Even when the family is local, Hepburn adds, the health care system isn't really set up to help those families cope.
"Families are what keep people at home, but they don't have the training to do it," he says. Nor is there communication in place between hospitals, nursing homes, home health care aides, and families to help the old and sick stay independent. "Hospitals are not responsible for my independence. They are responsible to their own bottom line and to getting me out of the hospital safely."
David Kern
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Today, he says, there are no bridges among our health care organizations. Those must be built, and then extended to reach the families.
Until then, seniors like the Links are likely to be in a position to fend for themselves. Kathleen Kelso notes that the system only caters to those who know how to manipulate it. That means, in short, that on top of dealing with the daily stresses of survival, folks in need must also make enough noise to demand support.
"People don't plan for this. It's not in our human nature," she admits. "You have to learn to cope, and at the most vulnerable point in your life."
Ralph is once again sitting at the dining room table, a bowl of slush in front of him. It's a few minutes before 9:00 a.m. and the home health care aide is getting ready to leave.
She tells him it was nice to meet him, shakes his hand, and takes off.
Ralph has been home for several days now, after weeks in the hospital and a nursing home for rehab. The doctors are still trying to kill off a bacterial infection they think is hiding behind his heart, so he takes two kinds of antibiotics--one delivered in a constant drip, the other a shot administered once daily. Sharon has to give Ralph the shot. Squeamish, she didn't think she'd be able to do it. But now it's become just another of those things she does out of necessity.
The home health care aide situation is still complicated. When Ralph was first discharged from the hospital, Sharon worried they wouldn't have any help at home. Then they hoped they'd be able to get services from an agency where one of their previous aides now works. (He just adores Ralph, Sharon says. He still stops by a couple of times a week, on his own. Sharon can't pay him, but she offers him gas money.)
But now they've learned that the agency doesn't have enough staff to pick them up as clients. So, for the foreseeable future, they're likely to get someone new every day.
"You train these people and then they never come again," Sharon complains. "You need consistency. Someone who can tell, is this wound getting better, or worse?"
So again, they're at the mercy of an overburdened system. "You get a change in schedule for an aide, and you've got to adapt your schedule to theirs rather than the other way around," Ralph says.
But despite the difficulties, they're just relieved to have Ralph at home again. Memorial Day marked their 52nd wedding anniversary. It was a lovely day, sunny and mild. That evening they went down to the garden outside their building, where there's a new glider on the patio.
"I sat in the glider, and he pulled up next to me," Sharon says, a lilt of happiness for once caressing her voice. "We looked at the gardens and the sky."
Those simple moments are so sporadic now. Yet when they come, there's still hope. And that, for now, is enough to carry them through. "I told him," she continues, thinking back to that anniversary evening, "that I've got a good feeling."
