Once in awhile, the realities of public policy become not just public, but personal. This happens when you leave Mom in a nursing home, with some poor bastard at the end of the hall endlessly screaming, “Help” through halls reeking of stale urine. This at the best nursing home you’ve ever seen.
Meantime, by way of contrast, the federal Department of Justice – they have the gall to call it that – wrenches guilty pleas from a half-dozen of the world’s largest banks for gigantic fraud schemes. So Jamie Dimon, the smirking CEO of J.P. Morgan Chase, goes to prison, right? Wrong. He gets fired? No. He’s no longer welcome on Capitol Hill? Get real.
Mom’s no Jamie Dimon. She’s just a poor woman, bent by age and wearing work. She never amounted to much at all – nothing like a law-breaking banker with impunity for crashing the world economy. She never did much in her life. Along with millions like her, she just beat the Great Depression, weathered and won the biggest war in the human history, reared four children, helped the civil rights movement along, promoted peace and justice by serene example, made such money as she could in jobs that never matched her talent, then lived to see ther granddaughters in professional careers and her friends and neighbors in an atmosphere of marriage equality. No, she never amounted to much.
I never agreed with Tom Brokaw that hers was “the greatest generation.” It was a generation that, like every other, rose to its challenges, but the challenges were immense. And every story, like my mother’s, is personal and intense. Hers goes in part like this:
Mom was a child of immigrants. Her parents left Norway and never looked back, which fact gave their children a rootless existence in a society of other immigrants’ great-grandchildren that never quite accepted them. She was a small-town girl and then a farm wife. A few years after the Big War, when it was no longer possible to maintain a family on the farm, even with a job in town, we moved to a big city of 60,000 blue-collar souls. Mom never suspected that the women there would condescend to her carefully hand-sewn garments, the product of skills they were, themselves, trying hard to leave behind. Cruelty was always foreign to her, and familiarity failed to make it less surprising. Call it naivete. I just never knew anyone else who failed so utterly in the universal human struggle to lose our innocence.
She didn’t lead a life at all for 55 years or so, but was led – led or ordered about by one power or another. It was the trial of divorce that liberated her and opened to her, eventually, the opportunities of full adulthood. She took advantage.
Now, though, twilight deepens into night for her and so many other such gentle heroes, and we are powerless to stop it or slow it or, often, even to ease the path. Theirs is the road to the nursing home, their wits intact for the moment, while around them the cadavers still technically alive waste away in a grotesque ballet of confusion and half-consciousness.
Why? Because that is what we, their sons and daughters, have decided we are prepared to pay for. Oh, not individually. None of us intended this to happen, and many of us promised our parents it never would. Then faced with the expense of assisted living or home care, we realized we’d have to take what government self-insurance programs would provide. And because we never paid sufficient attention to the whole, complicated, boring business, we didn’t expand Medicare to cover the practical alternatives to nursing homes, let alone to just take over the whole healthcare system because it is the most efficient part of the system.
Medicare and Medicaid typically don’t cover the interim, if there is one, between independent living and the nursing home; it’s one or the other at the end, whether or not assisted living or in-home care would be cheaper, and whether or not it might be appropriate or more humane in many a case.
As a society we failed. We didn’t pay attention to the details of our programs and the future of the elderly, all the while hoping to become elderly ourselves, and we failed. When it’s our turn, it won’t be better. We are so very fortunate in that when Mom’s insurance-covered rehabilitation ends, she can stay where she is for long-term care, and if she recovers enough for assisted living, there’s a place she can go. But so many millions of others are not so fortunate, and they are surprised by what happens.
It’s hard to leave someone you love in a place like a nursing home. The cruel irony of calling it a home stabs like a dagger. But sometimes there is no alternative, and sometimes the best alternative is rotten. It’s just that there should be alternatives, and there should be hope so long as we all have our marbles. As it is, even the dim realities of what we do provide as a society are constantly under attack from a right wing that says we can’t afford them; we can only afford trillions more for endless war.
Oh, but it’s alright. Mom’s no Jamie Dimon. Neither are the rest of us.