The Family Home or the Nursing Home?

At first it feels like I’m in a college dorm.

The lady at the front desk lets us in, and my boyfriend immediately signs me in as a guest. There’s a little convenience store with the same soft drinks and cookies and potato chips and sandwiches I gobbled in my own dorm. We make our way to the dining facilities, where a large sign outside the two closed doors of the dining room announces that dinner will begin at 5, with turkey and mashed potatoes as the main course. Yum. Ten minutes to go.

Some residents are chilling out in the lobby, chatting, looking through their mail, waiting for their friends to arrive so they can go to dinner together. It’s busy this evening; people are coming down and going up and asking each other how’s it going. We take the elevator to the third floor to get Mel. As I pass the laundry room I see the sign warning people to be considerate and not to leave their things in the machines for too long, reminding me once again of my freshman home.

We get Mel and head downstairs for dinner, and everyone is at their usual table in their familiar cliques – there’s friendly Gina at the “popular” table with her girls, and tall Sam with the other tough men at his “jock” table. Directly behind me sit the quieter ones who don’t say much to each other, focused on enjoying their meal.

After dinner, we head outside for some fresh air. Sam and Gina are sitting next to each other on the bench. They’re dating, you see, and their heads are bent together in conversation. They see us and wave us over, and though I’m shy about disturbing their couple time, we end up sitting with them in the twilight. Me, my boyfriend, Max, Gina, Sam. The college kids, hanging out together after a long day of activities and a big dinner. Or so I feel.

But in reality, Sam and Gina are 92 and 83 respectively. College is a thing of the past, their spouses gone, their children grown. Mel, my boyfriend’s grandfather and brother-in-law to Gina, is 96 years and 7 months old, as he proudly tells me every day that I visit. “Can you believe it?” he asks. He doesn’t look a day over 80, I say, and it’s the truth. An hour later, my boyfriend and I get up to leave, and the three elderly residents head back to their own apartments and go to bed at 9.

No, this isn’t a college dorm.

***

When I first learnt that my boyfriend’s grandfather lived by himself in a “home,” I was extremely indignant on behalf of this elderly gentleman I had never met. I imagined a vulnerable old Mel, cast aside and unloved, all alone in some cold, impersonal institution with bad food and sour-face nurses. A nursing home, the worst place for the elderly, a place of doom for those with the bad luck of having no family or a cruel family.

Of course I thought of homes for the elderly this way. In my Malaysian Chinese family, I’d been taught that taking care of your parents when they are old, having them live with you, is a responsibility that must never be questioned.

All around me were positive examples of this filial piety. A neighbor’s elderly father lived with him. My teacher’s widowed mother lived with her. An aunt uprooted her family so they could live with her husband’s aging parents in his faraway hometown. My maternal grandparents took turns living with each of their 12 children’s families. In my own home, I grew up with my dear paternal grandmother under our roof, and I watched my father lovingly cater to her needs, taking care of his mother as she had once taken care of him.

One day, my parents would live with me too. It was the right thing to do, I knew. On days when I fought with them, their angriest reproach would usually be, “You’re the kind of daughter who’s going to put us in a nursing home, aren’t you!” No! I thought when they mentioned those two “bad” words. I would never do that! Only the shameless, the ungrateful, or the thoroughly Westernized would put their elderly elsewhere… right?

But I was also confused by extreme examples of this filial piety at play in the cases of those who sacrificed their lives, careers and health so they could personally look after their parents during the most trying times. A personal example is another one of my aunts who decided to look after grandma after her health deteriorated. My father had two young children to handle; with no children of her own, Auntie was able to give grandma her undivided attention. She was a wealthy woman who could have put her mother in the best homes. She chose not to, putting her life aside to attend to her mother 24/7 after a series of strokes left my grandma with semi-paralysis and depression. I visited them in London six times in those six years, and I remember the feedings, the constant changings, how we would wake up one, two, three times in the night and rush to her side when grandma started wailing from nightmares. After two weeks of this, I could barely open my eyes. My aunt, already in her sixties, did this for six years, before finally crumbling from grief and exhaustion when my grandma died. It was a devotion I don’t think I will witness ever again.

***

Visiting Mel and seeing how he actually lives made me rethink what it means for senior citizens to live in a “home” away from their family. Maybe it’s not a shameless, ungrateful act by decadent Western children, as I’d been taught as a young Chinese girl. Sometimes, it’s may actually be for the best. Nursing homes are also on the rise in China, where one-child families have resulted in fewer relatives able to care for a growing elderly population. Perhaps my “Asian instinct” regarding what filial piety requires is incredibly unrealistic.

Mel’s residence is technically not a “nursing home,” but an exclusive assisted living facility, with a residential campus’s community feel. He has his own apartment, a spacious and bright two-bedroom pad that’s larger than the apartment I share with my boyfriend in Shanghai. Photos of his wife of sixty years are lovingly arranged on a shelf. Meals are provided for him in the dining room, and he also has a fully-equipped, well-stocked kitchen that I envy. There’s a flurry of activity at the home, enough to keep the more active residents busy, with buses heading to different destinations every day. Mel’s sister-in-law lives five floors up and checks in on him often, as do the smiling nurses three times a day. His family is always near — they go over to check on him daily, and his grandson practically lives with him when he’s back in the U.S. Mel may be in an “institution,” but there’s nothing impersonal or sinister about it.

Would the alternative necessarily be better? I imagine Mel living with his son in the large house in the suburbs, him navigating those stairs every day with his bad knee. What would Mel do all day when his son and daughter-in-law are at work, his younger grandchildren busy with school and extracurricular activities? Would technically living with family be worth more than what he has at his own apartment – his friends, the sense of community, his independence, his routine, round-the-clock healthcare and baseball at 7 p.m.?

After my visit to the U.S., I stopped in London to see my relatives, including my Auntie who had looked after my grandmother. Five years after grandma’s death, my aunt is still recovering from the toll of being a full-time carer. Her health is bad, her social life non-existent from the years of hiding her life from her friends. Of course she doesn’t regret looking after her mother – it was “the right thing to do,” but sometimes I wonder whether there could have been a balance between what was right for grandma, and what was right for herself.

***

In the end, despite changing my mind about the horror of nursing homes and the ambivalence I feel over whether intense self-sacrifice is necessary, I still want my parents to live with me when they are older and less able to do everything for themselves. It was the way I was raised. It’s what I want to do.

But surprisingly, they might not want to live with me after all. When I first told my mother that Mel didn’t live with family, she was horrified, like I knew she would be. “Harrumph!” she growled in a way that meant, “Why are you dating a useless American who puts his grandfather in a nursing home!” But after sharing with her my experience of visiting Mel, she seems to like the idea. “It doesn’t sound bad!” she said. “He has his own life, own friends, his independence. Maybe that’s what will keep him fit and alert. Maybe staying with family is not always the best thing.”

Are the elderly in your family living under “traditional family care” or “institutional care”? Is there “nursing home” stigma in your family? What do your parents want?

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