Although my B and her mother have on the surface a close relationship, my wife has made it clear that as soon as her mother becomes a burden, through illness or age, she will send her back to China, either to her sister or to a nursing home.

This is a very pragmatic approach, and oddly, her mother is in complete agreement with this.

Now my wife claims to have been raised in a very close family, and this is borne out of the ongoing contact she maintains with the rest of her family, but something about the pragmatism of these relationships doesn’t sit well with me.

They tend to represent relationships of convenience, which in my ‘Western’ world is the anti-thesis of the foundation for family. In any case, it has worked well for their whole family so far, and given that there has never been any family inheritence to fight over, the relationships have remained symbiotic and mutually beneficial.

Of course, this is the easy part. If or when her mother ages to a point where she herself needs ongoing help, the pressures on the whole family will be compounded. Although I have some work colleagues who have easily transitioned their parent’s into a nursing home facility, the emphasis on family within the Chinese culture, I expect, would make this a more difficult proposition.

Only time will tell, and although my mother-in-law is in great shape for her age, both mentaly and physically, she does have a worriesome tremor and increasing rigidity in her body, which is looking more and more like Parkinson’s disease.

For those who know about this disease, it is progressive and insidious, and takes a terrible toll on the whole family in terms of the level of care that is required. For my mother-in-law’s sake, I hope that this care, no matter how difficult, is provided by us, and not a nursing home. It just wouldn’t be right.

There is a national organization of professional GCMs. I’d encourage you to check out its website. http://www.caremanager.org/.

A couple of great articles about the use and benefits of GCMs are “Worry-Free Care for Faraway Parents” http://www.bottomlinesecrets.com/article.html?article_id=47887 and “Why Hire a Geriatric Care Manager?” http://newoldage.blogs.nytimes.com/2008/10/06/why-hire-a-geriatric-care-manager/

Almost 19 years ago, my two sisters and I were forced to make quick decisions on the care for my dad who suffered from Alzheimers. He was living at home with my mom who had a major medical emergency and we were faced with finding a safe place for him. With limited knowledge and time, the only option we could find was an institutionalized nursing home. Although the care he received there the last 7 months of his life was adequate, I often regret we didn’t have better options.

Fast forward to 6 years ago, my mom (now age 83) needed some place to live due to financial constraints. We were able to move her into our home where she lived for 5 years until passing away in April of 2008. We have a friend who is a Geriatric Care Manager and her guidance through that 5 years, including the last 4 months with Hospice, allowed me to bury my mom with absolutely no regrets.

I understand the importance of elders’ keeping control of their lives by staying in their homes as long as possible. But because of his health, my dad isn’t just another elderly person whose lost his spouse. Living alone is life-threatening for him. What do I do??