Resources and Articles about Aging & Caretaking
Resources
Iona Senior Services
Based in Tenleytown, NW, Iona Senior Services is a non-profit organization in Washington that supports older adults and caregivers with community-based services, advocacy, and resources to help them age well. Programs include adult day health centers, care management, counseling, community dining, and advocacy groups to help seniors maintain independence and quality of life.
Articles
Paid home care is buckling under the surging demands of an aging population. But there are alternatives that could upgrade jobs and improve patient care.
From the NYT https://www.nytimes.com/2025/12/02/health/seniors-aging-home-care.html
By Paula Span; Dec. 2, 2025
You’re ready to leave the hospital, but you don’t feel able to care for yourself at home yet.
Or, you’ve completed a couple of weeks in rehab. Can you handle your complicated medication regimen, along with shopping and cooking?
Perhaps you fell in the shower, and now your family wants you to arrange help with bathing and getting dressed.
There are facilities that provide such help, of course, but most older people don’t want to go there. They want to stay at home; that’s the problem.
When older people struggle with daily activities because they have grown frail, because their chronic illnesses have mounted, or because they have lost a spouse or companion, most don’t want to move. For decades, surveys have shown that they prefer to remain in their homes for as long as possible.
That means they need home care, either from family and friends, paid caregivers or both. But paid home care represents an especially strained sector of the long-term care system, which is experiencing an intensifying labor shortage even as an aging population creates surging demand.
“It’s a crisis,” said Dr. Madeline Sterling, a primary care doctor at Weill Cornell Medicine and the director of Cornell University’s Initiative on Home Care Work. “It’s not really working for the people involved,” whether they are patients (who can also be younger people with disabilities), family members or home care workers.
“This is not about what’s going to happen a decade from now,” added Dr. Steven Landers, chief executive of the National Alliance for Care at Home, an industry organization. “Do an Indeed.com search in Anytown, U.S.A., for home care aides, and you’ll see so many listings for aides that your eyes will pop out.”
Against this grim backdrop, however, some alternatives show promise in upgrading home care jobs and in improving patient care. And they’re growing.
Some background: Researchers and elder care administrators have warned about this approaching calamity for years. Home care is already among the nation’s fastest-growing occupations, with 3.2 million home health aides and personal care aides on the job last year, up from 1.4 million a decade earlier, according to PHI, a research and advocacy group.
But the nation will need about 740,000 additional home care workers over the next decade, according to the Bureau of Labor Statistics, and recruiting them won’t be easy. Costs to consumers are high — an average $34 per hour for a home health aide last year, the annual Genworth/CareScout survey shows, with big geographic variations. But the aides take home less than $17 an hour, on average.
These remain unstable, low-paying jobs. Of the largely female work force, about a third of whom are immigrants, 40 percent live in low-income households and most receive some sort of public assistance.
Even if the agencies that employ them offer health insurance and they work enough hours to qualify, many cannot afford their premium payments.
Unsurprisingly, the turnover rate approaches 80 percent annually, according to a survey by The ICA Group, a nonprofit organization that promotes co-ops.
But not everywhere. One innovation, still small but expanding: home care cooperatives that are owned by the workers themselves. The first and largest, Cooperative Home Care Associates in the Bronx, began in 1985 and now employs about 1,600 home care aides. The ICA Group now counts 26 such worker-owned home care businesses nationwide.
“These co-ops are getting exceptional results,” said Dr. Geoffrey Gusoff, a family medicine doctor and health services researcher at the University of California, Los Angeles. “They have half the turnover of traditional agencies, they hold onto clients twice as long and they’re paying $2 more an hour” to their owner-employer.
When Dr. Gusoff and his co-authors interviewed co-op members for a qualitative study in JAMA Network Open, “we were expecting to hear more about compensation,” he said. “But the biggest single response was, ‘I have more say’” over working conditions, patient care and the administration of the co-op itself.
“Workers say they feel more respected,” Dr. Gusoff said.
Through an initiative to provide financing, business coaching and technical assistance, the ICA Group intends to boost the national total to 50 co-ops within five years and to 100 by 2040.
