Hope There’s Someone Who’ll Take Care of Me*

In Home CarersOne of the most difficult decision adults have to make is arranging for the care of elderly parents when those parents are no longer in a position to care for themselves. It’s hard enough when parents lose their physical health; it’s even harder when dementia and other cognitive losses are involved.

Different people find different solutions. A lot depends, too, on individual factors such as income, local living options, size of one’s house and space available, and so on. There are cultural factors too (more on those shortly). No solution is entirely perfect, but many families opt to have in-home carers. This offers some benefits too. For one thing, it allows elderly parents to stay in their homes, and that’s what many of them would rather do. For another, it eases the caregiving burden on the adult son or daughter.

On the other hand, even a thorough ‘vetting’ doesn’t guarantee that an in-home carer will be the dedicated individual one would hope. And there’s the issue of having someone who’s not family live in one’s home. In-home care can be very expensive, too. Still, many people take that option, and it’s interesting to see how it plays out in crime fiction.

It’s  not surprising that it does. There is a rising population of adults who need such care, so it’s realistic and timely. And the context allows for lots of conflict, suspense and more.

In the years before there were well-established care homes, having an in-home carer was the only option available to those who could afford one. And in earlier centuries, those people often had no special preparation for that role. Robin Blake’s The Hidden Man, for instance, takes place in 1742. Attorney and Coroner Titus Cragg goes to visit local pawnbroker and would-be banker Philip Pimbo. When he arrives, it’s discovered that Pimbo has been shot. On the surface, it looks like a suicide, but Cragg’s friend, Dr. Luke Fidelis, isn’t sure. There is pressure to simply let the case go, but Cragg respects Fidelis, and starts to ask a few questions. One important question is: who would want to kill Pimbo? In part to get some background, Cragg visits the Pimbo home. There he discovers that Pimbo’s mother lives with her son. She is cared for by the family housekeeper, Ruth Peel, who does her best. She tries to make sure her charge is comfortable and well cared-for, but she has no medical background, and of course, in 1742, not much was known about dementia. So she certainly has her hands full, as the saying goes. It’s an interesting, if not exactly happy, look at the care customs of that time.

Agatha Christie’s Appointment With Death introduces readers to the Boynton family. They are on a sightseeing tour through the Middle East when they decide to spend a few days in Petra. On the second afternoon, family matriarch Mrs. Boynton dies of what looks at first like a heart attack. That wouldn’t be surprising, since she is elderly and not in good health. But Colonel Carbury isn’t quite satisfied, and asks Hercule Poirot, who is in the area, to investigate. Poirot agrees and begins to look into the matter. In this case, there are plenty of suspects. Mrs. Boynton was an unpleasant tyrant who delighted in keeping her cowed. And one of those people is her live-in nurse (and daughter-in-law) Nadine Boynton. Nadine met her husband when she came to live in with the family and look after Mrs. Boynton, and she’s had her share of abuse. But Nadine is the only person in the household who wasn’t really intimidated. She’s actually a very interesting character.

Fans of Elizabeth George’s Lynley/Havers series will know that Sgt. Barbara Havers faces the difficult challenge of finding the best care situation for her mother. As her mother slowly begins to suffer more dementia, Havers knows that she cannot live independently. Her mother has moved in with her, but even that’s not really enough. So Mrs. Gustafson, who lives next door, helps out, and looks after Havers’ mother while Havers is on duty. But the arrangement isn’t particularly successful. Mrs. Gustafson has no medical background, and more than once Havers worries about what might happen to her mother. In For the Sake of Elena, matters come to a head when Havers’ mother leaves the house alone without anyone knowing. This situation isn’t the main plot of the novel, but it does reflect the real difficulty many adult children have in trying to make the best arrangements possible for their parents. It’s a process filled with challenges.

The main character in Alice LaPlante’s Turn of Mind is former Chicago surgeon Jennifer White. At sixty-five, she has been diagnosed with early-onset dementia, and can no longer live on her own. But as the novel begins, she still has many more lucid days than bad days. Still, her grown children have arranged a live-in carer for her, Magdalena. Magdalena is very helpful at ‘anchoring’ White on her bad days, and all goes well enough. Then one day, Amanda O’Toole, who’s lived next door to the Whites for many years, is murdered. Detective Luton is assigned the case and begins the investigation. She makes the disturbing discovery that the body was mutilated in a way that suggests the work of a surgeon, or at least someone familiar with surgical tools. And, since the Whites and O’Tooles have a long (and not entirely happy) history together, Luton is naturally interested in White as a suspect. But White’s dementia is slowly taking hold, and Luton may not be able to get the real truth from her. Throughout this novel, it’s fascinating to see Magdalena’s role as a ‘memory bank’ when White forgets things. She has her own past, too, which makes her an interesting character.

In many cultures, it would be unthinkable to hire a carer for an elderly parent. In those cultures it’s seen as the family’s responsibility to look after elderly members. For instance, in one plot thread of Tony Hillerman’s The Ghostway, Navajo Tribal Police Sergeant Jim Chee gets a difficult case. Sixteen-year-old Margaret Billy Sosi has gone missing from the residential school she attends. Chee traces her to the outlying areas of Los Angeles, where she has a distant relative, Bentwoman. In the traditional Navajo culture, family members are responsible for taking care of elderly relatives, and that’s what happens in this case. Bentwoman is a very old woman, and doesn’t always speak coherently. She cannot live on her own. So her daughter lives with her and looks after her, doing everything that’s needed.

