Elder Care

When Marie Brown's 97-year-old mother fell and broke her hip two years ago, it started the family on an often frustrating quest for appropriate medical care. Doctors unfamiliar with the health issues of the elderly initially put Mary Holmes, then 94, on bed rest. That weakened her muscles so that her knees no longer could bend. The Washington, D.C., woman became permanently bedridden. "I think she became pretty down," said Brown, 65. Before the accident, she said, her mother loved to dote on her family and often would have her four children and a host of grandchildren over for dinner.

W.C. Stingley knows what good home health care is, and what it is not. Seven years ago, he hired a succession of home aides to help care for his wife, who had terminal cancer. Top-notch care was important, he said, because he wanted his wife of nearly 50 years to be as comfortable and as lovingly cared for as possible in her final months. The first caregiver, the 81-year-old San Clemente resident recalled, was "like a cub bear with boxing gloves on" in the kitchen and was not fluent in English.

Question: What is the first step in caring for an elderly person? Answer: The answer depends on the particular situation. In some cases, there is a dramatic event--a fall, a heart attack--requiring families to swing into action and change their life styles almost overnight. In other cases, changes occur slowly; relationships and responsibilities evolve over months and years.

State regulators responsible for protecting elderly residents of board and care homes routinely allow substandard and dangerous facilities to operate for months and sometimes years while senior citizens are neglected and abused, records show. Licensing officials say immediate action is taken to close homes if there is "imminent danger" to elderly residents.

The Board of Supervisors on Tuesday rejected a local preservationist group's efforts to block a 356-unit elderly care center that critics say would mar the landscape of the San Juan Capistrano area. In bringing the appeal at a public hearing, Mark B. Clancey, president of Friends of Historic San Juan Capistrano, charged that the development, as now approved, "bears no resemblance" to the religious retreat first proposed for the site in 1987 by the Crystal Cathedral Ministries.

A chicken, a raven and a peacock greeted Lisa and Ron Cerda when they moved into their southeastern Tarzana neighborhood almost two decades ago. It was just the sort of bucolic reception the couple hoped for when they fled crowded West Los Angeles for one of the city's rare residential-agricultural zones, a district that permits farming and the keeping of livestock. Today, the Cerdas say their rustic neighborhood is threatened with extinction. Schools, synagogues and commercial businesses have crept into the district, despite dogged opposition from dozens of residents.

Making the national list of top companies for working mothers took PacifiCare Health Systems two attempts, two years, more than 28 hours of preparing paperwork and a commitment to build a $2.5-million on-site day-care center. But what put this company over the top, according to Working Mother magazine, which lists 100 family-friendly companies in its October issue, was a rare, $15-per-week subsidy for child care or elder care for PacifiCare employees who earn less than $60,000.

As government and business leaders increasingly view stronger families as the solution to drugs, lawlessness and an unskilled work force, parents and their children will finally receive long-needed support in the 1990s, experts predict. "The '90s will be the decade of the family," said Nancy Claxton, president of the Orange County Chapter of the National Assn. for the Education of Young Children. "Families are in trouble."

The Travelers Insurance Co. conducted a survey of its employees several years ago and found that 28% of workers over the age of 30 were providing some form of care for an older person. The time spent by employees on such tasks as giving baths, running errands and driving elderly relatives to and from doctors' appointments was not trivial, the survey found: Nearly 8% of the surveyed employees reported spending 35 hours or more a week caring for an elderly person--"nearly the equivalent of a second full-time job," according to Andrew E. Scharlach, a USC professor who uncovered similar trends at Transamerica Life Companies when he recently conducted a study of employee problems at that organization.

"You don't call. You never write. You won't eat my dumplings anymore!" Chinese mothers will not have to utter those words again if the powers that be have their way. In Shanghai, the Nanjing East Road Neighborhood Committee recently took to public shaming to ensure that people attend to their aging parents. Anyone who doesn't visit at least once every three months faces having his or her name posted on a community signboard.