Monday, August 29, 2011

The Cost of Leaving Loved Ones Behind

Today, I held my mother’s hand as they prodded her arm for a vein, my heart broke as they pulled it out as the left arm veins are no longer usable.  A hysterectomy to remove the mass of cancer and thirteen chemo sessions later, she is starting all over again as the last six sessions did not work in reducing the remaining tumors sitting close to the bladder, colon and one kidney.  
The second time they tried in the right arm and found a good vein, no collapsing, but the pain was evident on Mom’s face as her knees lifted towards her chest and her face visibly sunk deeper into itself.  

Two days earlier, my father who turns 80 in November, fell down some concrete steps onto the tar road. He was picking up his post, a normal everyday event.  He wasn’t hurt too badly, a bloodied finger and damaged pride. He couldn’t understand how he could possibly have misplaced his foot. He has fallen three times on this visit.

My stomach knots and my heart saddens into itself when I think of the fight that my mother still needs to face and of my aging father. This is part of their lives that I will not be around to support. 

I am lucky, I have two wonderful sisters who have been around to drive my mother to and from the oncology center, to hold her hand when needed and to support and love her through part of this challenge.  All four of her daughters were with her when she was diagnosed, all four of us were with her at her first meeting with the Oncologist and all four of us were there for the first chemo session.  Unfortunately, my two sisters still living in the country live 11 hours away from her actual home, one of us is in Ireland and I am an expat. Mom has been living with my two sisters that are still here, one year on and she wants to go home to fight this fight, with her husband at her side and in her own home.  This leaves her four daughters many miles away from her, with an aging husband for support and the hospital an hour away. It is not the ideal situation.

In the last year, two of my friends have lost their fathers, they are both expats. Both knew their fathers were ill but were not there in the final moments. Another friend rushed home (a 2 day trip to the USA) because her mother had been given the last rights, she survived and is still going strong.  This is the reality when you are an expat living far from your home and have aging parents. You hope that they have sufficient support or family around to help with their requirements, that they have love and comfort, but you just never know what the future holds and that is the toughest part of leaving them behind. Each visit home I make sure that we spend quality time together, knowing that “You just never know”. 

On this visit I have been trying to convince my parents that the house with 12 steps up to the front door is not the best option to grow old in. We have looked at retirement homes, options of frail care, discussed the what ifs and what nots of cancer and ageing, the pros and cons of moving, and that at the end of the day the decision cannot be made by anyone other than themselves (at this stage anyway). This is their decision, where they want to spend their final years and quite frankly I want them to be happy, cared for and loved.  We are concerned for their welfare and we as their children will have to finalize whatever the outcome of their decision is.  

An Expat friend of mine wrote a blog with regards a Granny who was left tied to the toilet in an old age home, where she died READ Gwendaline Gleeson.  This is not what I want for my parents.  

I am frayed, how can you force your parents who have looked after you into adulthood, to do something that they are not comfortable doing. Yet, you know that the options are limited. They have no daughters close at hand to check in on them on a daily basis, they live in a house with numerous staircases that need to be maneuvered more agilely than they are capable of, chemotherapy is 50 minutes away which requires driving, while housework and meals need to be considered.

Thanks to medical science, our parents are living longer and so will we. Adults over the age of 80 are a fast growing segment of our population and unless they have provided a good pension for themselves, they will be dependent on others for their basic needs and medical support. 

So what are the solutions?

Firstly you need to consider your cultural roots, is it disrespectful to place your parents into an old age home?  Do you come from a culture where parents live in their children’s homes when they can no longer care for themselves? As an expat how can you accommodate this?

Consider the society you live in, if your parents live at home but both you and your partner work, who is there to look after them? Would you need to consider a caregiver? What about their social lives, can you cater for them to socialize during the day while you are not around? Where is their safety net when you are not around to help?

Allow your parents to make an informed decision, give them all the options that are available. These can include retirement villages with frail care units, remaining in their home or yours with part time or full time nursing staff, hospitals that are close by, etc.  

As an expat this decision becomes more difficult to answer, if you are not in the country to care for your parents, do you have the answers? 

As an expat have you thought about where you are going to lay your head to rest? Have you thought of the consequences and have you planned for your own retirement years?

I always think that if I was in the same situation, I would want to make the decision of where I would want to grow old, the view I would want to appreciate and where I would want to die.
Wouldn’t you?

Denise is an Expat, Mom, Wife and Marketing Manager at a website that provides cost of living index information and calculates what you need to earn in a different location to compensate for cost of living, hardship, and exchange rate differences. The complete cost of living rank for all 300 locations for all 13 baskets is available here.

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