When it comes to elderly loved ones and arranging for their care, it seems like everyone has a story...

This was certainly true for me and my family, but it was also true for my own grandmother, Erma Daniels.

Erma helped raise my sisters and me, and lived with us practically from the time I was in the first grade.  Her experience came just after a time when almost anyone with even a hint of gray hair had first-hand memories of ‘The Great Depression’ and knew what it was like to survive a world war.  

Early in life, Erma would experience as much hardship as many of us might see in a lifetime, beginning just after her 1st birthday with the death of her mother Lizzy, and later, in her mid-teens with the tragic death of her father, Archie.  

Life would continue on for her, being raised on the farm in central Wisconsin by her maternal grandparents.  She grew very close to them, and fully absorbed their influence of small-town values and passion for self-sufficiency. 

As a young woman, Erma's life would again take a turn as her grandfather passed away.  Her grandmother, still living on the farm, was now alone.  Everything was fine at first, but it wasn’t long before the burdens of living alone on the farm and the shifting concerns of her grandmother’s health, became overwhelming.

Gramma would disappear from the farm, and from Erma’s view, after hours of frantic searches, only to be returned home later by her sympathetic neighbor.  As these episodes became more frequent, Gramma's behavior also become more angry and beligerant. 

There were no ways at the time to deal with what was happening; no professionals to diagnose whether ‘dementia’, or ‘Alzheimer’s’ so treatments and plans for care could be developed, no available research on rural healthcare disparities, no concern about readmission rates or three-day qualifying hospital stays before Medicare covered the cost of skilled nursing.  Local communities of the day, especially rural ones, were not known for offering any form of long term care, let alone memory care.

Erma knew only that Gramma was “bothering the neighbors” and it had to stop, as much for Gramma's own safety and well being, as for Erma's peace of mind.  What began as an early vision in her mind, was now a significant reality:  It was time to talk with Gramma.

Gramma took the news of her move to “an old people’s home”, very badly.  It was the saddest, and most difficult conversation Erma ever had to have. Later in life, Erma would share elements of this story with me, but she never talked about the outcome of Gramma’s move; whether or not Gramma received great care, or was able to live out her life in comfort.  I knew she was left with guilt and it weighed heavily on her mind…

Years went by.  My mom passed away suddenly.  My grandmother, Erma, now in her 90’s, but still in great health, came to live with my wife and me.  It was a wonderful experience, we all learned a lot about life.

As Erma began to deal with her gradual loss of mobility, other daily challenges of dressing and bathing began to emerge. Even after two years with us, it still felt sudden; it was now time for me to talk with my grandmother…

I remember asking for help from my wife and sisters.  It was a day early in the spring. We agreed to talk with Erma, well in advance of any actual decision or move.  After all, Erma’s mind and spirit were both strong. She winced briefly when we told her, but she knew it was time…

Months passed, and as it turned out, Erma was very happy in her new environment. We were all happy in fact, for so many reasons...

I always remembered Erma’s only question from that hopeful spring day, after we told her it would be time to move.  There was sadness, but no anger, only, “OK, what’s next?”