If you're worried that someday your children just might ship you off to an old folks home, forget it. Most people never enter one.
On the contrary, says Victoria E. Bumagin, many alternatives to group homes are available to help even the physically handicapped live independent lives into their 70s, 80s and 90s -- if that's what they want.
One client in her upper 70s who lost both legs still lives alone in her own apartment with a minimum of outside help, "and maneuvers her wheelchair as if she were on a championship team.
"People are so inventive," says Bumagin director of social services at the Council for Jewish Elderly in Chicago. That's the message of hope she brings in her book, "Aging Is a Family Affair," written with Kathryn F. Hirn, also of the council (Crowell, 276 pages, $10.95). Bumagin, who teaches courses on aging at the University of Chicago and Loyola University, was in Washington for the annual meeting of the Gerontological Society.
Only about 5 percent of the elderly live in an institution at any one time, says, Bumagin, herself a sprightly 56, which means 95 percent "live out in the community -- alone or with their family -- pursuing their own lives."
She's not opposed to nursing homes for the elderly.Many do a fine job and provide a needed service, but she feels too many people go there who don't have to or don't want to because they -- or their families -- don't know what else to do.
Often, she says, families fear their relatives will get sick or have a heart attack or fall and injure themselves badly and no one will be on hand during the emergency. That is a possibility, she acknowledges, but:
"All our lives, we all take risks. Why shouldn't they (the elderly) continue to do so? Why should they change now?"
She tells the story of a daughter who wanted her mother to go to a nursing home "because she falls all the time." The mother refused, with the argument: "I suppose at two years when you fell all the time, I should have put you in an institution."
"What we tend to forget," says Bumagin, "is that the old have had more experience and often are better equipped" to deal with traumatic events in their lives, including the death of a spouse. "Perhaps that accounts for their philosophical outlook on life."
Many old people are very reluctant to enter nursing homes, she says, because "They are concerned about the possible loss of control over their lives." Living with their children though mutually acceptable in some families, can raise problems, even in a loving relationship.
The "youngeters" themselves may be well into middle-age or older when their parents need help, or they may be overburdened with the demands of their own children, juggling visits to the P-TA and the doctor's office.
For that reason, says Bumagin, more and more social-service agencies are providing supports for the independent elderly.
At the Council for Jewish Elderly, "our philosophy is to offer concrete chore-like help," which she says "help to relieve the family from feeling exploited." This includes home-delivered meals, housekeeping and transportation services for those who cannot manage for themselves.
"If a daughter doesn't have to take Mother to the doctor's one day, shopping the next, or houseclean for her the next, then she's more likely to invite Mother to lunch.
"We try to do everything we can to prolong the independent living" of the elderly, she says.
Depending on what's available in the community, "one can put one's own package together," which could include help from relatives or a neighbor. One elderly man was so beloved by the neighborhood children, she says, that they competed to mow his lawn when he was no longer able to handle that task. Another woman built up a large network of friends and helpers to keep from overburdening any particular person.
Bumagin warns a concerned family not to act hastily to remove older relatives from their own homes if they become ill, are injured, show diminished capabilities or lose a spouse. Instead, she advises:
Take time to talk over the situation with the older person.
Make absolutely certain that the nature of any alarming change in that person isn't rooted in some physical or emotional problem that can be treated -- "that the old person is not being written off for old age. Old age and illness are not synonymous," she says. "Everybody gets sick."
Remember that those changes that do occur as we grow old so very gradually. "There's always time to think about alternatives and really explore them. Solutions arrived at out of panic are usually not good solutions."
If the time does come when you have to make a decision to place someone in an stitution, and there's no other alternative, give the older person "enough opportunity to express his feelings and become involved, so he will be willing to make that choice himself -- because it is his life being decided upon."