There's a draft in here dear!

Living with elderly parents isn't always easy.
Has Mum been taken out today?"

By Toss Taylor

Is that blind closed?Bertha asks the same question every night as her daughter wheels her into the bathroom to get ready for bed. "Yes, Mum, it's closed," her daughter replies. It's the little things that can drive you nuts. The 30 minute denture-cleaning ceremony, the wads of Kleenex stuffed in sleeves and pockets. And the waiting.

Bertha's 92 and has been living with her daughter and son-in-law for the past 3 years. She doesn't have any serious health problems like Alzheimer's or even mild dementia, but her knees don't work anymore so she's confined to a wheelchair and needs to be helped in and out of bed and to the bathroom. She has homemakers who come in every morning, but her daughter Jean is her primary caregiver.

WHO CARES?
A 2002 survey by Health Canada reveals that 77% of caregivers in Canada are women over the age of 45, and 25% of this group are older than 65 years. With more and older people caring for elderly relatives at home, people are starting to worry about 'caregiver strain,' now a mini-cottage industry in geriatric research. To ease the strain, services like day centres providing respite to caregivers are available, and home care services are subsidised by most provincial governments. The new Compassionate Care Benefits legislation -- which offers one family member six weeks of employment insurance to care for a terminally ill relative -- is being criticized by many as insufficient.

The Health Canada survey states that only half (52%) of all caregivers believe they had a choice in taking on this responsibility, and a lack of choice is evident even among some who took on this role willingly." Perhaps this could explain the frequent poor health among caregivers of elderly relatives. Two recent studies, both in Age and Ageing, tracked health among stroke and Parkinson's patient caregivers. The first found that, among caregivers of elderly stroke patients in Japan, "the prevalence of depressive symptoms among caregivers was twice that of community dwelling older people." The second study indicated that 27% of caregiving spouses of Parkinson's sufferers experienced frequent sleep disturbances with 30% showing depressive symptoms.

HELP AND HINDRANCE
Despite these disturbing statistics, only 23% of caregivers in Canada are receiving help in the form of some type of home care, although 33% say they could use more help, mostly in the form of respite, but also in housecleaning, personal care, etc. The Health Canada report found that "47% said the help they received met their needs 'very well' while 42% said it met their needs 'generally well'." Anecdotal evidence, however, suggests that this isn't always the case. Jean and Bertha's experience with their home care has been less than glowing.

In New Brunswick, where Bertha and Jean live, private agencies are contracted by Social Services to provide home care to elderly clients. The cost is subsidized by the government, with the agencies shaving off a portion for their profits. Bertha pays just $19 per month for six hours of care every day; the homemakers earn $8 per hour.

"There are some good ones, but a lot are lazy and take advantage, some steal," says Jean. "The problem is they're not getting paid enough so they're getting bad people. I think the government should take it over and get rid of the individual companies. Maybe then they'd have enough to pay the girls a little bit more."

FAMILY SUPPORT
Mona O'Riordan is a 70 year old widow who recently took over caring for her 93 year old sister with Alzheimer's. "It's not always a bed of roses living with Betty," she said, "but usually she's fine -- except when she's trying to take a swipe at my cats with her canes!" One thing Mona finds trying is what she calls the 'family buttinsky effect.' "When my brother comes to visit, he just comes in, complains about the cold, criticizes everything, then leaves. Thanks for nothing, Jack."

Jean can relate. "It was my choice to take Mum in, and I have to say my sister has offered a couple of times to give us a break on the weekend. But mostly all she does is criticize. She's always asking things like 'Has Mum been out today?' -- even in the winter. How is that helping?"

Men don't tend to pitch in as much. Jean's brothers built a ramp for Bertha's wheelchair and are always there for the 'handyman' jobs, but they tend to steer away from getting too involved. This really annoys some men who do play a significant role in caring for their parents. "Men are quite capable of helping, says Alan Robertson, a 49 year old civil servant from Charlottetown who cared for his mother until her death. "But they foist it off on their wives or sisters because they don't want to do it."

For now Jean and Bertha play the waiting game. "She's so slow, but it's not because of her age," she says. "I sometimes think it's a control issue -- the only thing she can control now is her time. It takes her an hour and a half to get out of bed. And she'll trap me in the bathroom sometimes, waiting to put the drops in her eyes, and I think it's just because she can."

"The other day I said to her 'Mum, the doctor called to cancel your appointment so you don't have to hurry.'" Bertha answered: 'That's ok, I don't hurry for anyone."