In the Hands of Strangers

No one puts their infant in a nursing home just because the child can't speak and requires assistance. Why outsource our aging parents?

After my father died, I noticed rapid changes in my mother's mental and physical health. Her once-steady walk became a slow shuffle. She became fearful of driving. And, increasingly, she cried over the phone about how difficult it was to live in her Florida condo by herself, after 57 years of marriage.

Five years later, I could no longer justify my mother's tears, isolation and loneliness. Against the wishes of other family members, I insisted on relocating her to my home in Philadelphia and selling her condo.

My reasoning was simple. My grandparents had died in their own beds, in the homes they had lived in their entire lives, surrounded by family. My generation's embrace of shipping aging parents off to Florida retirement "villages," assisted living or nursing homes struck me as selfish and cruel. Sure, Florida is paradise, as long as you're in good health and have a companion. But alone and frail? It's no better than sending an elderly Eskimo off on an ice floe.

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At the time, I taught at a university and lived in a high-rise apartment. The first sign that something was wrong was my mother's nonstop phone calls.

"Where are you?" she asked. "I'm all alone here."

"I'm teaching, Mom. Why don't you go out to the pool?"

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"Pool? What is this? A hotel?" she cried. "If I had known you'd stick me in a hotel by myself, I would've stayed in Florida. I have a home there."

Actually, she didn't. I had sold her condo. I credited her confusion to moving back up north after more than 15 years of living in Boca. It was only natural for her to be disoriented, I rationalized. But the next phone call stopped me cold.

"Miss Friedman? This is Suzy in the manager's office. Your mother is wandering up and down the halls, knocking on doors. She seems very confused. You can't leave her alone here."

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Later that week, our family doctor asked my mother questions that determined her fate. And mine.

"Mrs. Friedman, can you tell me what month this is?" he asked.

Mom looked around sheepishly. If she glanced out the window, she could see trees in bloom. It was summer.

"February?" she ventured.

My heart sank.

"Do you know what year this is?"


"Can you tell me who is president of the United Sates?"

"Why are you asking me all these questions?" she asked.

A few minutes later, the doctor said the word that no family wants to hear: dementia. Back then, the only person I knew who suffered from the disease was Ronald Reagan. None of my friends' parents had, as yet, walked this plank into oblivion.

Here's what I expected. My mother would lose her ability to speak within months. She would die within the year. With that horrific prognosis in mind, I was determined to make her remaining time as comfortable as possible in my home. I rejected my sister's pleas to put Mom in a "facility." Not because I was experienced as a caregiver—I had no children and my houseplants committed suicide—but because of something my mother had said to me innumerable times before the onset of her illness.

"Never put yourself in the hands of strangers," she said with foreboding. It was an old Yiddish saying that had become her mantra following my father's death. I fully understood its implications. No one puts their infant in a nursing home just because the child can't speak, is incontinent and requires assistance eating, dressing and bathing. Why outsource our aging parents?

I consulted with the many local agencies that help the elderly "age in place." They provided a companion to stay with my mother when I was at work and transportation to take her to "day care," a neighborhood center where people with dementia could be engaged in recreational activities. Mom was less than thrilled about the place. So was I. In my eyes, my mother was far more functional than the other participants who moaned incoherently and stared into space.

I quickly identified things my mother still enjoyed—live music, hot fudge sundaes and watching "Wheel of Fortune." I took her to concerts and restaurants and to visit relatives until it became apparent that these outings were more to appease my own guilt than to relieve her boredom.

I did some reading and discovered I was wrong about her prognosis. The average dementia patient lives for seven years following the onset of symptoms. And not all lose the ability to speak. Mom was a chatterbox. She also had angry outbursts that came on with the suddenness and fury of a summer storm. Within less than six months, I realized I was in over my head.

Mom often wandered at night. I lived in constant fear that she'd leave my apartment, go outside and become one of those tragic news stories. I also worried that she'd trip and break her hip. The final straw had nothing to do with my mother. It was what a friend said to me.

"You can't go on like this," she said, "You've got to stop worrying about your mother and take care of yourself."

She was right. The constant stress of caring for my mother was so high, I couldn't eat. Couldn't sleep. I was emaciated and was seriously thinking of ending my life and my mother's because I knew I was failing and couldn't bear the thought of putting my mother "in the hands of strangers."

A therapist helped me sort out my deep feelings of guilt and restore my sense of self-worth. My role as primary caretaker didn't end the day Mom moved into an assisted living facility five minutes from my home. That's when it truly began.

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