Another approach gaining ground: registriesthat allow home care workers and clients who need care to connect directly, often without involving agencies that provide supervision and background checks but also absorb roughly half the fee consumers pay.
One of the largest registries, Carina, serves workers and clients in Oregon and Washington. Established through agreements with the Service Employees International Union, the nation’s largest health care union, it serves 40,000 providers and 25,000 clients. (About 10 percent of home care workers are unionized, according to PHI’s analysis.)
Carina functions as a free, “digital hiring hall,” said Nidhi Mirani, its chief executive. Except in the Seattle area, it serves only clients who receive care through Medicaid, the largest funder of care at home. State agencies handle the paperwork and oversee background checks.
Hourly rates paid to independent providers found on Carina, which are set by union contracts, are usually lower than what agencies charge, while workers’ wages start at $20 and they receive health insurance, paid time off and, in some cases, retirement benefits.
Other registries may be operated by states, as in Massachusetts and Wisconsin, or by platforms like Direct Care Careers, available in four states. “People are seeking a fit in who’s coming into their homes,” Ms. Mirani said. “And individual providers can choose their clients. It’s a two-way street.” Finally, recent studies indicate ways that additional training for home care workers can pay off.
“These patients have complex conditions,” Dr. Sterling said of the aides. Home care workers, as they take blood pressure readings, prepare meals and help clients stay mobile, can spot troubling symptoms early, as they emerge.
Her team’s recent clinical trial of home health aides caring for patients with heart failure — “the No. 1 cause of hospitalization among Medicare beneficiaries,” Dr. Sterling pointed out — measured the effects of a 90-minute virtual training module about its symptoms and management.
“Leg swelling. Shortness of breath. They’re the first signs that the disease is not being controlled,” Dr. Sterling said.
In the study, involving 102 aides working for VNS Health, a large nonprofit agency in New York, the training was shown to enhance their knowledge and confidence in caring for clients with heart failure.
Moreover, when aides were given a mobile health app that let them message their supervisors, they made fewer 911 calls and their patients made fewer emergency room visits.
Small-scale efforts like registries, co-ops and training programs do not directly address home care’s most central problem: cost.
Medicaid underwrites home care for low-income older adults who have few assets, though the Trump administration’s new budget will slash Medicaid by more than $900 billion over the next decade. The well-off theoretically can pay out of pocket.
But “middle-class retired families either spend all their resources and essentially bankrupt themselves to become eligible for Medicaid, or they go without,” said Dr. Landers said. Options like assisted living and nursing homes are even more expensive.
The United States has never committed to paying for long-term care for the middle class, and it seems unlikely to do so under this administration. Still, savings from innovations like these can reduce costs and might help expand home care through federal or state programs. Several tests and pilots are underway.
Home care workers “have a lot of insight into patients’ conditions,” Dr. Sterling said. “Training them and giving them technological tools shows that if we’re trying to keep patients at home, here’s a way to do that with the work force that’s already there.”
____________________________
Smart Guide to Aging in Place: 31 tips for making your home safer and more comfortable as you get older
From AARP https://www.aarp.org/home-living/smart-guide-aging-in-place/
__________________________________
How to Set Up Your Home to Age in Place for $1,500: Small changes can help you safely stay in your home for years to come
From the WSJ https://www.wsj.com/personal-finance/how-to-set-up-your-home-to-age-in-place-for-1-500-9a3508bf?mod=Searchresults&pos=6&page=1
By Veronica Dagher and Elizaveta Galkina; Jan. 31, 2026
Most Americans want to grow old in their homes, and some spend tens of thousands of dollars transforming their spaces for their later years.
But modifying your home doesn’t require a huge renovation or budget. There are ways to keep costs down by prioritizing changes that target two of the biggest challenges people face as they get older: preventing a fall and getting around after a hospital stay.
Here are some moves that can add up to about $1,500.
Falls, which frequently occur at home, often lead to hospitalizations and are the primary driver of mobility loss among older adults.
