The 20th century gave Americans the gift of easy social and physical mobility. My father grew up in the poverty of the Great Depression but was able to attend university and medical school. His brothers obtained their similar educations with his help and the G.I. bill. Each was able to choose where he wanted to live according to his own affinities. Friends, opportunities, hobbies, and weather all played their parts in where they and their wives, two of them met during World War II far from the Kuffel hometown of Missoula, Montana, decided to settle and raise families.
I seem to be the child in all three of these families to have taken advantage of this choice, immigrating to the East Coast for graduate school and my career. At the times I made those decisions, my parents retired and created new lives in the Southwest. They wanted to play golf and be with their friends who also moved there. They pursued new hobbies made possible in a retirement city. For a decade or so, they returned to Montana for the summer but when my mother was diagnosed with congestive heart failure, they made Arizona their permanant home.
Lately I've been disturbed by an old New Yorker article I finally got around to reading. When container ships offload their cargo in the New Jersey ports I can see during my walks with Daisy, their main pickup is American scrap metal and waste paper that are recycled by the Chinese into more junk we can't live without. It's hitting a little too close to home as I lean harder toward moving to the mountains and friends of the West after 30 years, and as I watch my parents' plans for permanance disintegrate in the quicksand of aging.
Three weeks ago, my 87-year-old mother fell and fractured her pelvis and upper femur. She was rushed to the hospital and placed in the cardiac unit because she has severe congestive heart failure and her vital organs were in distress. She is now in rehab, which is chasing the Medicare dollars of cardiac recovery, where she began, rather than orthopedic treatment, which essentially consists of waiting for the non-displaced fractures to knit. We've had some heated struggles to get her placed in a nursing facility to support the latter but how much longer than a week or two that the next stop will keep her is up in the air.
Then comes the choice between private 24/7 in-home care or moving both of my parents into one or another version of managed care/assisted living.
In the next three weeks.
Mom's cognition is impaired so the final decisions fall to my father, who is vacillating and frightened of the sudden loss of independence. It's a small independence that they've managed to keep until now -- he likes to cook, they watch different TV programs on different TVs (my father has macular degeneration and has to sit flush against the screen to see), they go to bed at different times. My mother has a favorite beauty parlor. Dad grows tomatoes. And that's it. That's what their lives have come to and the system is demanding either that they bankrupt themselves or that they give most of it up.
In the mean time, my brother and I are thousands of miles and many hundreds of dollars away. My brother has planted the idea that managed care should take place in Montana, the state they left for winter golf. They will have family there to take them to the grocery store and to look at tomato plants. It's much less expensive than Arizona and eventually they should be able to get the one-bedroom apartment that will allow separate televisions, bedtimes and fooling around in the kitchen.
And now my brother and I have to shut up and sit on our hands as the Medicare clock ticks, Daddy absorbs, and waiting lists open up.
And I am left to think about how we push paper and tin cans back and forth across the seas, first as product, then as refuse, then as product again. I hope we get to product once more time. They still have a lot to tell the family they left behind.
