Wednesday, September 29, 2010

Convalescent care

I spent some time yesterday chatting with friends I have known for 20 or so years. Our kids were all in kindergarten together. As the years go by and our kids grew up to go to different elementary, jr high, high school and colleges, our conversations have changed but we still offer advice, still sympathize with the headaches of child raising. We've gone through bullying, rebellion, entrance exams, failures, successes, boyfriend-girlfriend relationships etc.

Times are changing. Our conversations now flitter towards how to stay young, husbands' health problems, and most recently, parents and in-laws.

All of our parents and in-laws are in their late 70s or 80s. There have been a few funerals in the past couple years. That has been hard. Maybe harder though is the period of increasing dementia that so many of our parents are facing. My mother participates less and less with family activities. She forgets most things but seems content. A few years ago she went through a stage of fighting for her rights (right to drive a car, right to manage her own finances) but she is past that now and lets everyone else take care of her. "Time to take a bath, Mom." "Okay… if you say so…"

But some of my friends are at that difficult stage now. Parents calling or knocking at the door at all hours. Complaints, accusations, losing things, odors. Some of my friends are angry. Why should they have their feelings and life tossed around by this older person who has no regard to how sharp words, hysterics and threats hurt. And then there is the guilt. "I really should visit more." (This is my own guilt towards Tetsu's mother.) "I really should quit my job or take an extended vacation to care for my ailing parent (or parent-in-law)." I think these feelings of guilt are more prevalent in Japan because traditionally the eldest son and his wife cared for the parents till death. Until the past 20 or so years, there WERE no convalescent homes. That was the lot of the wife of the elder son; to produce sons herself and to care for her in-laws (from the first day of marriage!) You can see why a lot of women said that there was no way that they would consider marrying the eldest son of a family!

The elder son's hospitality is longer the only option for the older generation of Japanese. Other siblings are likely to get involved with care. There are convalescent homes springing up everywhere in Japan nowadays (Japan has the highest percentage of population over 70 years old in the world). They offer baths and ball throwing games, childish finger plays, kindergarten instruments and activities. There are programs for temporary day care, for overnight stay. There are programs for meals-on-wheels and low cost taxi service. There are helpers who come into the homes to clean or cook or cut toe nails. There are care managers who arrange transportation, schedule doctor visits, and evaluate the elder person's situation monthly.

But for many of this generation of elderly (Tetsu's mother, my friends' parents) all these programs are shunned as proof of ungrateful, adult children. I have heard a couple of times that at the mention of using such facilities the old grandma or grandpa will say (scream) that they would rather be killed right then and there! And then there are my friends who have already placed their parents in convalescent care yet feel a sad guilt that they couldn't or wouldn't do more…I can see no answer to the dilemma. If you put grandpa into a home you feel like you are a lousy daughter. If you bring him into your home you are likely to go crazy and do something unforgivable.

I think it will take a while before the Japanese society gets used to the idea of care for parents outside the home… And maybe a while before those in care get treated as more than aging children. MY generation, right?! Am I going to be ready? Will I go quietly? You could make me very happy right now if there was a lot of fabric and a needle and thread but when I'm 80? Am I even going to be able to SEE? I only hope I will be a cheerful old lady and go smiling to wherever I'm bound.

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