Who Is My Neighbor?: Elders Among Us
John and Nancy probably never knew each other, but they would have been good friends. Their teenage years were shaped by the Great Depression, each served in the military in World War II, and both enjoyed a middle-class life thanks to the post-war boom. Neither frankly expected to live beyond the age of 80, and each now wondered whether passing that milestone was a good thing.
John, a widower who lived at home, suffered from mild dementia and went about his days in a quiet way, just trying to get through. John’s son, Bob, had moved in with him four years earlier after the death of John’s wife. Some neighbors on the cul-de-sac thought it was nice that Bob was caring for his father, but others questioned whether Bob was taking advantage of him. After all, the new car in the driveway was not exactly something John would drive.
Nancy, who had never married or had children, lived by herself in a small apartment about 20 miles from John. Thanks to her Social Security payments and pension, she was not hurting financially, but she rarely had visitors. Unfortunately, Nancy had suffered a nasty cut on her foot a couple weeks back. It would heal, right?
John and Nancy’s names, as well as small details, have been changed to protect their families’ privacy. Though both died some years ago, their stories illustrate the unfortunate incidents that pastors, physicians, and attorneys are seeing more and more frequently because of our growing senior population.
In John’s case, I was retained by his daughter, Sarah, to determine exactly what was going on in John’s household. Sarah, a successful businesswoman, believed John’s mind was failing and her brother was milking her father’s bank and brokerage accounts for all they were worth. After learning from Bob that John did not have an attorney, I suggested that Bob, Sarah, John, and I get together at John’s home to talk about John’s circumstances. Bob stalled, made excuses, and then ultimately refused to have such a meeting. It was later established that Bob had stolen more than $150,000 from his father while living with him.
What could have been done differently to allow Bob to take care of his father while eliminating the temptation to steal from him? Ideally, before John’s mental abilities were compromised, he would have established and funded an irrevocable trust. A person of John’s choosing, perhaps an experienced accountant, would serve as trustee. The trustee would manage the trust’s assets and make sure John’s needs were met. With the trust in place, Bob could have lived with his father rent-free and perhaps have been paid a small salary as his father’s caregiver. Bob would have driven John’s old Chevy, however, instead of a new car.
Nancy’s matter, sadly, was more tragic. The wound she had suffered festered for two months, and no physician saw her until she was admitted to the emergency room. At that point, a doctor determined that tissue in Nancy’s right foot had died from gangrene. Nancy’s foot had to be amputated.
Discharged from the hospital, Nancy was sent to a nursing home. Her mental state deteriorated, and none of Nancy’s extended family members stepped up to assist her. In such situations, a facility will typically petition a probate court to select a conservator to oversee the patient’s personal well-being and financial affairs. Nancy’s court-appointed conservator was me.
Each week, I would go to the nursing home to meet with Nancy and her caregivers. Often, I would bring my two-year-old son and a pizza (Nancy’s favorite food) to brighten her day. I knew she really looked forward to our time together, but I was left to wish that, somehow, I had been able to prevent the circumstances that led to the loss of Nancy’s foot.
It would be nice to say that cases like those of John and Nancy are rare. Yet, at least once a month I encounter a shut-in who is living in filth, a retiree who is the victim of a scam, an elderly person who is a danger to himself and others because he refuses to give up his car keys … the list goes on and on. The common thread in each instance? The senior is isolated from a community of people who could provide the help that he or she desperately needs.
When encountering a senior in difficult circumstances, the attorney, physician, or pastor is typically not in a position to solve the problem immediately. The professional cannot compel the senior to hire a cleaning service, stop driving, or fund an irrevocable trust to preserve the senior’s assets. Such matters are each senior’s call until he or she is found to be incapacitated in a probate court proceeding. A further complication is the professional’s duty of confidentiality. Absent consent from the senior, an attorney may not contact the senior’s family members to discuss the senior’s care or financial circumstances.
With professionals’ hands tied, what can be done to assist the elderly who are on the margins of our society? In a world obsessed with youth, beauty, and the acquisition of material objects, the care of seniors would seem to be way down the list of important things to do. Indeed, it may sound like a fantasy to think a neighborhood or church could find the time and resources to care for the elderly. Yet I have seen it happen.
Back in the mid-1950s, a middle-aged man suffered a heart attack and died while working on his roof. His childless widow, Lee, continued to live in the house for the next 40 years. In the 1990s, it became clear to Lee’s neighbors that she was not exactly making ends meet. Rather than ignoring the elderly woman in their midst, the neighbors pitched in. One took her grocery shopping, another mowed her lawn, and one couple paid Lee’s heating oil bills out of their own pocket. Lee was able to live in her home to within a year of her death because of the help she received from caring people around her. The best part? Those who helped Lee said her thankful smile made their exertions totally worthwhile.
The neighborhood effort with Lee is one model of care for the elderly persons who live near us or attend our religious services. Another is Stephen Ministries or similar programs sponsored by religious congregations. In the case of Stephen Ministries, lay people are trained to offer one-on-one companionship or care to a hurting person in the community.
In my church, the lay ministry program is called the “CareNet.” Members are assigned to individuals who have suffered a death in the family, loss of a job, or other traumatic circumstance, and to seniors who simply need a friendly visitor to check in on them. In some cases, the senior will be easygoing and enjoy the attention. In others, it is all you can do to convince the senior even to meet with you.
In the mid-1990s, my pastor decided that, since I was attending YDS, he’d give me one of the most difficult CareNet assignments in the church, a woman I will call Shirley. Shirley was not a shut-in by any means. She loved attention and very much enjoyed our outings to lunch, to community events, and even to the Divinity School, where I had her sit with me in classes one day. However, no matter what I did for Shirley, she recited the same specific problems of her life each time we met. Nothing I could do would change those facts. After beating my head against the wall over and over, I learned something very important about pastoral counseling: I could not even begin to solve problems like loneliness and grief. All I could really do was sit and be present with the person in my care. The key was to listen actively and help where I could.
Churches, of course, are not unique in trying to assist our elderly. Some towns are launching Aging in Place initiatives to help seniors live longer in their own homes while retaining important connections to their established communities. Corporations and not-for-profits are developing assisted-care facilities that offer multiple phases of support as health transitions unfold. There, a senior can start out in her own apartment with limited services, then, as her needs change, move to assisted-living and if necessary to 24-hour care and supervision. Such initiatives will be critical as our senior population surges.
As I stressed earlier, clergy and other professionals are not in a position to unilaterally solve our seniors’ problems. Nevertheless, it is important to keep a watchful eye on our elderly because we may be the first to notice significant issues. Working with seniors – in some cases, their families and neighbors – we can help them take steps to avoid the personal and financial disasters that, sadly, too often define the twilight of life in 21st-century America.
Joseph M. Pankowski, Jr. ’96 M.A.R. is a partner in the law firm of Wofsey, Rosen, Kweskin & Kuriansky in Stamford, CT, where his practice focuses on estate planning, elder law issues, and probate court matters. He is chairman of the Darien Commission on Aging and a lay pastoral care minister and occasional preacher at The First Congregational Church of Darien.