This is the last in a three-day series on elder abuse, a growing concern as our population ages. In this series, we tell the stories of victims of emotional abuse, reveal disturbing data on how many seniors are affected, and detail the state’s efforts to combat abuse. We detail cases of abuse and the challenges of prosecuting them. We also examine financial exploitation of seniors and how to identify it.
Part 1: Physical abuse |Part 2: Financial abuse |Part 3: The strain on caregivers
Lisa Losanno always knew the day would come when her mother might need help.
“I look at it like this way, my mother cared for me when I was little, and now it’s my turn to care for her,” she said. “She’s my mom and I love her more than anything in the world.”
That day came more than a decade ago, when her mother, Diane Losanno, 76, a retired housekeeper, showed signs of Alzheimer’s. That’s when Lisa returned to their childhood home and has looked after her mom in their two-family house ever since. Her brother lives in the other unit where he cares for their dad.
More than 844,000 Massachusetts residents help their parents, spouses and loved ones live independently at home, according to the American Association of Retired Persons (AARP), the nonprofit whose mission is to help seniors improve their quality of life.
It is likely that you or someone you know, is caring for an elder. These caregivers have a huge responsibility and sometimes they need assistance to manage stress.
“It’s important to acknowledge there are lots of unintended consequences to the stress and it may manifest in the kind of physical abuse we hear about that breaks your heart,” said Michael Festa, AARP’s Massachusetts director. “If you’re showing up at mom’s four days a week and she’s cranky and you’re frustrated, the next thing you know it could escalate.”
AARP offers help through support groups for caregivers, he said, but it requires an acknowledgment on the caregiver’s part that they need help.
“Caregivers must be proactive,” he said.
In many cases, family caregivers are doing it on their own with little contact with elder agencies, he said. As a result, family caregivers who are reaching the breaking point need to call for help.
One of the most important thing caregivers can do for themselves is connect with others, Festa said.
Fortunately, Losanno, 55, who works full time as a phlebotomist, has help. Her mom is also served by Element Care, a North Shore health services agency whose mission is to care for elders and their caregivers. The nonprofit is Essex County’s participant in Programs of All-Inclusive Care for the Elderly (PACE), a national program which provides comprehensive medical and social services to seniors.
PACE offers medical and home care, nursing, personal care, homemaking, meal preparation, medications, transportation, and adult day care. Available in more than 50 North Shore communities, most participants pay nothing. In some cases, there may be a monthly premium based on the participant’s income or assets.
For much of the weekday, Diane Losanno is at the agency’s Friend Street center where she and other seniors socialize, have meals, receive care, and participate in activities such as bingo, crafts, and exercise.
“It takes a lot of stress off of me,” said Lisa Losanno. “They look out for her just like family and she tells me she loves going there. Most importantly, I don’t worry.”
The sandwich generation
Julie Fohrman, a gerontologist at North Shore Geriatric Care Management, said not a day has gone by in her more than 25 years on the job when she hasn’t talked to a family member under stress because they are juggling so many responsibilities.
“They’ve even coined the term “Sandwich Generation” to describe people in their 30s, 40s, and 50s who are raising their own families and caring for their elderly parents,” she said. “They are balancing work, career, spouses, and friends and they just don’t have the time for it all.”
She recommends having elders under your care visit their local senior centers, or an adult day program offered by community-based nonprofits. These programs typically provide transportation.
“These places offer a respite for caregivers and have support groups where people can share resources and ideas and network,” she said.
While Lisa Losanno has help during the week from adult day care for her mother, her weekend consists of doing housework, laundry, and preparing meals for the week ahead.
“My mother has no problem doing her own personal care, but I do a lot of the other work,” she said. “We hang out on the weekends, we go out for coffee and go for rides.”
Cole Gill, a PACE social worker, said the Losanno family is not typical. He said many caregivers are under tremendous stress and think they have nowhere to turn.
