The Nuclear Option

From time to time, I find myself talking with friends and family about aging in place. The expression, aging in place, refers to staying in one’s own home well past the time that others may have moved into alternative living settings – living with one’s offspring, a younger sibling, assisted living, or a nursing facility.

When I was a child, my paternal grandmother came to live with us. She was dying of cancer. The family story was that she had injured her hip and that cancer had grown at the site of the injury. Decades later, as a medical student, I sifted through the nonsense. She had been a lifelong smoker and like many of my geriatric patients who had long smoking histories, developed lung cancer that metastasized to her bones. She died in the care of her eldest son, my father – in our home.

My maternal grandparents lived in a multi-generational home that they had built. Their eldest son and youngest daughter never married. The two siblings took care of their parents until they died in the home that they themselves had built – aging in place.

Multi-generational households in the US occur most often among poor and lower middle-income families, I think. They are mostly minority households, I suspect, but I don’t have hard data on this. These days, in the US, the mark of adult success is the nuclear family. It is so much so that we talk about boomerang kids as if returning to one’s parental home were a mark of impending if not actual failure to achieve success as an adult. I am no less guilty of this bias than any other American.

Combing my hair, standing in front of the mirror this morning, I reflected on my desire to live out the remainder of my days in this house. I have mentioned this in other posts – recalling that my maternal grandfather, Don Jesus Lozano, would say that he wanted to die in his home because, “Estoy enamorado de estas piedras,” – I am in love with these rocks. He wanted to age and die in place.

As I cogitated the reality of the remaining years of my life trajectory, I pondered what it would take to make it possible for me to age in place until the end. As we age, some activities become more difficult if not impossible for us. I recently paid a bag of silver to have our flower beds cleared and prepared for new plantings. Three young men did in one day what would have taken me eight or twelve weeks to accomplish. Aging in place, I must conclude, requires help, and help, in turn, requires money.

Those who have resources to purchase the help that makes aging in place possible, are blessed. Those who do not, must turn to family or government. Those who have no family to help them and who do not qualify for government assistance are fucked. I so hate it when that happens.

I stood there, staring into the mirror of my dimly lit bathroom, thinking about the lady electrician that I had hired to come this afternoon to replace the ballast of the bathroom’s CFB light fixture because it is too much of a chore for me to undertake these days.

Sigh. Aging in place is challenging when we have chosen the nuclear option.