Physical therapist Jeannie Coston helps Lynn Wetzel, 74, exercise her joints in Wetzel's bedroom as Wetzel's daughter Carla Timmerman-Stuart learns how to continue helping her mother from occupational therapist Kathy Hinson. Timmerman-Stuart's family is living with Wetzel as they try to help her cope with the challenges of old age.
Photo by M. Scott Moon
The Wetzel family experienced the reality of coping with the aging process after caring for their parents at home became a priority.
With the average life ex-pectancy now extending to 90 and beyond, more adult children are faced with the decision of where and how their parents will be cared for.
Carl Henry and Alta Lynn Wetzel taught their four children Carla, Cynthia, Burton and Carroll to think for themselves, work hard and believe in the Lord. They learned their lessons well, each making their own way, having families and setting up their own homes which is why it was easy to miss the first signs that their parents needed assistance.
Both born in 1929 and raised during the Depression, Carl and Alta took nothing for granted, saved, planned and dreamed of the things they would do once Carl retired from his oilfield work. Their foresight and long-term planning paid off, but not how they had hoped.
Carl retired in 1993 as a Kenai gas field operator for Unocal, but the couple's "golden years" did not go quite as they had planned. Carl developed health problems that eventually left him wheelchair bound and plagued him until his death last March. In the meantime, his care, the household chores and the daily errands fell to Alta.
Still, the couple maintained active lives attending church, enjoying the outdoors and league bowling and continued to remain optimistic that Carl's health would improve.
"The lessons they learned in the Depression were burned into their way of life you worked hard, you made do, you did what needed to be done and you didn't whine about it," Carla, 52, said.
The couple had assured their kids all was well, but by 2000 the changes in their parents' daily life became apparent. Many gentle but insistent talks about their parents' ability to handle even routine chores ensued between the couple and their children.
Coston and Wetzel share a laugh while working on mobility exercises. "It's the strength, coordination and balance we want to maintain," Coston said. Wetzel's daughter Carla Timmerman-Stuart said the family has had to install motion detectors and other devises to help them keep Wetzel from injuring herself in her home.
Photo by M. Scott Moon
Alta's own health was beginning to decline. Parkinson disease-type tremors, forgetfulness and disorientation had begun to affect her ability to help her husband.
The couple discussed the options available to them: assisted living, where they could live alone but have on-site medical care available to them, or living in a senior citizens facility, where a smaller apartment and help with errands would lighten Alta's responsibilities and meals and companionship would be just down the hall.
In the end, an overwhelming desire to stay in the home they worked so hard for and hoped to leave behind as a legacy to their children and Carl's belief that theirs was only a temporary need led them to the decision to ask Carla and her family to return home to help.
At the time, the Wetzels were typical of many American families in that they lived spread out in different states. Carla and her husband, Keith Stuart, lived in New Mexico; Burton, 51, and his wife, Melody, lived in Anchorage; Cynthia, 49, and her husband, Mike Sausedo, lived in Virginia; and Carroll, 50, and his wife, Grace, lived in Arizona.
Not typical was the fact that Carl and Alta were able to help make the choice. According to the National Family Caregivers Association, one in four households are involved with caring for an elderly family member. For many of those families, the decision had to be made after an emergency took place and there was no time to consult with all members of the family about the best course of action.
Carla and Keith had been living in New Mexico for about 18 months and were looking into business opportunities.
"Mom and Dad where always our support system. It was important to help them. It was my turn to give something back," Carla said.
"The plan was to come home to assist them, not take over their lives. That meant leaving the house the way it was and never making a decision for them that they could do themselves," she said.
After seeing the day-to-day interactions between her parents, it became apparent it was going to be a long-term arrangement and a second discussion be-tween Carla and Keith took place concerning their time commitment.
"It was a given I would help Carla take care of her folks," Keith said. "It was understood that our marriage would take a back burner and our time would come later."
"Communication and Keith being, without a doubt, the most loyal man I have ever met makes this work," Carla said.
Carla and Keith help pay bills, care for the home and cook. Carla also attends doctor appointments, arr-anges physical and occupational therapy and home health appointments, files Medicare paperwork, takes notes to share with her siblings and does Internet research on the medications and medical procedures that are taking place.
Carla Timmerman-Stuart loads a pill carrier with her mother's medications and vitamins. Keeping prescriptions filled and making sure elders take them as they have been told is one of the many challenges that family's face when they need to step in to help.