Sometimes that arrangement can work. But very often, when an elderly parent cannot be left alone, a live-in carer has to be found. That has its own benefits and challenges, but it is an option many people choose.

 
 
 

*NOTE: The title of this post is a line from Antony and the Johnson’s Hope There’s Someone.  

18 Comments

Filed under Agatha Christie, Alice LaPlante, Elizabeth George, Robin Blake, Tony Hillerman

18 responses to “Hope There’s Someone Who’ll Take Care of Me*

  1. Such an emotive subject, Margot and one that does cross my mind, often. As you know I lost my mum last year and in some ways I’m grateful we won’t have to make these decisions for her, but my dad who lives 350 miles away, well that’s another matter. Still, we are not there yet. For now we’ll concentrate on enjoying the present and I’ll try not to include this theme in any of my books in case he thinks I’m getting ideas 😉

    • It is a really difficult and emotive topic, D.S. And it’s something that a lot of adult children have to deal with at one point or another. I think you’re wise to enjoy the present as it is. And to not give your dad any worry about ideas you may have… 😉

  2. Margot: In The Lewis Man by Peter May one of the main characters, Tormond, is suffering dementia and his care for his wife, Mary, has become a challenge. I summarized the issue in my review:

    May takes the reader on an amazing and heartbreaking venture into
    Tormond’s deteriorating mind through the book. He hopes the bad Mary
    who sent him away will change back to the good Mary who has loved him
    for almost 50 years. He knows he is not at home but cannot figure out
    where he has been taken. Initially he thinks it is a hotel.

    • Thanks, Bill. I really should have mentioned The Lewis Man, but didn’t. I’m glad that you filled in that gap. This novel also shows just how hard it is when a spouse or loved one does the caregiving instead of someone else. It adds even more pain and difficulty. I think May handles it effectively, without being melodramatic.

  3. I must admit this is a plot point I actively avoid where possible – having had a mercifully brief experience of dementia with my own mother before she died, I find it very hard to read about even when sensitively handled. Having said that, I agree with Bill that Tormod in The Lewis Man is an extraordinarily convincing and moving portrayal of a man with dementia, and of the difficulty his family is having on deciding on the best way for him to be cared for. We also see Ellie in the Dalzie & Pascoe books having to accept her father’s dementia and go to help her mother with his care.

    • I can completely understand your reluctance, FictionFan. Some topics/stories are just too close to home, as the saying goes. I think we all have those topics. But that said, yes, May handles this extremely well, I think. It’s convincing without being so overpowering as to be unbearable. And thank you for reminding me of Ellie’s father (I really need to re-read those novels!!!!). It’s a very effective depiction of how these care decisions impact everyone.

  4. Patti Abbott

    Also Kurt Wallander and his dad. Very sad indeed.

  5. Margot, if it weren’t for the children who look after their parents dutifully and lovingly, the elderly in India would be a doomed lot because, unlike in the West, we lack in-home or hospice care. We are lucky because of strong values that bind most families together. Aged and ailing parents usually stay with sons or daughters, and are looked after until their end.

    • Thank you, Prashant, for sharing the way Indian families band together to look after the elderly. As you say, it is fortunate that there is a high premium placed on caring for elderly parents and grandparents. It means that there is likely to be a caring home available for those who are no longer able to live independently. Even in a system that does have hospices and in-home care, those family bonds can be very important. It’s even more so when it’s not as easy to find ‘outside’ help.

  6. Some really intriguing examples, though personally it’s the sort of topic that I wouldn’t want to see treated too dramatically or negatively anyway as I would just find it too depressing to be able to enjoy in a crime story – that’s just me of course 🙂

    • I don’t think it’s just you, Sergio. I think a lot of people find this particular topic difficult to read. And when it’s treated very dramatically, it just adds to the sorrow in the story.

  7. Col

    A subject that’s quite close to home. I think I read THE GHOSTWAY a few years ago but can’t recall too much about it.

  8. Fascinating topic, Margot. I’m reminded of an excellent crime novel I read (and reviewed), Elizabeth is Missing, by Emma Healey. Maud is suffering from dementia. All she knows for sure is that her friend, Elizabeth, is missing, but no-one believes her. The details of today are constantly being lost, while her memories of the past and the disappearance of her sister seventy years ago are as vivid as ever. It is not an easy read, but Maud’s dementia and her daughter’s efforts to cope are very well handled.

    • Thank you, Christine. And thanks so much for reminding me of Elizabeth is Missing. It’s been on my radar for quite some time, actually, and I just haven’t (yet) got to it. Good to know that something good is awaiting me when I get there.

  9. It took me awhile to return to this post because it is too close to home for me too. At this point, I don’t know if a subject like this in a fiction book would bother me or not. Probably depends on how it is handled.

    • I think that’s probably the case for a lot of readers, Tracy, especially those for whom it hits very close to home. Sometimes a topic is so intense and personal for a reader that it’s hard to read about it. And the way the author handles the topic really would make a difference.

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