Dr. Colvin Idol worked for almost half a century as a doctor in South Knoxville. At the age of 70 he retired, but only because of the effects of Parkinson's disease. That was 12 years ago.
Now Dr. Idol is confined to a wheelchair. He lives at home under 24-hour care, paid for by Medicare. Though he is fed by a tube and can speak only rarely, his mind remains sharp.
"The burden on him must be amazing," says his son, Colvin Jr. "This is a man who used to write poetry, whose mind is still there, who can't speak."
Not long ago the retired physician diagnosed himself with pneumonia in his right lung and told his caretaker to get him to a hospital.
"If he said so, call an ambulance," the son told his father's caregivers. "He knows."
The younger Idol, 48, makes all the arrangements for his father, visits regularly, takes him to doctor's appointments, and mows the lawn.
"I don't even mow my own lawn, but I mow his every week," says Colvin Jr., known around Knoxville for his career in broadcasting and as education director of AIDS Response Knoxville.
Idol is considering cutting back to part-time work so that he can better tend to his father, but demands on the son's time and energy are only a part of the burden. There's the psychological weight of watching a parent suffer a degenerative illness.
"It would be much worse if I didn't have the total support of my wife, who's a psychologist," he says. Idol's wife, Saroj Chand, is a psychotherapist in private practice.
With a daughter who's a social worker in Knoxville and two sons in college, the Idols are part of a growing segment of Baby Boomers who find themselves, just as their children leave home for independence, having to turn their care-giving attention to aging parents.
The Sandwich Generation
If you've never been faced with caring for an elderly parent or relative, you may not have an up-to-date picture of senior care in the '90s. But statistics indicate there's a good likelihood that sooner or later you will. By 2000, nearly half of all working-age people in the country will have some day-to-day responsibility for elderly parents.
The reason is that Americans are living longer than they used to. The average life expectancy is creeping upward, and the nation's fastest-growing population group is those over 85. At the same time, our definition of frailty is changing even more dramatically. Nowadays, large numbers of healthy seniors take up tennis for the first time after 65. Many live with minimal assistance past 75 and beyond.
One upshot is that in place of nursing homes, we are developing different choices to answer the specific needs of individuals from the mobile, active older person to the Alzheimer's patient. Another implication is that the burden for finding these solutions and making them work is falling on the generation best known for doing its own thing.
The wags in charge of identifying and naming national trends have already gotten hold of this life-experience Boomer happening. As a result, history's most over-named generation is now "The Sandwich Generation," caught between late-in-life children and long-living parents.
Many Boomers are beyond their child-rearing years when they face the toughest trials of elder care. But more and more are finding themselves taking over daily care issues ranging from the minor--handling finances, medical bills and legal matters, taking care of household tasks and home upkeep, ferrying to and from appointments--to the more major ones that call for help from places like the Senior Citizens Home Assistance Service, a private company providing everything from companionship and light housekeeping to medical monitoring.
Angels for Senior Citizens
Peggy Wirtz got a personal perspective on services for the elderly when she found herself coordinating the care of five elderly relatives--her mother, her father, her father's sister and two elderly cousins (two of them Alzheimer's patients)--all at the same time. Now Wirtz is the aging services specialist for the Knoxville-Knox County Office on Aging.
"When people call us," says Wirtz, "we find that the first thing we need to do is help them think through what the problem really is. Often a person will say, 'I need to know about nursing homes.' They are in the midst of a crisis, often a health crisis. Often the answer is not a nursing home. Often the answer is an assisted-care facility, or in-home care."
After Helen Demerath's husband died two months ago, she decided it was time to move from her retirement-community home outside of Tucson, Ariz., to be near her daughter, Julie Hardin, in Knoxville. Demerath is wheelchair-bound and 83. With help from Wirtz, Hardin--a former director of Big Brothers/Big Sisters and a former mental-health social worker--investigated 14 assisted-living care facilities.
Hardin eventually narrowed the choices to Weston Place, an assisted-living community off Middlebrook Pike, and Colonial Hills, a nursing center in Maryville that offers all three levels of senior care--the full-time care of a nursing home, intermediate care (involving help with daily tasks), and basic assisted living. Last month Demerath looked at both and chose Weston Place, and she hopes to move there in September.
"The science of gerontology has blossomed in the past 20 years," says Hardin. "It's something that's talked about. And we know a great deal more about the aging process and how to care for aging people."
In Knox County, some 59,000 out of the total population of 343,000 are over the age of 60. Some 31,000 of those are over 70, and some 4,600 are over 85. The Office on Aging has 45 employees, including drivers. Among its services, the Office publishes a 155-page "Service Directory for Older Citizens" listing every conceivable advocacy group, support organization or government office that can offer assistance to seniors.
The hub of public-agency activity is the Community Action Committee, a conglomeration of dozens of programs provided serving people of all ages and headquartered in the MLB (Mechanicsville-Lonsdale-Beaumont) Community Building on Western Avenue. Nonetheless, local resources are hard put to keep up with the demand.
You don't hear much anti-government invective from families of senior citizens who are living on Social Security and modest pensions, who absolutely need Medicare, who depend every day on the work of selfless public servants like Peggy Wirtz. Like the care and education of children, senior care is an area of government that continues to grow. All the debates--even those about Medicare--are about slowing the growth, but the growth is inevitable.
