home careIn the 2006 movie Away From Her, Julie Christie was nominated for an Oscar for her portrayal of Fiona, a woman with Alzheimer’s who voluntarily enters a long-term care facility to avoid being a burden on Grant, her husband of 50 years. As Fiona’s disease progresses and she develops a close relationship with another man in the facility, Grant must draw on all the love and respect he has for her in order to ensure his wife’s happiness. It is a touching and very moving portrayal of people wholly committed to each other, who none-the-less must make extremely difficult choices when circumstances change.

Modern Love,” the May 11 2014 column, Promises That Can Bend Without Breaking, describes a similar circumstance. Author Robert St. Amant talks openly about the choices he made when his wife of 28 years developed severe Alzheimer’s-like symptoms following treatments for brain tumors. His  – their decision was for both he and his wife to move into an independent living apartment in a care facility. Robert was just 50 years old and in excellent health at the time of the move. “I’m not sure I belong here,” he says.

I found both the movie and the “Modern Love” feature thought provoking and inspirational about the long-term power of love and commitment. They also caused me to think about my own marriage and the promises that my wife and I have made to each other. If something happened to one of us, how would the other respond? Will we be there for each other if circumstances change? What if one of us is unrecognizable to the other because of Alzheimer’s?

I have no criticism of either Grant or Robert. If I were ever to be in their shoes I would hope that I would find the strength and courage to do for my wife what they did for theirs. But beyond the love and commitment and very honest difficult choices in these two portrayals, one thing bothers me however.

In both portrayals, the unquestioned choice was to move to a care facility. Was home care not even considered?

In Away From Her, Grant feels lonely and isolated at home, “away from her.” Visiting Fiona in the care facility is stressful on many levels. It may have been that home care was considered, but Fiona’s motivation in moving to a facility seemed to be driven more by not wanting to be a burden to Grant than the considerations of what it would be like for both of them to live apart. When Fiona moves out, she is not incapacitated by her illness yet. Would staying at home and staying together have been a better choice?

In Promises That Can Bend Without Breaking, Robert’s move to the care facility is completely motivated by his desire to remain with his wife. Did he consider the advantages for both of them in staying home with home care?

I sincerely hope that there will be more movies, books, and articles about aging and the devoted family members who are part of making the difficult decisions about care. I also hope that from now on when the question of how to care for an aging family member comes up, home care is considered as one of the answers.

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