On independence, and the wisdom to know you shouldn't have it anymore

I went to Martha's 90th birthday party in Vacaville, Calif. I've told you about Martha, my mother's first cousin, who for 40 years moved around the world with the Red Cross to be the eyes, ears, legs and hands of our injured soldiers.

Martha's party was at the clubhouse at her mobile home park. Bright colored balloons and "Happy Birthday Martha" signs decorated the large gathering room. The side table was loaded with cherry and apple pies from Costco, and a large chocolate birthday cake. Martha, wearing her new pink dress appliqued with butterflies, sat down at the head table and thoroughly enjoyed her cherry pie and ice cream. Many of her friends stood up to share stories and remembrances. When I spoke, she tugged on my skirt and told me to sit down, embarrassed by my praise. We counted 62 friends and neighbors who celebrated with us. That is the happy news.

The sad news is that Martha is experiencing memory loss. Her short-term memory loss is severe, so severe that the day after the big party she remembered the cherry pie and that is about it. During the party, many of her friends came up to us, the family, to tell us that Martha needs more help than they can give her.

A friend, another cousin and I toured an assisted living facility with Martha - three meals each day, bingo, movies, gardening if she wants to, bus trips to the doctor and mall.

"Maybe someday," Martha says, but "not yet; not as long as my friends live next door."

We talked firmly to her about moving to assisted living. She quietly listened and said "not today." As we pressed the issue, she told us to "go home." Later I jokingly told her friends that they would have to move.

The friends and neighbors were sad to see us leave. They had no high expectations, but they held out hope that distant relatives could solve the problems.

I know that the elderly are much better off living in their own homes as long as possible. I know that services such as Meals on Wheels and visiting nurses are available to help them stay in their own home. We have those wonderful services right here in Mohave County through Mohave Home Care/Case Management, and the Kathryn Heidenreich Adult Center.

I also know that once independence is lost - even something as simple as deciding when you will eat - decline often speeds up and happiness recedes.

Will Martha physically and mentally continue to decline? Yes, but she is happy rocking in the sunshine. Will her friends/neighbors get tired of shopping and taking her to the doctor? Probably, but not yet.

Can she draw a clock? It is highly unlikely. One of the tests for Alzheimer's is to have the patient draw the face of a clock and place the hands at 2:15. My husband and I ask each other that once in awhile - can you still draw the clock?

I am forever grateful to my mother, who at age 80 made those decisions a year or two after my father died. She was headed for hip replacement surgery and knew she would need help, so she sold her house and moved into a retirement center. However, mother had one more reason. She was lonely and her daughters lived hundreds of miles away. Loneliness is a well-known cause of failure to thrive.

Keep your independence as long as possible, but make your own decision to move on while you are still able. That is good advice to remember.

There are other community living arrangements besides assisted living and the standard retirement center. I particularly like the Golden Girls concept where friends live together and take care of each other in more of a house/home environment; where you can still have your evening glass of wine and your pet cat; where you can eat on your schedule instead of the facility's schedule. We need more of those.

As for Martha, the State of California wants to take over for her own good. Hands That Help will visit and talk Martha into "doing what's best." I say "good luck." Martha will enjoy the company as they rock in the sun together and she tells them "not yet."

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While in Vacaville, I reunited with my cousin, Steve. Steve recalled visiting with Martha while he was in the Peace Corps in Thailand years before and Martha was in Vietnam. These days he is with U.S. Foreign Service as an attorney and economic officer for the State Department. U.S. Foreign Service personnel are required to serve out-of-country every three years. He served repeatedly in China, Japan and India. Now it is time for Steve to set out again - this time to Bagdad for one year. I asked him what he will be doing in Bagdad, and he rattled off three jobs. One assignment is to reduce government waste - as in money. I think there is a lot to do there. He will live in the Green Zone in half of a cargo carrier, an 8 by 10 space, and share a bathroom with the occupant of the other half. Steve is a large man, and says he will not leave Qatar until he has a flak jacket that fits.

Another question I asked was, "Do you find it difficult to support new policies when an administration changes?" He replied that he did not because when he signed up, he pledged to support the president. No matter what.