the roof getting old and starting to leak? Are the gutters jammed with leaves and need to be cleaned? How is the drainage around the house? Is water collecting underneath causing damp, mold and fungus? Are there ants and termites collecting in the foundation and attic? The home inspector will red flag all the areas that hint of these conditions and recommend a termite inspector, a drainage specialist, a roofer; anyone who will give you a clear picture of what is going on in your house. Then, based on the results you can budget for repairs but you must not ignore them. Your home must be safe and solid.

If you are having trouble with your balance you may want to have bars installed in areas where you need support. If you have been sleeping on the second floor you may consider moving to ground level and eliminate too many stair trips. If you are having trouble walking and are considering a walker or wheelchair, then the time has come for a ramp to be built from your door to the street. And now is when you might consider widening those doorways to make sure you can get from room to room. Take up the carpets and expose the bare floors to make it easier to propel; remove excess furniture that will block your path. As you walk through the house look at it with a new eye to what things you can do to make it easier to live in that space. You don’t have to ‘make do’ anymore with the way things are – you are now living in a new phase of your life presenting new problems and requiring new solutions.

Once the house is organized you can start to look at what you can do for yourself. Make sure you get a complete physical and take all the advice the doctor gives you. Get into an exercise program; walking or swimming, light aerobics or yoga at a senior center. Start to make new friends of all ages to keep abreast of all the things going on in the world. And while you are at it, make sure you read the newspapers each day, including your local paper. Here the Palo Alto Weekly is invaluable as a resource for information on local events, classes, performances, opinion pages, discussions. Make sure you keep up with what’s going on in your town and neighbourhood and stop watching so much television. Get out to the library; get a computer or at least learn to use one at the senior center if you don’t want to own one. Keep your mind as exercised as your body. Make sure your nutrition is good and you remember to eat properly each day.

And best of all, find someone who is not doing as well as you are and try to help them. If you have done any of what I suggest above, you have a lot to share with them.

This reminds me of a lady I heard about. She was a single woman in her 80s who had always lived in the family home here in Palo Alto. She had been alone for years by now and was living in the 3 story home that contained all the detritus of her family dating back 3 generations. She existed on social security and a pension which should have provided her a reasonable life except for one thing: this large, drafty old house was on a large piece of land in the middle of one of the most expensive areas in the country. Her home was probably worth 3 million dollars but that meant nothing to her. She didn’t know where she could move to and she didn’t know how/where to start thinking about it. She got depressed by just walking through the rooms filled with stuff she didn’t use, want or care about but which were all ties to her past.

She felt trapped – and she was. Her needs were pretty simple now and she lived essentially in one room of this large, creaking house and she didn’t know what to do to change this. How I wish I had known about Clutterboy when I heard this story. I don’t know what happened to that poor little woman. She might still be in that sad place, trapped by the things accumulated from three lifetimes of her family. I would like to think that someone came to her rescue, cleared out the house, let the sun and fresh air in and moved her to a place where she had light, laughter and friendship for her final years.

There are several local agencies that can provide help with personal care, companionship and transportation as well as household tasks such as light housekeeping, shopping and meal preparation.Our greying population has created a whole new profession: Geriatric Care Managers. These people assist the senior with information about resources and options as well as a care plan that will continue to monitor the older adult for changes on an ongoing basis.

Meals can be prepared and delivered to the home, groceries can be ordered by phone and delivered; in some communities a telephone service will call every day to check to the health and well being of a homebound person. Home visits can be arranged and a friendly volunteer will visit the senior in the home, sharing interests and providing light help with chores. Many hospital auxiliaries provide emergency call units so a beeper alert can be sent by the senior who falls or becomes ill and cannot get to a phone.

There are many other services that can help the senior remaining in his home to live comfortably and safely. Services such as heavy cleaning, yard work and home repair are available; low interest loans can be taken for major projects. An architect or home remodeling contractor can be found who will make modifications to the home with such things as grab bars in the bathrooms, wheelchair accessible counters, widening doors to allow for wheelchairs, ramps to allow easy access outside to access either the garden or transporation.

Many communities have day care/health centers that offer a range of socialization activities, health monitoring and therapies on a regularly scheduled basis. These programs provide an alternative to moving out of the home and offers respite to families. Lectures, exercise classes, arts and crafts; field trips – all are available to add to the quality of life of someone who might otherwise feel isolated and disconnected.

