Most of the people older than 65 in the Kansas City area live either on their own or with family, meaning a spouse or child or a grandchild.
It was different for me. When my mother died, my husband and three young children moved into the family home to live with my aging father. We lived together for 17 years.
An ideal situation
At first, I thought it was the best of all possible worlds. My kids had the benefit of their grandfather reading to them regularly. He got to be part of shaping their young and curious minds.
Nestled on either side of him on the window seat, in footie pajamas, holding stuffed animals, they hung on his every word, just as my sisters and I had decades ago. He'd read to us and make up stories.
One was an ongoing saga about the adventures of an elephant, a butterfly, and box elder bug. Their names were Fifi, Bobo, and Joe.
My father would texture the tale with details from his vast knowledge of nature and his own vivid imagination. He was a larger-than-life Renaissance man. A combined history and literature major in college, he became a neurologist and chaired the neurology department at the University of Kansas Medical Center for more than two decades. Teaching was in his DNA. But it was my mom, his wife of 40 years, who ran the house and allowed him the freedom to accomplish as much as he did.
When she died after a yearlong battle with cancer, he was traumatized. It shouldn’t have come as a surprise when he suggested we move into the family home and live with him.
The decision to move in
I was ambivalent at first, but we decided to do it anyway.
There were lots of benefits.
My dad was passionate about family history and he'd guide all of us down the wall of archival photographs and clippings outside his bedroom.
He'd explain the personalities and family connections reflected in the sepia photographs and yellowed newspaper clippings. I was grateful when he'd gently quiz the kids on who was who, providing them a sense of their own history and me a comforting feeling of continuity.
So these early years were mostly good.
Not that we didn't have our moments. Dad would sometimes yell at the kids when they wouldn’t eat their dinner.
He couldn’t understand why my husband raked leaves in the fall. Once my husband left for work, Dad would dump the leaf-packed bags from the end of the driveway on the flower beds.
But this was small stuff. Style-stuff, I called it.
It got harder as my dad aged. He got more and more depressed.
Depression in the elderly
I thought maybe the depression was inevitable. He’d lost his wife of 40 years. He was losing friends.
But he had us.
I recently called Dr. Gary Kennedy to get some insight. He’s the director of the division of geriatric psychiatry at Montefiore Hospital in New York.
Dr. Kennedy affirmed what we heard from many others — that we were doing the right thing.
"This is the best-case scenario — what your father had," he said. "An educated man, physically active ... living with his family. That's the ideal."
It turns out depression isn’t at all inevitable among the aging. Dr. Kennedy said research shows only about 30 percent of the aging population suffer from clinical depression.
So I asked him, "What’s the difference between those who get depressed and those who don’t?"
"It’s physical illness," he said. "The physical disabling issue in late life is most associated with depression."
This explains a lot. My dad suffered from congestive heart failure. It accelerated dramatically toward in his mid 80s. He got increasingly short of breath. He fell a number of times. Pain medicine made him confused and heart medicine damaged his kidneys. His body became a fragile ecosystem of failing parts. But his mind stayed sharp.
Here’s some of what that looked like. After one particularly bad fall, he was in rehab for months.
During that time, his driver’s license expired. He tried to renew it, and failed the test. So, without a license, he got his caregiver to practice with him on the road. It wasn’t until he had an accident that he gave up the keys.
Yards of plastic tubing allowed Dad to wander the house while attached to oxygen. He loved to sit and read in his greenhouse on sunny winter days.
But the feeling of isolation consumed him. I began to wonder if we’d made a huge mistake. Would he have gotten remarried, or been happier among peers if he weren’t living with us?
I met with Phil Bohlander, a clinical social worker at Wyandot Center in Kansas City, Kansas, to ask what he sees among his elderly clients. He says the more human interaction, the more purpose they have in their lives, the better they do. Even if they have a physical disability.
"You can play cards, you can play checkers, be an audio reader," he says. "There are kinds of things you can do that don’t require physical activity. Humans need to feel they are making a difference and a contribution at any age."
Here’s the thing. My dad desperately wanted those connections, that sense of purpose. But the betrayal of his body was relentless. He got frustrated. Sometimes he was just grumpy.
My daughter had a room next to Dad’s. When he’d crank up the heat to the 80s, she’d dial it down so she could study. When he turned up the volume on the TV in the middle of the night, she’d ask him to lower it He'd be annoyed.
One night toward the end, I brought home the movie Departures, about Japanese funeral rituals.
When it was over, I asked Dad if he liked it.
“Well, I’ve been thinking a lot about death. I’d probably have chosen something little lighter,” he said.
“What are you thinking, I mean about death?” I asked.
“Three things,” he said. “Are my affairs in order? Have I said everything I want to say to important people in my life, and then, what happens at the moment you die? Is it as if the lights just go out?”
My father's joie de vivre, curiosity, and will to live kept him with us longer than his body wanted to permit.
He died on Sept. 13, 2012. His last words were “It’s OK. I’m ready.”
I’ll never know if we did the best thing for my dad, or my family. It was messy and often hard. I worried I gave my children psychic scars; I demanded they spend time with their grandfather while subjecting them to the sometimes icky stuff of aging.
But in the end, we felt we modeled something good, something many cultures take for granted: respect for the elderly and the value of family.
I tell the kids today, when they come home, that their grandfather is with us still. He's in the beauty of the spring flowers, the birds that flock to the feeder, and at our dinner table conversations as we discuss everything under the sun.
This story is part of KCUR's reporting project “Aging in Place,” an exploration of how the Kansas City region will meet the needs of an expanding population older than 65.
Laura Ziegler is KCUR's community engagement reporter. Follow her on Twitter, @laurazig.