Article Independence

No place like home

“I think I’ll stay here, after all.” My Dutch grandmother’s voice was sad, but confident. My grandfather, her beloved husband of 56 years, had passed away just days earlier and now she was faced with one of many big decisions: could she continue to live independently?

My now 80-year-old grandmother Corrie, or “Omie”, as we lovingly call her in Dutch, ran the household together with my “Opie”, Kees. His actual name was Cornelis, but as my oma was officially Cornelia, they decided early on in the marriage that two “Cor’s” would not be handy and that he would be Kees instead. For many years, they lived in the house where my granddad was born.

Eventually, the steep staircase became too much of a hurdle for my gran and they moved into a nice apartment a few minutes down the road from their old house. Opie did the cooking and Omie ventured into the centre of town on her mobility scooter, which she received for free from the council, for daily supplies. My granddad still had his driver’s licence so he drove them to the supermarket, hospital or just a trip around town. A cleaner came once a week but apart from that, they managed most things by themselves.

Intertwined independence

It was not until Opie died in March this year that we as a family realised just how much Omie’s independence had been intertwined with his. Omie started to lose weight, which we initially put down to the mourning process and later blamed on the sickness caused by the tablets she took for her elderly diabetes. But when she had shed more than 20 kilos in less than half a year, we wondered if she, in fact, was eating enough when she was alone.

Thankfully, my mum is a home-based care nurse, which means she knows the way around the many organisations, funds and services available to elderly people. We ordered a selection of healthy ready meals, which she would get delivered weekly, directly to her freezer. Five minutes in the microwave and she’d have a hot dinner every day. It worked for about a week, until she decided that the food was not what she was used to. I suspect that the fact that Opie wasn’t there to potter around in the kitchen had more to do with it than the actual food, which my mum has served to hundreds of her patients, who tend to like the traditional Dutch fare.

The Dutch government announced last year that it is closing at least 800 old-age homes because it has become unaffordable to house all the elderly.

For a while, Omie wondered about whether she should move to an old-age home. In the Netherlands, elderly people who did not need medical care were able to move into a heavily subsidised residential home. Different from a nursing home, these facilities were aimed at elderly people who only needed support with, for example, showering or getting dressed. Collective activities such as eating meals together and playing bingo helped tackle loneliness for many people who would otherwise live alone. However, the choice had been made for Omie, as the Dutch government announced last year that it is closing at least 800 old-age homes because it has become unaffordable to house all the elderly. Policies are geared towards more home-based care, to allow the fast-growing group of elderly to live independently for longer.

The journey

Thankfully, with time, Omie is starting to adapt to her new life alone. Her health problems caused by arthritis and cancer do not stop her from getting around. Last week, she took me shopping in the mall near her flat. She showed me how she has support during the entire journey.

Every time I see her, she reminds me that the little motorised wheelchair is her lifeline. I can see why.

To get out of her chair in the living room, she presses a button to lift the chair seat up and tilt it forward a bit, so she can step out easily. Then, she takes her walking frame, or rollator, to make her way to the front door. She sits on the rollator seat to put on her coat and again once she is inside the lift down to the basement of the flat. Automatic doors open when she presses a button and the whole building is step-free. In the special scooter garage, she unplugs hers from the power socket (she pays €30 a year for the extra electricity) and hops on. Every time I see her, she reminds me that the little motorised wheelchair is her life line. I can see why.

Once outside, she easily navigates around steps and crossings. I can hardly keep up walking alongside her, but she jokingly says I should hurry a bit as I am slowing down her daily routine. Almost all shops have wide entrances, step-free access, a low checkout desk or helpful staff to hand her the card machine. Since I taught her how to use the ATM when my granddad was in hospital, she rarely carries cash any more. She says she carries no handbag but just a small purse in her coat pocket. “You hear these stories sometimes of bags being robbed out of the front basket”, she says. “I wouldn’t be able to do anything. This way, I can always feel if it is there. You have got to look after yourself.”

Gran tries hard to make the most of her life alone. In November, she will go on her first trip without Opie to a town on the German border. She has booked a holiday with care, where nurses and volunteers will be joining in and where she hopes she will get to know new people who are in a similar situation to her.

