An “Oh shit!” moment and old world nostalgia
He cried. He stood on our grandfather’s porch in Ciudad Juárez, Chih., tears running down cheeks still padded with baby fat. Before him, a nurse and medic loaded our patriarch into the ambulance parked in front of the house. He’s my cousin, and he wasn’t quite a teenager when this happened, if memory serves, but already, he had helped care for our grandfather in his last weeks with cancer. Until the decision was made — by adult family members I assume — that our grandfather needed to be in a hospital.
“But you don’t know how to take care of him like I do,” he said, begging them to leave his abuelo at home. Over the years, I’ve come to interpret his expression at that moment as one of bewilderment: We’d been taught to have the utmost respect for our elders. When they were sick, we cared for them at home and there never seemed to be a shortage of someone who could step in to help. Yet here we were entrusting strangers with our grandfather’s care! How could that be? When our grandmother died, we held her wake in her living room, for Christ’s sake! That’s how traditional we’d been up to this point.
The ambulance eased away from the curb and moved down the street anyway, inching us further away from old world traditions such as caring for our elderly at home.
I thought of this yesterday because my sister e-mailed to say that one of mom’s caregivers quit overnight and the Medicaid agency has up to two weeks to find us another caregiver. In the meantime, should she look into adult daycare for Mom? Should she take her to work with her? We have another caregiver whom we pay out of Mom’s resources but her shift is Monday and Tuesday, and yesterday was Wednesday. What did I think of Mom spending a few hours alone?
My first email back was literally: “shit!” Then I thought of my cousin, and of how expansive our family seemed then, rife with children, grandchildren and sons- and daughters-in-law who lived close by or in multi-generational households. Everyone helped. Back then, we would not be facing this heart-stopping moment of deciding what to do about someone who should not be alone.
Our mother can still be alone for a couple of hours. Most of the time she sits and prays her rosary. But the cognitive gears can slip at any time. My mother-in-law lived in my house for about eight months, and I’ll never forget the time my husband called me into the kitchen. “Beatriz, my mom doesn’t know who I am,” he said very gently. “Would you please explain that I’m her son?”
The big differences in our families are financial and cultural. His mother has a pension and savings that paid for caregivers during the day and long-term care insurance that covers a big chunk of the care she gets in a wonderful memory-care residence now. Our mother’s pension and Social Security add up to a few hundred dollars a month. Plus, my family is still very Mexican in at heart — we struggle with holding on to old world traditions in the face of western culture’s fast-paced evolution. One of my closest cousins flat out asked that we never place Mom in a nursing home. I don’t want to do that either. To do so would feel not so much like giving in to today’s social norms — rather, it would feel like giving up a part of my cultural and family history. Not to mention the very practical issue of quality. I fear the quality of a government-paid facility would not equal the standard of care someone like my mother-in-law receives, and we simply could not afford to pay for that ourselves.
I’m a realist. Our extended family is fragmented now. We live in our small nuclear family bubbles, in different cities, and we all work. We can’t afford to not work. There is a very good chance we will be facing even more difficult decisions than the one yesterday of what to do about Mom for a few hours. I’m just hoping we face those decisions later rather than sooner.