The People of Bridgeview
Mary Hinerman spent most of her life in Fort Worth, Tex., where she worked for 25 years in insurance and admitting at a hospital. In 1980, when she was 65, Hinerman retired and moved to Knoxville to be near her son, Bob, an insurance broker, and his wife, Jo, a Food City home products demonstrator. Hinerman lived happily in Townview Towers until 1994, when a bout with pneumonia put her in Baptist Hospital.
Even before the pneumonia, Hinerman had grown less and less capable of managing her own apartment. After she recovered, she moved into Bob and Jo's South Knoxville home, where she received various health services (provided by Medicare) through First American Home Health Care. Still, it wasn't a long-term solution.
"My mother has lived by herself for many years," says Bob Hinerman. "It really wasn't on her long-term agenda to move in with her son."
Last summer, the Hinermans heard about Bridgeview Assisted Living Facility, a subsidized-housing operation on the second floor of Isabella Towers near Summit Hill Drive. It offers residences for 31 senior citizens, who are provided with food, services and health care. Last September, at a healthy 81, an elated Hinerman moved in to Bridgeview.
"I'm amazed at the service they have to offer," says Bob Hinerman. "And it's the only facility of its kind in the area."
Bridgeview is run by KCDC's case management services office. Mary Drexler is program administrator, and Tracy Black is program coordinator. It has a waiting list of 37.
"I get calls every day," says Black. "I could fill another one."
Generally, qualification for Bridgeview falls under the same guidelines as subsidized housing. Elderly persons must have assets and income of no more than $21,900. Along with a $400 service fee, which includes food, utilities and 24-hour assistance, the rent is based on 30 percent of adjusted income.
"So a person on social security can do it," says Black.
The Deeper Issues
Much of this story has revolved around the practical side of taking care of an elderly parent. Members of the Sandwich Generation must also understand the psychological and spiritual issues in reversing the roles of parent and child. Sometimes it's a task in itself to get to know a parent while simultaneously adjusting to his or her changing condition.
John Bohstedt, an associate professor of British history at UT, spent the last decade or so of his father's life working hard to repair a strained relationship. Bohstedt says he made this effort "for my own mental health and for his." According to his son, Whitey Bohstedt had been an archetypally distant, absent postwar father. He had been raised on a farm in the Depression. He was away during the war, on the road selling radio and TV parts during much of John's youth, and in a trailer in Koppell, Tex., through much of his senior years.
Over time, the son got to know the father and the father got to know the son.
"You're John's father," said one of John's fellow church members at the Tennessee Valley Unitarian Universalist Church when Whitey Bohstedt came to town. "You must be very proud of him."
As he always had, Whitey stayed quiet. For the first time, father and son talked about this stoicism. Raised on an Iowa farm, Whitey explained, "You were supposed to be modest." Bragging on your children was just like bragging on yourself. You didn't do it.
After John told Whitey how he'd yearned for praise and approval, Whitey went overboard--telling everyone about his son, the professor. It was a process with unexpected results.
John was surprised when he visited his son Jake's dorm room in Austin to see a picture of his own father on the wall. He was shocked when Jake said he saw some of Whitey in John--and some of Whitey and John's relationship in the interaction of son and grandson.
"One of the key things is to see where we came from," says Bohstedt. "You begin to realize your parents aren't so different from other parents, and your relationships aren't that different from other people's."
As a Relationship Winds Down
Whatever the details of the situation, the final years of a parent-child relationships are unavoidably poignant.
For 30 years Erskine Campbell was the cashier at a drugstore in Chattanooga. She never had benefits and often worked on a cash basis. But she was always independent and dedicated her life to seeing that her son, Paul, had a better life.
Around five years ago at 83, Mrs. Campbell suffered a stroke. After she left the Patricia Neal Rehabilitation Center, she lived for two years at the Golden Age Retirement Village, an independent living facility in North Knoxville operated under the aegis of New Canaan Baptist Church.
"It's a wonderful place," says Paul Campbell, the director of UT's Office of Social Work Research and Public Service. "It's topnotch in every way."
Over time, Erskine Campbell, who had lost most of her short-term memory, became unable feed herself. She found a spot in Bridgeview, where meals and other assisted-living care are provided.
"If my mother were not in Bridgeview, I have no idea where she would be--the system has really worked for us," her son says.
What amazes Paul Campbell, who knows the social-work field from the inside, is that both facilities are so good.
"Both these places are generally geared to serve those without a great deal of means, and the service and caring is as good or better than the places where people are paying. It's amazing that there are people out there who so caring and willing to work for what these places can pay them. You couldn't ask for a better staff."
Mother Campbell is always happy to see her son. Often she notices his wedding ring and asks if he's married. He tells her, yes, he's been married to Susan for 20 years.
"I won't treat her like a child," says Paul. "You start doing that and you take away their dignity. I keep a picture of her from when I was about seven. It was made in a 10-cent store, in one of those booths, and she's dressed in the style of the period with her necklace, bracelet and rings.
"I keep it on my bureau and I look at it every day so that in my mind I can remember what she was like."