Well elder interview study

¶ … perceptions about well elders who live independently within the community. Perceptions about well elders tend to skew two ways: some people assume that age equals disability, so that even well-elders are treated as being incapable of self-care, while others fail to recognize that even well-elders face significant health risks. By focusing on a well-elder as an individual, the author used the interview technique to discover the assets and liabilities of a particular well-elder living within the community.

Before interviewing the well elder subject, my perception of a well-elder was an older community member with no significant health issues and substantial family support, so that independent living was not problematic for the individual. Having come from a family that enjoys good health well into old age, I had not given much consideration to the challenges that even a healthy older individual could face. Instead, I viewed age as more of a function of state-of-mind than physical state, a position that was not fully supported by the interview that I conducted. This made me aware that even highly functioning older individuals may need adaptations and accommodations to ensure independent living.

Discussion

The older adult that I chose to interview is a 71-year-old woman who lives independently in a single-family home in a suburban neighborhood. She has been divorced for more than 30 years. She has an adult daughter, age 49, who lives with her, but the daughter moved in to her mother's house because of a job loss, not to provide physical care for the mother. She is a member of the middle class, with significant retirement savings, a large amount of personal savings as the result of an inheritance from her parents, and no significant debts.

The main risk factor evident in the woman that I interviewed was a pre-existing health condition, COPD (chronic obstructive pulmonary disorder with emphysema). She has other health issues including high blood pressure, which are easily controlled with medication, but the COPD is the only of her health concerns that impacts daily functioning. She does not use oxygen, but is on a variety of medications to treat the COPD and fears that she will soon begin having to use oxygen on a regular basis. This concerns her because her doctor has explained that once she begins regular use of oxygen to help her breathe, she will likely be on oxygen for the rest of her life.

From my interview, it appears that most of the older adult's physiological and safety and security human needs are being met. She has a large family, with five surviving daughters, three son-in-law, and five grandchildren. One daughter lives in the home with her and two daughters visit multiple times a week. The other two children, though they live within proximity of visiting, do not visit frequently. The three highly involved daughters seem committed to ensuring that her needs are met. For example, when her home was recently victimized by a kick-in burglar, four of her daughters and a son-in-law had the police out immediately and had repaired the damage and ensured the safety of the home by that evening. Grocery shopping has become difficult for her, so the daughter who lives with her handles this task. When a tree fell in her front yard, her grandson came over with a chainsaw and cut up the tree. From all appearances, there is substantial family support to ensure that her needs will be met at this time.

One of the reasons that the woman I interviewed is able to maintain independence in the home and in the community is because of her relative degree of affluence. She would no longer be capable of doing the routine maintenance needed for a single-family dwelling, such as yard work, but has the money to pay for these services, as well as for a housekeeper. Furthermore, though her daughter moved in because of the daughter's financial difficulties, as the woman's COPD has progressed, the daughter has played more of a caregiver role, taking over routine errands like grocery shopping and household chores, such as meal preparation and cleaning the kitchen.

The woman is very close to several of her children, and her relationships with her children are the most important in her life. In addition, she visits with friends several times throughout the month, attending a monthly luncheon with one group of friends, meeting another friend regularly for drinks and dinner, and attending other social gatherings. She has strong relationships with several neighbors. She has no pets of her own, but is fond of her granddaughter's parakeet, which stays at her house because the granddaughter's cat eats birds. She has very close relationships with her grandchildren, particularly the two youngest grandchildren, whom she sees at least once a week. All of these relationships promote love and belonging.

The woman plays multiple roles in her life. Her primary roles are mother and grandmother, and she has some contact with her children and grandchildren on a daily basis. She is also well-connected with her friends, maintaining long-term friendships and cultivating new friendships. She has been in the girlfriend role after her divorce, but has not dated for the last five years. Her transition out of that significant romantic relationship was one of her more difficult transitions of recent time, as she and her boyfriend were deeply in love, but had conflicting life goals. One of her most important roles is sibling, and she has a younger sister with a terminal cancer diagnosis, which provides significant challenges.

Her family support system is excellent, but incomplete. Her parents died a few years ago and her siblings are beginning to experience health issues. Three of her five daughters and one of her son-in-law are very supportive. The others are loving when present, but are largely absent. There seems to be sufficient family support, but one can foresee conflict between her children if there is a major medical decision to be made because the children who do not visit frequently are in denial about their mother's declining physical condition.

The woman's self-esteem is moderate. She seems aware that she is an attractive, nice woman who does good things for others and is confident that she is a good grandparent. However, her marriage was an abusive one and one can see glimpses of that in her demeanor. She still regrets not leaving her husband earlier, and questions whether that decision led to the early deaths of her other two children. She made comments about one daughter, a domestic violence advocate, speaking up for Domestic Violence Awareness Month, and her regrets that her children had personal experience with the issue. However, at the same time she showed tremendous pride to have helped her children break a generational cycle of abuse.