Couple Faces Separation in Nursing Home

As I continue to mourn my father's death eight months ago and witness my mother's slow, seeping decline in her assisted living facility, I am becoming acutely aware of not only mortality, but of the gnarled and hazardous path you have to walk to get to the end of life. How many people get to die quietly, in their own beds, holding the hand of their beloved? The story below about an elderly couple facing separation from each other because of institutional regulations and efficiencies makes me very afraid.

Do you have stories to tell about this issue? What are your thoughts about your own mortality road? How do you want your end to be? These are questions we rarely say out loud, or write. They frighten me as I type them. But I am interested in your thoughts.

Here is an excerpt from the story by Max Harrold in the Montreal Gazette, June 25, 2010

Couple Survived the Holocaust; Now Faces Separation at Nursing Home

"They survived the Holocaust, but now Elena and Francisc Basch - married for 65 years - face the prospect of being separated in the Côte de Neiges nursing home where they live in adjacent rooms.

The case highlights the difficult choices faced by long term care facilities and the often disorienting consequences for frail residents. The couple's son says separating them - both his parents have Alzheimer's - would be too traumatic. The nursing home says it is legally entitled to do what it feels is best, based on each resident's needs.

The Baschs, both age 90, have different stages of the illness that impairs memory, thought, speech and can lead to complete helplessness. The Montreal Jewish Eldercare Centre says Elena must be moved to a different ward as soon as possible because she needs a more advanced level of care, her son Max Basch, 59, told The Gazette this week.

"They cannot survive without one another," explained Max, from his home in Tenafly, N.J. His mother's more advanced condition makes the familiarity of her surroundings critical and her husband in the next room is a big part of that, he said.

"They always hold hands," Max said. "They kiss each other. They're this incredible, great couple in theirs 90s. When he went to the hospital for a few days, she said 'Maybe I can go to the hospital and check in on him and cook for him.' She doesn't realize exactly where she is but she knows they are together."

Would You Place Your Ill Partner in a Nursing Home?

I recently heard a story about a couple in which the wife has had Huntington's Disease for twenty years. They married in their early thirties and she was diagnosed five years later. Over the course of the last two decades, each exacerbation has left her at a lower level of functioning. For the past ten years, she has lost her ability to do any self care, to transfer herself from bed to toilet and back to bed, and to speak. Over the past five years, her cognitive abilities have become compromised.

Her husband has been her steadfast caretaker for all this time. He modified their house to make it handicap accessible. He found aides and home health care providers to help with her care. He took her to try many avenues of treatment. He was the primary parent. And he worked at a full time job.

Now, after twenty years, he realizes he just can't do it any more. He has his own physical conditions, and he is bone weary and wants more joy in his life as he enters his own final decades. He is afraid that if he keeps being the primary caretaker, he will get sick and be unable to help his wife at all.

He decided to place her in a high quality nursing home - for her sake and for his.

This is one of the toughest issues couples dealing with debilitating illness face. What do you think about this man's decision? Have you made the decision to place your ill partner in a nursing home or other long term care facility? Would you ever consider doing this?