For Aged, Big Costs Can Mean Little Care Long-term Aid Often Impossible

December 03, 1990|By Gary Gately

He looks like somebody waiting for a date, sitting in the lobby on the vinyl-covered couch that matches the flowered wallpaper. On this Saturday afternoon, the balding man wears pressed gray wool pants, a stylish cotton shirt striped in red, white and blue and a navy blue cardigan.

He straightens the cusp of white hair that has receded to the middle of his head, taps his foot gently and looks at his watch. In his hands, he holds a little plastic container fastened with a rubber band.

The 72-year-old gets up and heads for her second-floor room. He feels the bottom of the plastic container.

"Good, it's still cold, you know I don't want it to melt before I get there. She loves it, you know, Haagen-Dazs coffee flavor. Boy, that's her real love."

When he sees her, his eyes light up, and a smile spreads across his ruddy face.

He kisses her and touches her face ever so gently, and his words, full of excitement and nervous anticipation, run together in the thick accent of his native Boston.

"You know what I have in here, Lillian, don't you? I brought you some of your favorite ice cream. I got you some Haagen-Dazs coffee ice cream."

He pulls the little yellow cup from the plastic container of ice that keeps her favorite treat cold on the way from Annapolis. Then, staring into her eyes, he feeds her little spoonfuls of the ice cream.

"There, there, how does that taste? Kinda mushy today. It's warmer than it was yesterday. Does it taste good?"

William MacDermott's wife of 45 years, Lillian, slurps the ice cream, spoon by spoon. Some spills onto the white sweat shirt marked "Lillian MacDermott" in the black letters of a felt-tip marker. She says nothing and shows not the slightest hint of emotion.

His smile fades, and he swallows hard.

She sits in a big tan chair with wheels on it, and rests her hands on a tray connected to the chair. He grasps her right hand, massaging her palm and stubby fingers between his hands, and stares hard into her eyes.

"Do you know who I am? Who am I? You tell me."

Her blue eyes focus on him for just a moment.

"I don't remember," she grumbles, her voice sounding at once hoarse and out of practice.

He turns away from her and sighs. Then, as if fearing she'll see his pain, the smile returns, and he fixes his gaze on her once more.

But her vacant eyes shift from him to the hallway outside the door of her room at the Glen Burnie nursing home, Arundel Geriatric and Nursing Center.

Just like that, she is asleep.

Still, he clings to her hand and watches her intently.

"My greatest pleasure is to be with her," he says. "Just to sit here and hold her hand. Sometimes, we don't even talk, or it's a pretty one-sided conversation."

Every day for the past six weeks, the retired federal mediator has followed the same routine. He packs her Haagen-Dazs coffee ice cream and drives from his Annapolis town house and holds her hand and combs her hair and talks to his 70-year-old wife who no longer recognizes him.

And every day when he walks out, William MacDermott wishes, more than anything, that she could come back home with him.

For almost two years, he managed to keep her there with him, even though Alzheimer's disease had devoured her mind. He paid private nurses to work eight-hour shifts seven days a week, cleaning her, dressing her, helping her to the bathroom, fixing her meals. The cost: about $40,000, the couple's life's savings.

Then a blood clot in her leg left her unable to walk. At once, the cost of keeping her home would have tripled because she needed round-the-clock supervision.

Medicaid, which now pays the bulk of her nursing home costs, wouldn't help with the tab for in-home care, and the couple's pension and retirement income couldn't come close to paying for round-the-clock care in the home.

"Nothing in this life," MacDermott says now, "nothing could have prepared me for her leaving home. You look and you see this 70-year-old woman. But that's not what I see. I see the woman I knew from 45 years of marriage.

"The good Lord provided that. She never ages in my eyes. Every day, I wish she could be at home with me."


William MacDermott, like countless others, quickly became an expert on "long-term care," out of necessity.

In Anne Arundel County, where the elderly population is growing faster than anywhere else in Maryland, you'll hear the term more and more in the coming years.

It encompasses a bewildering array of services: "home health aides" who help with daily tasks; round-the-clock nursing care at home; respite care; case managers who help find services and a way to pay for them; adult day care for seniors; nursing homes.

And in this county, it's getting harder and harder -- often impossible -- to find care for frail seniors and to pay the hefty tab. Already, experts say, shortfalls plague practically every facet of long-term care in Arundel and will likely worsen considerably in the next few decades.

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