Small changes, such as removing throw rugs and using color contrast tape to mark edges of furniture and stairs, can significantly reduce the risk of falls, says Carol Chiang, an occupational therapist who owns Evolving Homes, which consults on home modifications. She also suggests installing offset hinges, which allow doors to swing completely clear of the frame to widen walking paths.
These steps improve visibility and open up space to allow safe, independent movement and can be done for about $1,000 in less than a month (especially if you do it yourself), she said.
Getting Around after a Hospital Stay
Another challenge is getting around your home after a hospital stay.
Chiang suggests targeting frequently used spaces such as the bathroom and bedroom for a more comfortable daily routine. This can reduce the energy required for basic tasks.
By spending a single weekend and about $500 on simple modifications—such as installing a shower hose and seat—you can proactively make your return-to-home easier for any future hospital stays, she said.
_________________________________
The Help That Many Older Americans Need Most
With shortages of medical professionals and an aging population, thousands of community health care workers prevent older adults from falling through the cracks.
From the NYT https://www.nytimes.com/2026/04/18/health/community-health-care-workers.html
By Paula Span; April 18, 2026
On a recent Monday, Sandy Guzman, a community health worker in rural Oregon, drove to visit a patient in her 60s in a small city called The Dalles.
The patient lived alone, and “really struggles with social isolation,” Ms. Guzman said. After a serious fall and subsequent surgery, the woman was using a wheelchair. She confided that she would like to attend services at a church down the road but had no way to get there and did not want to seem “a bother.
“We called the pastor to see if there was someone who could pick her up” on Sundays, Ms. Guzman said.
And there was. The next day, Ms. Guzman visited a woman with heart failure who required constant oxygen. She lives in “less than ideal housing,” with no kitchen and only a plug-in heater for warmth.
“We were trying to figure out if she qualifies for HUD housing or assisted living,” Ms. Guzman said. “We spent a lot of time talking about the options and came up with a game plan.”
Wednesday’s schedule included a 20-mile drive to Hood River to see an 81-year-old woman whose partner of nearly 40 years was contending with a serious cancer. Ms. Guzman, who speaks to her in Spanish, found her distraught at the possibility of losing him
Ms. Guzman had arranged for the woman to begin seeing a therapist to help her through the crisis — no minor achievement. But on this visit, “I just handed her tissues and tried to give words of comfort,” she said. “Honestly, sometimes just sitting and listening” is the best response.
A community health care worker, the American Public Health Association says, is a “trusted member” of a local community or someone who has “an unusually close understanding” of it, enabling the worker to serve as intermediary between patients and the health care system.
These workers have been on the job since the 1960s, particularly in rural and low-income areas. Today, their numbers are growing. The Bureau of Labor Statistics reports about 65,000 of them, which the National Association of Community Health Workers says is probably an underestimate.
That partly reflects the difficulty of counting workers who go by a variety of names — community health educators, outreach specialists, promotores de salud — and operate under different state regulations, sometimes with no licensure or certification required.
What they have in common is that “they talk like the people they work with,” said Sam Cotton, who directs the curriculum for several such programs at the University of Louisville in Kentucky.
With shortages of health care professionals and an aging population, “there’s a lot of momentum for this,” she said.
In Oregon, for example, five rural clinics employ community health workers, who become state-certified after completing 90 hours of online training, through a program called Connected Care for Older Adults.
Their frail patients are struggling. “They can’t drive, so they can’t get to a grocery store and shop,” said Dr. Elizabeth Eckstrom, the chief of geriatrics at Oregon Health and Science University, who helped oversee the program’s start in 2022. “They’re not taking their medications, either for cognitive reasons or because they can’t get to a pharmacy.”
Few have completed an advance directive, specifying the care they want — or don’t want — if they suffer a health crisis.
Connected Care’s community health workers tackle many of those not-exactly-medical problems — from installing wheelchair ramps to helping patients apply for food and housing benefits. They are allotted 90 days to work with each patient, usually during home visits.
They help coordinate follow-up appointments. They administer cognitive and mental health screenings and watch for use of too many medications, entering their observations in the patients’ electronic health records.
