REFLECTIONS
Reflections
A MODERN TALE
Teresita Bacani-Oropilla, MD
A
husband and his wife were both
physicians. For several decades,
in quiet obscurity, they took care
of patients in a state mental hos-
pital. They witnessed the transi-
tion and modernization of patient care from
huge homogenous wards to individualized
private rooms, from chronic long term to brief
acute treatment protocols, with discharges to facilities in the com-
munity. They were also privy to the social protests and upheavals
that accompanied these changes.
After many years, having seen their own children become suc-
cessful in their chosen professions, the pair retired. They maintained
two homes: one a hobby place where he tinkered with old cars and
kept them running, the other as their habitat where the children
and grandchildren came to visit. He loved to shop for what he called
antiques in the flea markets. She loved to keep up with medical
journals. In a pinch, their children would ask them to babysit their
grandchildren in the Midwest, in the East, or in California on the
west coast. Life was good and kept humming along.
The ravages of time and fragility of old age were slowly catching
up with them, however. He started falling due to poor balance. His
children thought his driving skills were not as keen, and she had a
cardiac episode that required hospitalization. The family converged
in love and sympathy, but of utmost importance, they needed to talk.
With Dad still in rehab from his latest fall and Mom in cardiac
12
LOUISVILLE MEDICINE
rehab after some stents, it seemed obvious that the beginning of
the end to independent living had come. The choices were many
but all had flaws. Maintain the houses and cars and get help to do
so. What help? Where help? Close the houses and live with one of
the children. But who among the seven can give up their work and
familial obligations and take care of two elderly people who will need
new doctors and support systems in a new state? Where? Midwest?
East coast? West coast? They have only few remaining friends as
it is. If they leave, they will have none. Transfer to assisted living?
With or without intermediate and nursing home progression? These
options can easily deplete seed money that had been laid aside for
“old age!” But to their credit, they did not think they were all that old.
With lifespans getting longer, seniors have to prepare for when
maintaining their lifestyles, their homes and activities of daily
living without endangering themselves or others, becomes more
difficult. These times may come like a thief in the night. Accepting
these changes and limitations is a trial for all, emotionally, socially,
financially. In a perfect world, we would like to spend the closing
days of our lives cradled in the security of loved ones’ arms, in a
home we know. Unfortunately, time and progress have marched on,
sometimes leaving the debris of woe, dislocation and misery behind.
However, man is innovative, hopeful, and always finds a way to
an acceptable compromise. The lesson today is, “Smile, for behind
the clouds, the sun is still shining!”
Dr. Bacani-Oropilla is a retired psychiatrist.