Doris Cawthon’s longtime home
held family memories. Here, photos
of her sons flank one of her father.
in a fall. Because the older woman couldn’t
take care of herself, she moved in with her
son and Doris.
“What alternatives were there?” Doris
asks. “My mother-in-law got to where she
needed our help.”
So it’s little surprise that Doris expected
she, too, would one day live with her adult
“She never verbalized it,” Paige says.
“But it was assumed.”
Paige and her sisters, though, were like
millions of other boomers whose frenetic
lives differed radically from those of their
parents. Their households couldn’t eas-
ily accommodate the extended families
once taken for granted. Paige, who is
divorced, works outside the home and
And like many Americans born in the
wake of World War II, Paige and her
sisters moved far from where they were
raised. Even if they could somehow care
for their mother at home, that no longer
meant the slow-moving East Texas community of their birth but, rather, Houston.
Doris Cawthon, by contrast, had never
lived outside of Jacksonville. For their
mother, Paige knew, any change at all
would represent a form of homelessness.
LIKE AGING ITSELF, some of the pain in
finding a new home for an elder relative
is unavoidable. “There is a kind of grief
associated with this kind of move,” says
geriatrician Bill Thomas, a leader in the
national movement to improve senior liv-
ing conditions. “The grief is loss. Your dad
was this amazing guy who was strong and
smart and funny, who took care of you…
and now your dad is going to be living on
the third floor of a nursing home.”
When it’s possible to delay or deny that kind of pain, most
of us usually will. But that same failure to confront a par-
ent’s—or a spouse’s—looming needs helps to overwhelm us
when those needs spike.
Delay and denial aren’t the only complications, though.
Systemic factors can make the decision more arduous than
it needs to be, activists say. Above all, the long-term-care
industry is highly compartmentalized, with little coordina-
tion among the various kinds of facilities or care providers.
Navigating the system can be nightmarish for specialists, let
alone for neophytes.
oris was failing. In the two
weeks since she had entered the rehab center, the
color had drained from
her face and she’d stopped
eating. The woman who
had teased her nieces in
her living room hours
after her fall, and who
walked in the hospital just days after surgery, now refused
to get out of bed. It wasn’t because the facility wasn’t caring
for her properly. Doris was homesick.
Millions of Americans will eventually face the same
violent wrench from their past routines and self-image.
Often pressed by finances, two-thirds of disabled elders
depend completely on relatives to look after them.
According to one estimate, one in four U.S. households now
cares for an elderly relative. Paige, while not rich, could at
least give her mother more choices than most. An education consultant who had just retired from 27 years
directing and owning two schools, she was determined
to bring the same authority to finding a home for her mother.
Doris, for her part, spoke little about the future, but she
made one thing consistently clear: She wanted to stay in
Jacksonville forever. She had grown up there, raised five
children there—including t wo sons, who died in adulthood—
and spent her married life there. Even as a widow, she
remained deeply immersed in Jacksonville’s community
life. Perched on the porch of her old wooden ranch house,
she welcomed visiting neighbors and relatives nearly every