Aiding Elders: When Care Skips a Generation

June 25, 2007— -- Growing up, Ray Payton, like many people, was especially fond of her grandparents.

As a young child, when visiting their Arlington, Va., home, she would hide under the dining room table, one of her favorite spots. Admittedly a tomboy, Payton would play with toy trucks given to her by her grandfather, Dowell Tillman.

Payton's mother died when Payton was in her 20s, and so her grandparents were more like parents to the only daughter of their only daughter.

But as Payton grew, even by the age of 12, she knew the day would come when she would be called upon to take care of them. That day is now here.

"I reflect on how my grandparents brought me up, what they sacrificed for me," Payton said. "They gave up things for me when I was a baby, and they gave things when I was going to school, and now it's my time to show them that they taught me well."

'They Built This House'

According to USA Today, Payton, who is 38-years-old, is one of the millions of Americans caring for elderly family members, working through the financial burden and emotional hardship that such a task requires.

Dowell Tillman, who turns 94 next month, is now blind from glaucoma. Payton's grandmother, Vidalia Tillman, is 90 years old and suffers from dementia. The couple has been married for 70 years.

Despite their deteriorating conditions, Payton made the difficult decision to maintain their care in the same Virginia home where the couple lived for 54 years. Keeping them there, she said, is the only option.

"[I] think if I lost the house, it would kill them. They built this house. I don't want to give it up because this is my family home," she explained. "They came up with two trunks and a little girl -- my mom. They built this house, they saved, they worked. My grandfather and my grandmother pretty much had two or three jobs all the time."

Nursing Home Not an Option

Payton's father also died when she was in her 20s. As the conditions of her grandparents and their home began to worsen, and as she began to shoulder more and more of their care, she briefly considered moving them into an assisted living community.

"When they had mold in the house, I had to move them out, move all their furniture out, renovate the house. I looked into nursing homes in the area," she said. "I called some of the most popular nursing homes that you see all over the place and because of the types of diseases that they have and the number of medications that they have, they quoted me a price of $12,000 a month."

But it wasn't only the steep cost that dissuaded Payton from moving her grandparents. She also said many of the homes she consulted would have separated her grandparents due to the disparity of their ailments.

"After being together for 70 years, I couldn't imagine having to separate them," she said. "They would be in the same facility, but they wouldn't be able to even be in the same room or in the same area because their diseases are so different. It would kill them."

'A Hard Day'

But around-the-clock care is now required, and Payton said despite her desire to do it, she just doesn't have the skills. "My grandmother is always stiff in the morning. I don't know how to lift her. I don't know how to rotate her so that I'm not going to break a bone. I don't know how to clean her to get her ready.

"They need somebody with them 24 hours a day," she continued. "A doctor has written prescriptions for them. They need 24- hour care. And that's what we're giving them."

This care comes in the form of a nurse named Kathy and two other skilled health care providers. But the transition was not easy, especially for Payton's grandmother, the matriarch of the family who felt her independence was being threatened. "She is the boss, even now. Kathy will tell you when she first came here my grandmother said, 'I am the lady of this house.'"

Payton wound up taking her grandmother to court to gain custody of her, to prove she was incapable of caring for herself.

"It was a hard day," she said. "I mean, it hurt in two ways. I had to pay a lawyer, I had to pay the court, I had to pay for a bond, I have to pay for my filings and I had to take my grandmother to court.

"I broke down and cried that day. I'm trying to take care of her, but I had to take her to court to prove to the government that she could not take care of [herself], and I was fit to do it."

The High Cost of Care

Such care does not come cheap. It costs an estimated $10,000 a month just for skilled nursing, to say nothing of living expenses and medicine.

"The dollars are just ticking away, every minute," she said. "I can't buy back these memories. I wouldn't be able to live with myself. Remember, I lost my parents in my 20s, and I wasn't able to do this for them."

Payton said she is rapidly running through her grandparents' savings, over which she has legal guardianship. She estimated they'll be out of funds in about six months. To make ends meet, Payton and her new husband of one year are planning to move into the basement of her grandparents' home. If she can rent her current place, Payton said her mortgage payments can then go to her grandparents' care.

Payton splits the cost of their in-home care with her grandparents, using funds she acquired when she was granted legal guardianship.

In addition to working as an information technology specialist for the federal government, Payton acquired her real estate license so she can have a second job. She's even considering selling stocks to fray the ever-escalating cost of her grandparents' expenses.

Feelings of Resentment, Then Guilt

Despite the patience and genuine love she has shown for her grandparents, feelings of resentment do surface, and Payton can't help herself from thinking of the day her grandparents leave her.

"I hate to say it," she explained. "I have friends who have gone through this as well. And some of them have challenged me and said, 'You're just tired. That's why you say that. …You'll regret when you don't have them to come home … to hug, and then you'll wish that you could run that errand for them.'"

But at 38, with a new marriage and hopes of beginning her own family, Payton admitted that she wouldn't be considering the move if it weren't for her grandparents.

"Sometimes I think, where could I be? What could I be doing? Could I be traveling? Could I have taken another honeymoon? Could I live in another state? Could I change my life completely?" she said. "And the answer is yes, I probably would have. But I take my responsibilities seriously. And I still love and embrace what I have to do."

Payton said it is a sense of duty that leads her and many others to fill the "caretaker" position. She believes we owe it to our elders.

"They say it takes a village to raise a child, but I would say it takes a community to take care of its own," she said. "It's not just one individual; these are people who not too many years ago were giving to this community, and they need us to take care of them. Just as much as we needed them to take care of us when we were children."

There has been an overwhelming response to Ray Payton's story. She wanted to respond to all of the offers of financial assistance from viewers. She writes:

"Please tell anyone who writes in requesting information about contributing money that I appreciate the offers. However, my grandparents and I request that they contribute money to their favorite charity or share a smile and say a hello with a loved one or elderly person that they meet. This is not a request for donations. Donations of the heartfelt support and comments and sharing their empathy with others is all we need. "