Last month, definitions for the term frontier were examined. Frontiers may be: 1: a border between two countries 2: a region that forms the margin of settled or developed territory 3: the furthermost limits of knowledge or achievement in a particular subject 4: a line of division between different or opposed things 5: a new field for exploitative or developmental activity. The predominate American concept of a frontier as a region (the West) to be settled is limited. The frontiers springing up around us now, with the exceptions of space and the oceans, are best described by definitions three, four and five.

Frontiers may be encountered on different levels. Some are world wide in scope, others affect specific regions, nations or cultures and many are individual or personal in nature.

Eldercare is part of a multifaceted frontier that is found on all three levels. World demographics show an age/population distribution that is changing rapidly and dramatically. It has been said that we live during a time in the earth's history where there are more humans alive at this moment than have populated the world since the dawn of mankind.

Certain countries have older "age mature" populations, others are dominated by the young. Demographics of age certainly carry implications for governments beyond the scope of this article. The elderly population of the United States has been growing at a moderate pace recently, but this rate of growth is projected to increase rapidly over the next twenty years.

	"During the 20th century, the number of persons in the United 
	States under age 65 has tripled. At the same time, the number 
	aged 65 or over has jumped by a factor of 11! Consequently, 
	the elderly, who comprised only 1 in every 25 Americans 
	(3.1 million) in 1900, made up 1 in 8 (33.2 million) in 1994."

On a more personal level, one thing is certain - each individual will some day face the frontier of elder care as it relates to parents or to that person individually.

When this series began my intent was to tell in a "Walden's Pond" style about my experience in eldercare with Mother. On returning to Raytown eight months ago, I set up a computer and started keeping detailed notes about my "experience". Like Henry David Thoreau, I kept "accounts" of expenses with the idea of making our household as efficient and as self supporting as possible. There was even a brief attempt at raising vegetables but the haul from generous neighbors far out weighed my pitiful efforts.

Right now, I want to go on record (as a matter of self protection and because it is true) and say that this period has been one of the most enjoyable in my life. There have been difficult moments but I would do it again without hesitation.

Mother's condition is this: she is 73 years old; she suffers from a neuromuscular condition that caused her to loose 40% of her muscle tissue eight years ago; she walks with the aid of a brace on her right leg and with the help of a walker; since February 1995 she has been attached to an oxygen condenser as a result of a lifetime of smoking.

She is still able to dress herself, prepare her toilet, and move from her bedroom in the Southeast corner of the house to kitchen/dining room in the Northwest corner of the house (about 140 feet) while attached to the oxygen tubing. Because of the loss of dexterity and muscle tissue she has great difficulty in preparing anything other than very limited meals. She has been greatly restricted in doing any house work for eight years (a cleaning service comes in) and has not driven since 1994.

Our plan was for me to move back into her home for one year to assist with meal preparation, laundry, grounds care, household maintenance, light house keeping chores, and driving while we looked at options for her future. Following are some of the issues that we faced together and our solutions. Not everything that we did is applicable to others but by presenting our situation, we may be able to guide others in similar circumstances.

Territory

I moved back into a home that had not been inhabited on a long term basis by a second individual since my sister married and moved to Colorado in 1980 (Father died in 1973). Moving in on someone's established territory can cause problems. Our family home is large with a furnished downstairs which is inaccessible to Mother because of her restricted mobility. I set up my primary residence down there rather than in my old upstairs bedroom. As with any well regulated household, we recognize areas within the house that are hers (upstairs - south end), mine (downstairs - garage) and common (breakfast nook, living room and dining room).

The kitchen is still a shared area and there have been times when a question of responsibility has been raised. It must be very difficult for Mother to "let go" of a duty that has been such a primary facet of her life for so long. We do plan meals together and Mother certainly has input and choices. We like the same foods so this is not the major problem that it can be for some elderly persons (2). The majority of the food preparation is done by me but at times we cook special dishes together and learning/teaching family recipes has been a source of great satisfaction for both of us.

Routines

Mother has well established daily, weekly and seasonal routines. Over recent years friends and relatives have built a schedule with her for keeping in touch and checking on each other. Each day at exactly 8 a.m. (it used to be 7 a.m. until about a year ago), there is a 'get up' call from her best friend Eleanor - they small talk about weather, the passing of the night, health and plans for the day. As the day progresses, a series of calls is made to and from her - regulated by a complex system of whether the day is odd or even and by which week of the month it is. These routines have remained intact since my return.

We have established our own additional routines working around those already in place. At certain specific times of the day we come together. Her morning coffee is delivered to her just about the time that Eleanor calls. Then we have a light breakfast at 9 a.m., lunch just after 1 p.m. and the evening meal at 6 p.m. followed by television together in the living room (News and Wheel of Fortune). At 7 p.m. she makes her evening calls. Other less precise contacts occur during the day when the mail arrives, when we sit on the front porch in the afternoon sun or when she occasionally comes up to the kitchen for coffee or snacks.

From the beginning, one of my goals was to give Mother a certain degree of relief from daily cares. In previous short term trips home, we had noticed how much better she had been able to sleep while another person was staying in the house. Her coffee consumption dropped dramatically during those visits and she also ate better. Since my return, her weight has increased from 100 pounds to 130, she actually shuts of the television at night, and she seems less preoccupied with household security. In this sense she has "let go" of some of the worries that can come with aging.

In conjunction with my exploration of the field of eldercare, I have plunged full force onto the cyber frontier with my computer. Next month, additional issues of eldercare will be presented along with some resources found on the World Wide Web that relate to elder care.

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(1) Sixty-five Plus in the United States
Bureau of the Census Statistical Brief
May 1995

Sixty-five Plus in the United States
Economics and Statistics Administration,
U.S. Department of Commerce
Elderly population -
Frank Hobbs or Bonnie Damon
301-457-2378

(2)"Important Ideas from Little Known Experts for Care of Older Adults in their Homes", 32 pages, distributed (free) by Elderlink Enterprises, Inc. Mary Ann Brown, R.N., M.S., 6732 W. Coal Mine Ave., Suite 301 Littleton, Co. 80123 303-972-6782.

copyright 1995 William R. Eubank