“It’s like being the eyes and ears for the doctors, to see what’s happening outside the 20 minutes they get to spend with patients,” said Ms. Guzman, whose work has ranged from ordering a bath mat to reporting suspected financial abuse.
In a study of Connected Care patients (average age: 77), a subsample found substantial decreases in emergency department visits and hospitalizations among those served by community health workers. ore extensive research, not yet published, supports that finding, Dr. Eckstrom said.
“E.D. visits cost thousands, and hospitalizations are tens of thousands,” she pointed out. The cost per patient for the 90-day program is $1,500. Its workers earn $25 ann hour, a fairly typical wage, and receive full employee benefits.
Dr. Manali Patel, an oncologist at Stanford University, found similar benefits and cost savings for older patients with advanced cancer in a clinical trial at the V.A. Palo Alto Health Care System.
“Lots of people were passing away in the I.C.U.,” she recalled. “If we’d asked, they probably would have wanted to be at home.” Oncologists, she added, are “notoriously bad at engaging in and documenting those conversations.”
But when a lay health worker made regular phone calls to help patients understand their options, discuss their preferences with their care team and file advance directives, the results — published in JAMA Oncology in 2018 — were “very dramatic,” Dr. Patel said.
More than 90 percent of the participating veterans had their goals documented in their records compared with less than 20 percent of the control group. The lay worker’s patients had significantly fewer emergency room visits and hospitalizations, and were more likely to enroll in hospice care.
Dr. Patel and her co-authors have gone on to document the benefits of lay health workers, the term they used, in undertaking other tasks in other settings.
In oncology clinics in Arizona and California, for instance, two bilingual lay health workers made regular phone calls to cancer patients over age 75 to assess symptoms like pain, nausea, breathlessness and depression.
Alerting the health care teams to these patients’ problems substantially reduced their emergency department use and hospitalizations, and the cost savings averaged $12,000 per patient.
“This low-tech, human-administered intervention reaped huge dividends,” said an editorial accompanying that study in the medical journal JAMA.
“Community health workers should be part of every health care team,” Dr. Eckstrom said. “They support the patient in ways the medical system just can’t, no matter how hard we try.”
One obstacle to expanding their use, however, is unstable funding.
In 2024, Medicare began covering some community health worker services, but not all. (The costs of driving 30 miles to remote homes, for example, are not reimbursed.) Medicaid coverage is piecemeal, reimbursing for some services in some states and not others.
“A lot of community health worker roles rely on short-term grants,” said Neena Schultz, a director of the National Association of Community Health Workers. “Sustainability is something we talk about every day.”
The organization and other supporters are pressing for more state and federal funding. The new federal Rural Health Transformation Program, which will distribute $10 billion a year, will include some funding for community health worker programs, but cuts to state Medicaid budgets could more than offset those gains.
The grants funding Connected Care for Older Adults continue, though. Ms. Guzman, employed by the nonprofit clinic One Community Health, keeps making her rounds.
One recent victory: A newly widowed patient in his 60s, struggling financially without his wife’s income, lost his housing and was sleeping in his truck. Through another patient, Ms. Guzman learned of an unused R.V. whose owner was willing to donate.
The widower now lives comfortably in a mobile home park.
When you’re in a patient’s home, “there’s a sense of ease,” Ms. Guzman said. “They feel safer talking about things. They don’t feel rushed. You develop a relationship, and they feel they have someone to advocate for them.”
_________________________________
Aging in Place: Growing Older at Home
From the National Institute of Aging https://www.nia.nih.gov/health/aging-place/aging-place-growing-older-home
___________________________________
Smart Guide to Aging in Place: 31 tips for making your home safer and more comfortable as you get older
From AARP https://www.aarp.org/home-living/smart-guide-aging-in-place/
___________________________________
Are You Aging Well? Try These Simple Tests to Find Out.
They can’t guarantee future health, but they can tell you the trajectory you’re on.