“It’s not always the best situation when a family member has to take in their elderly parent,” he said. “Not because they don’t want to, but because of the circumstances. If you have a partner, young children, and are trying to care for your parents, all under one roof, it’s like trying to keep a tennis ball in play. It can be very challenging. Everyone gets stressed.”
That’s where programs such as PACE come in, he said, which cost nothing to MassHealth, Medicare and Medicaid members.
Mary Ann McGuirk, a social worker and center manager at Element Care, said employers need to be understanding when caregivers need time away from work to assist their aging parents.
“Managing day-to-day care for an elderly parent is stressful enough and it’s exacerbated when negotiating time off with employers,” she said. “It’s getting better, as more employers understand, but it’s still a stress.”
Elizabeth Agnes, Element Care’s site operations director, said the benefits of getting outside help to care for your elderly parent is priceless.
“We give respite to caregivers by providing simple things like filling pill boxes and doing chores,” she said. “We’re able to help caregivers spend more quality time with their loved ones rather than just working when they visit.”
Elders can be wary of outside help
But it’s not always easy getting parents to consent to having anyone, other than family, in their home.
“I don’t know how many times I’ve heard, even my father say, they don’t want a stranger in their house,” Agnes said. “But it’s a way of keeping them safe and cared for in the home.”
Getting outside help, while not always easy, provides release for the caregiver so they don’t get to the point of being resentful or abusive, she said.
One thing is certain. Elders want to remain in their homes, Agnes said. PACE support programs and partnerships with the Lynn Community Health Center, Greater Lynn Senior Services, and the Lynn Council on Aging surround them with resources to do that.
“Together, we provide everything from nursing care, home care, and we even have nurse practitioners and doctors who can make home visits and we can get medications delivered to their home,” she said.
Agnes knows something about caregiving. She’s not just a healthcare professional, she looks in on her 94-year-old father in Everett.
“I take time off to bring my father to doctor appointments, I’m taking time, at my expense, to clean, do the laundry, prepare meals, and fill his pill boxes at his home,” she said. “I was brought up to take care of your own and my grandparents lived with us when I was growing up. I cherish the time I have with my Dad, and I work it into my day.”
Still, Agnes said there may come a time when caring for your parents at home is no longer safe. That’s the time to consider assisted living or nursing home care, she said.
“Every elder wants to age in place, and we try to honor that,” she said. “But if they are at-risk of falling, if their memory becomes an issue, and if they are so weak they need supervision, staying at home is no longer the right choice.”
For the Carmosino family (not their real name), the toughest decision they ever made was to place their 78-year-old mother in a nursing home.
“It broke my heart and I know I speak for my brothers and sisters,” said Michael Carmosino. “My father died from a heart attack in 1990 and my mom was able to live on her own for many years.”
But a few years ago, she started showing signs of Alzheimer’s and could not be left alone, he said. His mother forgot to turn the stove off, had trouble balancing her checkbook, and tried to call her long deceased mother on the phone.
“The disease got worse and we knew she couldn’t really take care of herself, or be home alone without supervision, so the family made the painful decision to move her to a nursing home,” he said. “We knew it was the right thing to do, but it still hurt because she wanted to stay in her own house.”
Frances White, 66, a math teacher at St. Mary’s High School, is part of the Sandwich Generation. She is married, has two adult daughters and seven grandchildren.
“I was working full time, being a grandma myself and had all kinds of obligations in the family,” she said. “At times, I felt pulled in different directions because I wanted to do all things for all people and to be good to myself as well.”
After her father died at 86 in 2013, White, her siblings and their mom decided she would have a better life at Brightview Danvers, a retirement community that offers apartments that feature independent and assisted living, as needed.
“It was mom’s decision to go to Brightview because she wanted other kinds of experiences during the day,” she said.
Brightview offers restaurant-style dining, fitness classes, games, a movie theater, get-togethers, and more.
“It was a wonderful experience,” she said. “Sadly, my mom passed in 2015 at age 87.”
Cheryl Charles contributed to this report. She can be reached at [email protected].