This article first appeared in the St. Louis Beacon, June 11, 2012 - Midday on a bright, hot Tuesday, Eunice Spratt kneels in the dirt of her momma’s garden. She comes here each day, to her childhood home in the city, and tends the small, fenced-in rectangle of earth where cabbage, broccoli, lettuce, peppers and spinach all grow.
“I’m trying to keep this garden going,” says Spratt, who is 65 and a retired teacher. “It’s hard, and trying to do everything else.”
Everything else includes caring for her grown son, who has autism, and coming here each day to visit her mother, Rosetta Spratt, who is 101 and still lives at home, thanks to the efforts of her eight living children.
Caregiving.org, a nonprofit association of national caregiving organizations, reports that 29 percent of adults are family caregivers. But that’s not the only relationship seniors today have with their families.
There’s a myth, perhaps, that it's just the seniors who need care, says Nancy Morrow-Howell, the Ralph and Muriel Pumphrey professor of social work at Washington University, as well as the director for the school’s Harvey A. Friedman Center for Aging. But the reality, she says, is that their relationships with their families are much more reciprocal. And they can change throughout the aging process. Seniors might take care of their grandchildren, they might be the financial backbone of the family, they might engage with their families emotionally, and yes, they might need full-blown caregiving. Over time, they could experience all those things.
“It’s not all about them being in need,” she says.
The tribe next door
Franklin Oros’ wife calls his family “the tribe.”
“Like a tribe,” he says, “everyone is involved. We’re all in each other’s business.”
That’s easier now that his mother, Annabelle De Dona, who turns 83 this month, moved to St. Louis from Chicago after her second husband passed away several years ago.
“My son said, ‘there’s no reason for you to stay there, why don’t you come here. There’s a lot for you,’” says De Dona.
So she moved into a condo in Shrewsbury and thought she’d just relax for a while. After two weeks, De Dona got, in her words, totally bored. She began looking for a church and started volunteering, too.
Now, she says, she’s happy, has friends and her family nearby. But she doesn’t want to be a burden.
“They have their own lives and are very, very busy,” she says.
With her move to St. Louis, Oros and his family are now better able to be a part of his mother’s life. And that includes being more actively involved as caregivers, he says.
He, his wife and kids all take turns visiting her, having her over and encouraging De Dona to drop in whenever she wants. One challenge for Oros, a professor at Washington University, is watching his mother's abilities change with age and helping her understand limitations that she didn’t have before.
Steve Miskovic, program director with Memory Care Home Solutions, deals primarily with families acting as caregivers for people with Alzheimer’s or dementia. For many families, he says, caregiving usually starts out in small ways.
“It will often times start out with the family doing some of the more executive roles of the loved one,” he says. That can including paying bills or managing their calendar. But, depending on the family, the health and situation of the senior, it can become managing medicines and meals, going to doctor’s visits and possibly living together or seeking out the best living situation.
“Regardless of what disease process is going on,” he says, “they’re going to need some assistance at some point in some way, shape or form.”
And whatever form that assistance may take on, there are benefits to having seniors’ families involved in their caregiving, says Jeannie Krause-Taylor, a social worker and founder of Pathways for Aging.
Seniors still need to feel important to their families, she says, and to know that they’re valued.
“It’s the caring part of caregiving,” she says. “You can’t pay for that.”
That sentiment is a focus for Oros and his family. Clear communication has been very important, he says. And in everything, even when things get frustrating or challenging, he and his tribe remember to do what they do out of love.
Far but close
After living in many places during his life, St. Louis is home now to Ed Odom, 83, but not to any of his five grown children.
“We live in six different states,” says Odom, who spent his career working with United Methodist Children’s Home and started the Shepherd Center of Webster-Kirkwood 18 years ago.
Odom’s wife passed away in 2007, and though he is healthy and active, loves to garden and lift weights, he’s planning a move in the near future to a continuing care retirement community in town.
If Odom’s family lived closer, he would remain at home, he says.
“But that’s not the case, so I just have to get ahead of this and make the decision that I’ve made at this point,” he says.
Being in charge of his own decisions is important to his father, says son Pat Odom, who lives in Chicago. Many issues came up for the family during the 10 years when his mother was ill and his father was caring for her. Because neither he nor any of their siblings were present, they encouraged their father to seek outside help, and they dealt with many common issues that come with that. They include reluctance to let strangers in the home, resistance getting help and difficulty letting go of traditional roles.
Now, after a very difficult period, Odom seems to be doing great, his son says. He’s healthy and has always been very social. Because his own family doesn’t live nearby, Pat Odom says, his father has managed to create a family and community that is now really stepping up for him.
“That social network is going to be a support for him,” he says.
Not having family in town can be a tough situation, says Ann Bannes, vice president of home and community based services with St. Andrew's Senior Solutions.
"If they have sufficient resources, meaning financial, they can buy all the help they want," she says.
But most people don't. And sometimes, even if family is present, they might not have the resources to help. St. Andrew's raises money and writes grants to help the most vulnerable seniors, Bannes says. And they also ask, who else is in your community? Does your church have programs? Are there neighbors willing to help?
For Odom, even though he has a plan, the answers are yes.
Pat Odom says his father has always fostered community and is lucky to have so many people who care for him in St. Louis. He and his siblings take turns visiting and have their own routines for calling their father.
When Odom talks about his new home, he’s already planning on helping other seniors and working in the community gardens.
He might not have family close by, Odom says, but he does keep them close.
“Our ties are as tight as they can be,” he says. “We are extremely attached and caring. If one of them was in difficulty, I would be there somehow...We’re a very tight family that are emotionally tight, but not physically tight.”
The family Spratt
Inside the large, old home where Spratt and her brothers and sisters grew up, Eunice Spratt's mother is cared for by a home health aide who works with the family through St. Andrew's Senior Services. Many of Rosetta Spratt’s children do something to keep her, too.
Eunice Spratt helps lift her in and out of bed and takes care of her mother’s medications. Daughter Eleanor Williams, 77, lives in the house to the right of the childhood home.
Williams, who has arthritis and can’t help as much as she used to, still cooks for her mom sometimes. Williams took care of her grandmother when she was younger, too.
“Mom and dad, they raised us that you take care of each other,” Williams says.
And with eight living children, nearly all of them are now taking care of their mother. Two brothers and a sister live in the childhood home. And several of the homes next door are owned by Spratt’s children.
“Each somebody knows how to do something,” Williams says.
“There’s a lot of cooperating and working together,” Eunice Spratt says.
“We’re glad to have her,” Williams says.
“Yes, we are,” Eunice Spratt agrees. “We feel very blessed to have her with us this long.”
Typically, it’s the daughters or daughters-in-law who tend to be the most hands on, says Krause-Taylor. A lot depends on the dynamics of the family.
“Some of it is personality types and some of it’s gender and also what their roles were in the family,” she says.
Often, families providing caregiving need counseling, Bannes says, to get them in agreement about what needs to be done for their senior. Among the seniors and their families, it's common to find resistance and denial that help may be needed.
The practical part of caregiving is fairly straightforward, says Bannes, who cared for her own mother for 25 years. But the psychological toll can be much tougher.
"It really is taxing," she says.
What's important, she says, is getting families on the same page and getting help for caregivers so that people can enjoy the final years with their family member. Seniors aren't taking, she says.
They're getting back after a lifetime of giving.