Photo by M. Scott Moon
"Over the years Dad's health continued to decline and Mom began to withdraw further into dementia, decisions I had never thought about and didn't want to consider had to be done," Carla said.
Tough issues had to be brought up and decisions made about legal and financial matters. Health care directives had to be discussed and put into place.
While Carla was in the heart of things, the rest of the Wetzel kids were burning up the phone lines, e-mailing, visiting as much as possible and keeping abreast of things as best they could.
Long-distance care giving is stressful and often leaves family members living far away with feelings of helplessness. Another difficulty Carla faced was, due to different time zones, getting medical updates to her siblings and input back from them in a timely manner, but their desire to have their folks at home helped ease early misunderstandings.
"We are lucky that Dad and Mom got their wish to remain at home together. Dad was sure clear up until he died that he was going to get better. He didn't, but he got to be at home and with Mom until almost the end," Burton said.
As Alta's signs of dementia intensified and she became increasingly disoriented, it was apparent to everyone but her that it was time to stop driving. Even after getting lost several times and Carla and Alta having "strong words," it wasn't until Alta got in a wreck that she finally gave up the keys to Carla.
"This was the hardest thing to do. We tried so hard to let her make up her own mind, give her dignity to choose," Carla said.
So far, the planning that Carl and Alta did early on has helped her remain at home, but as her savings dwindle, on the horizon looms the need to find financing so she can continue to be cared for at home.
There also are Carla and Keith's own financial worries. For, Keith working away from the home was not cutting it. Carla needed his emotional support and a physical break, if even for a nap. Keith began Professional Carpet Systems, a home-based business, figuring it was the best way to support his family and be flexible enough to help Carla when she needed it.
Timmerman-Stuart works to catch up on insurance-related paperwork in the family's home office. She said it is a real challenge to manage her family's finances, her mother's finances and the needs of the family's carpet care business all at the same time.
Photo by M. Scott Moon
Burnout is a major factor for care givers. In a survey of National Family Caregiver Association members, 65 percent said they suffered from depression due to their care-giving experience. Carla is aware of this and has applied for respite care through the area NFCA support program. If accepted, the family will qualify for eight hours of care a week.
"I need to be able to leave. At first, my granddaughter, Natasha, 13, could stay alone with her for short periods of time, but Mom has become too unpredictable. Now if I need to go somewhere, I have to wait for my son, Brandon, 25, or Keith to be available. They are big enough to keep her inside the house should she set her mind on taking off," Carla said.
Natasha reads aloud or watches their favorite soap opera, "The Young and the Restless," with her great-grandmother. The hardest lesson to learn was to not take personally the mood swings that her great-grandmother has and to remember they are changes taking place due to her illness.
Wetzel's hands work to grasp a latex band during a physical therapy session in her home. Wetzel's family hopes that their care can make old age as comfortable as possible.
Photo by M. Scott Moon
Alta's sleep patterns change constantly. She sometimes wanders about or stays awake all night, so the family installed a motion sensor, voice monitors and bell for Alta to ring when she needs something. The family also subscribed to Lifeline for her. Lifeline is a response service designed to ensure that older adults living at home can get fast assistance whenever they need it, 24 hours a day, 365 days a year. Subscribers wear either a pendant or wristband that has a personal help button they press when in need of help. Carla, however, is not sure her mom would remember how to use it in the event of an emergency.
Worth the trouble
For Carla, the number one problem with caring for her mother is the red tape that surrounds applying for assistance, filing insurance, following up on insurance and just knowing where to begin.
"It is mind boggling and we are everyday people, not professionals. It is mostly everyday people that are caring for their loved ones, so somebody should make it easier," Carla said.
She gives credit to the First Choice Home Health and Hospice workers and nurses for teaching the family how to properly handle the physical needs of her mom, and the Independent Living Center and National Family Caregiver Support Program for helping her maintain her sanity and search for funding to assist the family in keeping their mother at home.
Though it has been challenging for the Wetzel kids, the pride they feel in being able to respect the wishes of their parents and give back to them a portion of the care they received is worth any of the moments of stress and hardships they have en-dured.
"Being able to sit with my mom and knowing who is taking care of her at all times helps make the hurt of knowing that bit by bit she is leaving us a little easier to take," Burton said.
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