I know of a family that was becoming concerned about their widowed mother. She and her husband had been long time residents of a fine brownstone in Boston. After he died she continued her activities in the church, saw her friends and attended her clubs; she was comfortable there. She loved her home and her little garden; loved that she could easily get around town on public transport to the museums, parks and shops. But as she got older her son and daughter in law who lived on Cape Cod began to encourage her to move closer to them. They wanted their children to spend more time with their grandmother; they envisioned being able to drive to see her 5 minutes away and take her to local things they thought would interest her. A new environment with new stimuli, new friends, close to family in a beautiful location on Cape Cod – what could be nicer than that? She dismissed the idea out of hand and hoped they would drop it.

But they persisted and finally they wore her down. They took her to visit a beautiful retirement community near them where she could have all the luxury she wanted plus assisted care as she got older and began to need help. They presented her with all the reasons why this was the right decision. Many of her friends had taken that path already, many others had passed on, her circle of intimates was shrinking, and here was a chance to start a new phase of her life. Finally, she agreed to their plan. Her possessions were disposed of, her home was sold, the few things she could take with her were packed. Sadly but obediently, she moved into the retirement home. She did what her family wanted her to do. And one week after the last picture was hung, the last box was put away, she died.

I remember this was a powerful object lesson for me: this lady was, as far as anyone knew, perfectly healthy and competent to make decisions about her life and where she would live. But they didn’t listen to her well enough and so she felt devalued, unheard, irrelevant. She just gave up. Died of a broken heart? Possibly.

So in discussing the next step with your elder parent, make sure you take all things into consideration but especially their own feelings and opinions on the matter. In some situations remaining in the home is just not an option for safety or financial reasons. Sometimes this places an unreasonable burden on family members who may also be living in the home, each situation is different. Older folks want to feel useful and they want to feel they can make a contribution. Remembering how active and independent they were once makes one more sensitive to the feelings of uselessness that may come with dependence, diminished health and physical weakness. They may also have symptoms of depression.

Bob was a widower in his late 70s who lived alone in a duplex in Menlo Park. He had no family but had befriended many young students over the years, financing their education and supporting them as they started their lives. His mantle was covered with pictures of these surrogate children and their families and they stayed in touch with him. When I knew him, Bob was dealing with a heart problem and recovering from a stroke. He refused to have help in his home, determined to keep his independence. It took him all morning to change the sheets on his bed; he did his own cooking and even baked bread. To shop or go to movies he would hire someone to drive him and sometimes was grumpy about having to depend on anyone for that.

One day I suggested he consider some “hot wheels” and I told him about the motorized wheelchairs that were becoming available. Within 10 days he had contacted two of the vendors, had tried out the available models and ordered one in dark red. When I saw him next he had installed a large golf umbrella over the seat, attached a flag and he was off and running. You could see him zipping along El Camino in his baseball cap checking in at Safeway and the drug store, the book store and video place; he could travel a few miles before he had to come home and recharge the battery. This changed his life, providing him with a sense of freedom and independence that brought back his good humour and his zest for living. It kept him in touch with lots of people he would see on his journeys each day and I am positive the good feelings this evoked added many years to his life. They were certainly happier years, that’s for sure.

Everyone is different and has needs that are unique to them. Many different housing options are available to the senior and the first to consider is his own home. The piece following this one discusses the services available in most communities, certainly present here in Palo Alto, which makes remaining in ones own home a very reasonable option.

When I started writing this blog I asked GB if she would add her thoughts. Her main advice was to make changes in your life while you are still young enough to adjust to their new environments. Making new friends, learning new skills are easier for a younger senior. GB intends to move to her church retirement facility when she is no longer interested in maintaining her home. She has done an Excel spread sheet detailing every single item in her home, its provenance and to whom it is bequeathed.

For my sweet little mother in law who is as delicate as a tiny bird, has made the computer her friend. She is famous for her personalized greeting cards; she manipulates all the family photos including all the slides scanned from family trips over the years. She is included in all the emails that fly between the family members on both coasts each day. Especially important are the daily photos of her 2 year old great granddaughter Harmony in California. Through the computer she followings this child’s daily antics.

The emails I receive from her are the most precious to me; sometimes a brief remark, sometimes a longer commentary, but quickly available to me with the click of her Send key. Thus we have an immediate connection and share our thoughts and observations. In this way her world is large and filled with love, connected to friends and family. At a time when it could seem an older person’s life is being limited with shrinking boundaries, hers is growing larger and richer.