From the NYT https://www.nytimes.com/2026/01/22/well/aging-tests-longevity.html
By Dana G. Smith; Jan. 22, 2026
Take a minute to consider the last decade of your life. What type of physical shape do you hope to be in? And what are the activities you want to be able to continue doing?
While there’s no crystal ball to predict your future health, there are a few basic tests you can give yourself to gauge your current strength, power, cardiovascular fitness and balance — all of which will influence your physical abilities going forward. These kinds of tests have been associated with longevity and independent living. They’re also proxies for activities that many people want to be able to do in old age, like getting down on the floor to play with grandchildren or traveling and exploring a new city by foot.
It’s never too early to begin training for your later years, said Stuart Phillips, a professor of kinesiology at McMaster University in Ontario. People naturally lose strength and muscle mass with age, so you want your starting point to be as good as possible. Getting a head start on training is “money in the bank,” Dr. Phillips said.
It’s also never too late to improve your physical abilities, he added: “We’ve got data showing that nonagenarians, so people in their 10th decade of life, or in their 90s, can make gains in strength and function with just a little bit of even light activity.”
Try these four tests to determine where you currently stand. If you don’t perform as well as you might have hoped, don’t worry: A few strength, conditioning and balance exercises, done regularly, can help you improve your score on each one.
1. Sitting-Rising Test
The goal with this assessment is to go from standing to sitting on the floor, and back up again, using the least amount of support as possible. The test is scored on a 10-point scale — five points for sitting down and five points for standing up — and you lose a point for every hand, knee or other body part you use to help yourself. Subtract a half point if you’re unsteady or lose your balance.
Adults in their 30s and 40s should aim for a perfect 10, said Dr. Claudio Gil Araújo, the dean of research and education at the Exercise Medicine Clinic in Brazil, who developed the test. Anyone over 60 who gets an 8 is “in very good shape,” he said.
The test evaluates strength, power, balance and flexibility. Dr. Araújo has also shown it’s a predictor of mortality. A recent study of his looked at more than 4,000 adults age 46 to 75 and found that, over the course of 12 years, the people who scored 4 or below on the sitting-rising test had death rates nearly four times higher than those who scored a 10. He said that was primarily because people with low scores were at a higher risk for falls.
2. Walking Speed Assessment
How fast someone walks at their normal gait is “a very important indicator of functional ability and vitality,” said Jennifer Brach, a professor of health and rehabilitation sciences at the University of Pittsburgh. “It is predictive of future decline, it’s predictive of mortality, nursing home placement, disability, a whole host of different things,” she said.
To assess your walking speed, measure out four meters, or about 13 feet, on a straight, flat surface, and time how long it takes you to cover the distance. (Remember, you’re walking at your normal speed, not as fast as you can.) People of all ages should aim for a gait of at least 1.2 meters per second, a little over three seconds total.
Dr. Brach recommended people retest themselves every few months. “If the value changes, that can be a warning sign,” she said. That’s because while walking feels like a simple task, it requires proper functioning of the cardiovascular, musculoskeletal, vestibular (balance), sensory and nervous systems. A slower gait could indicate that there’s a problem in any one of those systems that may need to be investigated and addressed.
3. Grip Strength Test
Grip strength is also related to mortality. While that connection may seem far-fetched, experts say a grip strength test serves as a helpful indicator for how active a person is in their daily life.
“When you’re using your hands more, it’s probably because you’re doing things more,” said Cathy Ciolek, the president of the American Physical Therapy Association Geriatrics. “You’re carrying groceries, you’re opening the car door, you’re picking up a grandchild.” All of those things work your hands, she said, and the more you do them, the better your grip strength.
Grip strength is also important for maintaining independence with household tasks like cooking. (Think about pulling a heavy dish out of the oven.)
A doctor or physical therapist typically assesses grip strength using a special device called a dynamometer. To test yourself at home, try walking for 60 seconds while holding a heavy weight in each hand (also known as a farmer’s carry), suggested Dr. Nima Afshar, a physician at the concierge medical practice Private Medical. Start with lighter weights and work your way up to heavier ones over time. If you experience hand or body pain, stop.
