I met Sarah one evening when my wife and I had been invited to an open house at the newly opened Continuing Care Retirement Community (CCRC) near where we lived. We were early and the first ones there so I had a chance to get acquainted and visit with the Hostess without any interruption for a short while before all the other invited guests arrived. Sarah was the hostess and a resident. She was a very attractive, silver haired lady in her mid-seventies. I was asking a number of questions about the community and its services which she answered fully but I could tell she lacked a certain enthusiasm. So I asked her if she was really excited and happy about living there; she said no.

Naturally my next question was why she would volunteer to be the Resident Hostess if she was not enthusiastic about her circumstances there? Her reply was that it was a perfect place IF you needed to be there. So I asked her to explain. She told me about her very active life: she was an active member of the Assistance League, the Symphony Association and many other organizations. She had lots of activities, friends and associations outside and apart from the community that kept her very busy and involved. She just didn’t feel like she belonged there.

So I asked how she happened to be there. She said that she had been a widow for a few years and her two sons lived a long way from where she did. One Thursday the both showed up together and unexpectedly. By Saturday she was all set to move into this community. Her sons (there were no other children) were obviously worried about their mother’s well-being and safety and their ability to respond quickly if something happened to her. Her move was, in part, an effort to give them some comfort that their mother would always be in a safe, responsive environment that could respond to her needs as she aged and her needs changed. But she wasn’t ready for the move; at least, not yet.

Cita I know a lot more about; she was my mother-in-law. She lived until age 94 and the last 11 years was on her own. She had lived in the same retirement community and home ever since she was about 65 years old so when her husband died it was easy for her two daughters to agree that she should stay there as long as she wanted to and could. She had macular degeneration but because she knew her home and her surroundings like the back of her hand she was able to get around very well.

She walked about a mile one way a number of times each week to go swimming and often took walks around the community. It was a gated and guarded community with controlled traffic so it was safe and easy for her to get around. She had many long time friends and activities that kept her involved and interested in her life. It was an easy decision for everyone for her to stay where she was at home and safe. There had been talk, while her husband was alive, of moving into a continuing care retirement community such as Sarah moved into but because he was not well she didn’t want to move him. And after his death she had no desire to move.

My wife would drive down to be with her Mom every month or 5 weeks (her sister lived in the immediate area) and help her with her chores but mostly just for a visit. Over time it became noticeable that the house was not getting cleaned as well as normal. My wife would make up a number of individual size dinners and freeze them for her Mom but when she returned a few weeks later they would still be in the freezer. Occasionally I would come down and help clean up the yard and would find burned pots and pans hidden in the bushes. Cita’s eye sight was getting worse and she was losing her sense of smell so she was burning her food when she cooked more often. So she quit cooking and was eating cereal. Her hands were losing there strength so it was harder to push a vacuum around and too see any dirt and dust. My wife and her sister tried to hire help but Cita would fire them when they came to the door.

Cita began to complain to the neighbors that no one every visited her or called even though my wife would have just been there and her sister stopped by frequently. They both called often and we were certain that her friends were contacting her as well. One morning on her walk, when it was very cold, she had both hands in her pockets when she fell on her face. Even though it was early in the morning there was a lady who saw the fall and immediately helped her get home. She was a nurse as well. Fortunately there were no broken bones or serious harm done but it ended her walking; she became afraid to go out on her own. Then the neighbors began to call to say that Cita was often over there crying and very distraught over her loneliness and isolation.

My wife and her sister reluctantly decided to move her into an independent living retirement home near us. It was a wonderful, warm and loving environment run by a local church. There were three meals a day and weekly housekeeping. Her room was spacious and inviting as were the common areas. It was ideal but Cita was very unhappy about being moved; even angry. This situation required that she be able to care for her own personal needs and be ambulatory. Within about a year she was unable to care for herself so we had to move her into an assisted living home. Again it was a very warm and supportive environment with very engaged and qualified help but because many were Hispanic, Cita thought she had been kidnapped and taken to Mexico. She refused to take her medication and was a disruption to the home for a few weeks after her arrival but eventually, as she had before, became accepting of her situation. Unfortunately this occurred not long before her sudden and unexpected death at age 94.

The question these two stories raise is which set of children made the wrong decision? Was it Sarah’s two sons who moved her against her wishes when she was still very active and engaged in life or was it Cita’s two daughters who moved her against her wishes when she had become mentally and physically unable to care for herself?

The answer? Neither of them made the mistake. It was Sarah and Cita who made the mistake of not envisioning their future and the possible outcomes as they aged. If they had, they could have (should have) given guidance to their children as to what they would want when they could no longer live as they had been living and guidelines on how to make that determination. It is possible, even likely, that when the time came for a move they would still have been resistant and unhappy but, at least, the children would have known that they were doing what their mothers had wanted them to do when they were in a position to think things through with detachment. If this had been the case both Sarah and Cita would have retained their autonomy and control over their lives. As it was they lost that and their children were never certain that they had done the right thing.