Life is slowly getting back on track, but some moments are still hard. The toughest times are at night, when the house goes quiet and Opie’s chair stays empty. She recently moved from “her” side of the bed to Opie’s, which is nearer the door. She finds comfort in the fact that the memories of his presence remain, within every room, every song in their CD collection and every piece of furniture in the place. “It is still our home”, she explains to me. “If I had left here too, I would have lost everything at once. I would like to continue on for as long as I can.”

For many people, the value of staying in their own home is about much more than the financial gain that the government is after.

Financial incentive

Seeing all the many small and big things making a difference to my grandmother’s independence, I wondered if things would have been different had she lived in the UK, which has been my home for the past six years. Around the world, the growing ageing population is putting pressure on health budgets. In the UK, just like in the Netherlands, the government is making cuts.

By mid-2012, there were 10.8 million people aged 65-plus in the UK and more than 1.4 million people aged 85 or older. According to the charity Age UK, the average annual fee in 2012 for a single room in a private residential home in Britain was £536 per week. For a nursing home, it was £738 per week. It is clear that politicians have an incentive to keep people in their houses as long as possible. But for many people, the value of staying in their own home is about much more than the financial gain that the government is after.

There are enough people out there complaining, but I think I am really very lucky.

All-Bran and banana

Alice, 93, agrees. She lives in a self-contained bungalow in a town in the north-west of England. She is the grandmother of a friend of mine and she is delighted to tell me all about living on her own. She warns me that I will not be getting a complaint story from her: “There are enough people out there complaining, but I think I am really very lucky. My daughter and my other children and grandchildren help me to cook and clean and I see someone every day.”

When I ask what it means to her to live by herself, Alice does not hesitate: “It is my independence more than anything, really. I can manage my own breakfast, usually All-Bran and banana. I try to eat healthy with lots of fibre. I make my own lunch too and at dinner time my daughter comes over to eat with me. I guess I could have these warmed-up delivery meals, too, but my children are very good at helping me out. My daughter brings the dogs and they always come right up to me when they see me. They are lovely dogs.”

Alice got her bungalow after she left the three-bedroomed council house where she’d lived with her husband before he passed away. The bungalow has been fitted with a wet room, which means she can manage to shower without help. Other than that, it is the small things that make life a bit easier for Alice: a lightweight jug so she does not have to lift a heavy kettle, and an alarm button around her wrist in case of an emergency. “I pressed it accidentally once and they talked through the speaker right away, so I know that it works”, she laughs.

Library ladies

Like my own gran, Alice has various walking aids, including a mobility scooter. Unlike my gran, she had to pay for the device, but she feels aids like these are worth the money. She is wary of driving it alone, but she does not feel limited in any way because, “at 93, you don’t have to go out much by yourself”. Her children take care of her shopping and drive her to appointments and volunteers from the local library regularly stop by to bring her a pile of new books to read. “They are two lovely ladies and they pick four or five books that I like. I like reading a lot and thankfully I still have my eyesight. I always enjoy talking to the library ladies about my day or just about anything. I am quite a chatterbox.”

I don’t think I am too much trouble to my children yet. I try to do my own things as much as I can.

Alice has seen friends and relatives end up in elderly care homes. She is grateful that she does not have to live in such a place herself. “I would dread it. People deteriorate when they move in there. I guess some people have no choice. I have two friends with Alzheimer’s and they become more and more reliant on others. They say it might affect one in 10 people so sometimes I worry. I think to myself, I hope I just go quietly in my sleep, before I become a nuisance to anybody. I don’t think I am too much trouble to my children yet. I try to do my own things as much as I can and they are all there for me.”

All in all, Alice is pleased with her life and the services available to her, and she is keen to hear how my grandmother is getting on (they have never met but both loved to be part of this story). She recognises my Omie’s optimistic outlook on life and says she often takes inspiration from people she sees around her, or on television: “I like watching sport and I watched the Olympics for disabled people. Have you seen it? There are people running with no legs, and they are still succeeding. And across the road from me lives a lady who is 100 years old and she still lives by herself, with the help of a carer. I realise how lucky I am.”

[Photo credit: me and my grandmother during her visit to London in March 2013.]

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