There aren’t age-related norms for the farmer’s carry like there are with a dynamometer. But Dr. Afshar says a 45-year-old man should aim to carry two 60-pound dumbbells, a 65-year-old two 40-pound dumbbells and an 85-year-old two 25-pounders. For a woman at those ages, goal weights are 40 pounds, 25 pounds and 15 pounds in each hand.
4. Single-Leg Stand
Just as strength naturally declines with age, so does balance. And that raises the risk for falls — a major cause of injury and death in older adults.
Testing one’s balance is as simple as standing on one leg. Adults should aim for a minimum of 10 seconds on at least one side. For an added challenge, Dr. Afshar recommended attempting the test with your eyes closed.
According to a study Dr. Araújo published in 2022, 20 percent of adults age 51 to 75 were unable to make it to 10 seconds. And those individuals had an 84 percent higher chance of dying in the next seven years, possibly because they were unhealthier at the start of the study.
“You can’t predict an individual’s precise mortality” with these types of tests, Dr. Afshar said. But if you’re below average on any of them, it’s likely you won’t fare as well long-term.
That said, he added, all of these metrics — strength, fitness, balance — can be improved, and as you improve, your risk of dying soon goes down.
Dana G. Smith is a Times reporter covering personal health, particularly aging and brain health.
________________________
Home Improvements to Help Your Loved One Age in Place: The best way to continue living independently in a home you love
From AARP https://www.aarp.org/states/ohio/home-improvements-to-help-your-loved-one-age-in-place/
________________________
How Far Would a Daughter Go to Save Her Aging Parents from Self-Neglect?
Millions of adult children face agonizing decisions when their parents can no longer care for themselves
From the WSJ https://www.wsj.com/health/wellness/how-far-would-a-daughter-go-to-save-her-aging-parents-from-self-neglect-9170f67a?mod=hp_featst_pos5
By Clare Ansberry; July 4, 2026
Nonie Heystek’s dad and stepmother were showing signs of dementia and self-neglect. They lived on their own, nearly 1,000 miles from family. They didn’t want to move and refused in-home help.
She made frequent trips to visit them and could see their world crumbling. Bills weren’t paid. Meals on Wheels deliveries sat uneaten in the refrigerator. Mice roamed their once-meticulous home.
In a desperate effort to get the couple out, Nonie devised a plan involving a fake letter from the water company and a friend impersonating a utility worker. The ruse worked, but she regrets having to resort to such lengths.
“I am conflicted,” she says. “But something had to change.”
How far is too far when it comes to keeping an aging parent safe? No one is comfortable with deception, especially involving loved ones. But what if it avoids a health crisis or a legal battle that would pit child against parent? Are there exceptions when dementia is involved?
These and other worrying questions face the 23.6 million people in the U.S. caring for aging parents.
Each family is different and decisions are deeply personal, says Rani Snyder, president of The John A. Hartford Foundation, an eldercare philanthropy. While she doesn’t advise deception, she says “there is no perfect way” to handle difficult situations. One thing families can do, she says, is talk early, often and openly about priorities.
It seems basic, but many people don’t. Only 19% of adults have talked in detail with loved ones about care preferences, and nearly half haven’t discussed them at all, according to a survey of 1,000 people by Talker Research for LogicMark, a health-monitoring technology company.
Nonie first raised the issue when she and her two younger siblings left Minnesota years ago. “If you fail to make a plan, you’re planning to fail,” she remembers telling her dad, Hank Heystek, and stepmother, Marjorie.
They wanted to stay in their houseon a lake for the rest of their lives. Her dad was outgoing and friendly, chatting with neighbors. Marjorie was more of a recluse.
About six years ago, Hank became uncharacteristically forgetful and talked about his “fuzzy brain.” His own mother had had dementia. Nonie urged them to move closer to family or consider senior living. Exchanges often grew heated.
When Covid hit, Hank and Marjorie became increasingly isolated. “I would call and they would say they were just fine. I would visit and see all the ways in which it was not fine,” Nonie said.
By 2024, Nonie was traveling from Pennsylvania to Minnesota every other week. She paid bills, arranged Meals on Wheels and a driver to take her dad to the grocery store. She consulted with her dad’s doctor and social workers. She invited a home-care provider to meet her parents.
Her dad told the woman they didn’t need help.
“I was angry,” Nonie says. “I told them, ‘You can get this and do that. I will help you.’ They didn’t. They were expecting me to do everything and I did it as long as I possibly could.”
Meanwhile, Nonie’s partner in Pittsburgh was in the late stages of Alzheimer’s. Her college-age daughter needed her attention, too.
Nonie, who had power of attorney for her parents and lived closest to them, kept her siblings informed. They visited and helped when Nonie couldn’t.
In late 2024, her dad called in the middle of the night in pain. She told him to call 911, but he didn’t know how and had refused medical-alert systems. She called a neighbor, who took him to the hospital for emergency hernia surgery. Thinking the crisis would make them open to moving, Nonie found a nearby senior living apartment.
Her dad said no.
She recalls thinking, “Oh my God. I can’t do this anymore.”
Nonie came up with a plan. She leased a two-bedroom, assisted-living apartment nearby. She typed a letter, ostensibly from the water authority. It said service was being shut off to repair a broken main and advised residents to seek temporary shelter. Nonie made a card reading, “NOTICE: TEMPORARY WATER SHUT OFF” for the couple’s doorknob. She enlisted Jamie Freel, a friend who was a former actor, to help.
Nonie told her siblings, mom, her dad’s neighbors, doctors, and staff at the senior-living community about her plan. “I wanted everyone to know what I was doing and why,” she says. Nearly everyone was supportive.
A nurse supervisor said she shouldn’t lie. Nonie could have gone to court but chose not to.
Shortly after, while visiting Hank and Marjorie, she retrieved their mail, including the purported water-company letter. She read it aloud. Then Nonie called the number listed and put the phone on speaker.
Freel answered, explained the problem and told the couple they would need to leave the house. He asked if Hank and Marjorie had questions. They didn’t.
“I think he just needed to hear a voice of authority telling him what had to happen,” Freel said of Nonie’s dad. Freel said he had no qualms about playing the role. He had listened to Nonie talk about her parents’ deteriorating conditions and was a volunteer hospice worker, familiar with dementia.
Nonie packed Hank and Marjorie’s bags and dog. She told them they could stay at “her apartment,” referring to the apartment in the senior-care community. She stayed with them for a month. During that time, she says, they never asked to return.
“They forgot they had a home,” says Nonie.
Denise Brown, whose Caregiving Years Training Academy certifies caregiving consultants, says Nonie’s monthlong stay demonstrated her desire to make sure her parents were all right. Nonie, she says, also accomplished something Brown couldn’t.
Brown’s mom was in rehab after a serious illness and wanted to return home. Brown said she wasn’t safe at home and had to move into senior living. Years later, she remembers the look on her mother’s face.
“I broke my mom’s heart,” says Brown. “She (Nonie) figured out a way to keep them safe without breaking their heart.”
Nonie believes her parents would have moved on their own if they had physical limitations, rather than dementia.
Jason Resendez, president of the National Alliance for Caregiving, sees more caregivers dealing with conflicting emotions surrounding dementia.
“At some point, it is really outside the ability of someone with dementia to determine what is safe and to ensure their own physical safety. That is entrusted to a family caregiver,” says Resendez. Doing so may involve deception and that is not necessarily wrong. One study, he notes, found that about 96% of residential-care staff use some form of deceit with people with dementia.
Nonie’s dad, stepmom and partner died within seven months of each other. Now 64, Nonie doesn’t want her daughter to go through what she did.
“It’s up to us in our 50s and 60s to really understand that we won’t be independent forever and to start making plans now,” she says.
Clare Ansberry writes the Turning Points column for The Wall Street Journal, exploring the various turning points in people’s lives. She was previously the Journal's Pittsburgh bureau chief, overseeing coverage of various industries, while also writing about issues involving aging, family, community and people with developmental disabilities.