I recently interviewed Julia Jimmie, the daughter of Josephine Enok of Tuntutuliak, amidst a most tumultuous week when YKHC announced the closure of its Home Care department and the grand opening of the newly built Yukon Kuskokwim Elder’s Home.
It was a whirlwind of a week for YKHC in late September, with sequester budget cuts, the government shut-down, lay offs and programs such as home care being eliminated. . . but nothing compares to the storm numerous families must weather and the choices they may have to make when it comes to long term care options for the elderly, homebound or those who may not have family around to take care of them.
The decisions do not come lightly. No one thinks or prepares for the time or day when the choice to consider admission into a nursing home becomes a reality.
Like YKHC’s Lead Medical Social Worker, Marcia Coffey, said, “building a new skilled nursing facility isn’t the solution, it is part of it. No matter how beautiful a long term care home is, families still struggle in making a decision to send their loved ones off to nursing homes. Nobody wants to go to a nursing home.”
Many families in southwest Alaska recall situations where they have had to make this choice for a family member or loved one. Keep them at home, hire an attendant, or send them away to a nursing home in Anchorage? Many families sacrifice or ponder clearing a spare room, or doubling or tripling their children into one room to accommodate a parent in their own home or avoid the thought or expense of sending older folks away to the never-mentioned “old folks home.” Although the new Yukon Kuskokwim Elder’s Home can accommodate up to 18 residents—which YKHC hopes to fill before the year’s end—it doesn’t necessarily mean all YK Delta residents who may need hospice care or 24 hour skilled nursing services will automatically obtain a placement at the new Yukon Kuskokwim Elder’s Home.
Take Julia Jimmie for example, daughter of Tuntutuliak elder Josephine Enok. Josephine was the first resident admitted into the new Yukon Kuskokwim Elder’s home on October 1. I visited with Julia after Josephine’s first night staying in the beautiful new facility.
Julia, a soft spoken, compassionate mother of six who resides in Bethel took the time to describe the stress of assisting her mother amidst raising her own family as her mother’s health worsened over the past several years. Josephine, a long time elder, had been admitted into Bethel’s Yukon-Kuskokwim Delta Regional Hospital (YKDRH) the Saturday prior to being moved into the Elders Home the following Tuesday.
Julia described the adjustment as both a good thing and a very difficult decision. Through several tears and the occasional tissue, Julia explained how her mother battled dementia and memory loss over the years and how she often required assistance throughout the night. She explained that there were things that require more help and lifting than she was able to do. She elaborated on the many difficult conversations she and her husband, children and siblings had thought carefully about, whether or not 24 hour skilled nursing care was the right choice. “It was difficult to make this decision (to admit her into the YK Elder’s Home). After my father passed away over three years ago, my mother was our leader back then. She was against putting my dad into a nursing home. All of us, as his children, didn’t want to send him away, so we kept him here, in Bethel.”
Explaining the stress and sacrifice families often dread in making this decision, Julia said, “my teenage daughter heard her praying in Yup’ik one day. . . as my mom drifted in and out of her self she explained how she didn’t want to place a burden on anyone.” Upon hearing this it made it easier to consider placement. Josephine had experienced a fall in the middle of the night which left her incapable of movement. The fall made it apparent to the family that a move into 24 hour care was the right decision. After the ambulance transferred Josephine from the hospital into the new YK Elder’s Home, Julia described the adjustment for her mother as somewhat restless, sleeping in a new place, as well as the buzz and commotion around the newly built facility very stressful. “She didn’t sleep good the first night.”
“I knew taking care of her at home would almost prove more of a hazard to her health than keeping her here where she can be watched or monitored 24 hours a day. I dreaded having to make this decision. Here, I can stay with her, family can come and visit and eat or pray with her. I can watch what kind of care she is getting. I can cook for her.”
“We feel very lucky to have been accepted here, with home care closing. Gee – what would I do? I’d have to think about sending her away and I wouldn’t be able to go with her . . .because my kids are here and they need me, too. This place is here, right when she needs it,” Julia says as she wipes away a few tears. “Some of them go away and a couple of weeks later, they die.”
“At first, I didn’t want anyone to know, but I’m accepting of it now. It is almost her time, and she needs more care than I am able to provide her at this time.”
This story is dedicated to the first admitted resident of the Yukon Kuskokwim Elder’s Home, Josephine ‘Caiggluk’ Enok and her numerous family members, children, grandchildren, health care providers and nurses over the years who have been instrumental in taking care of her.
Josephine passed away on October 7, 2013, less than one week from our interview with her daughter, Julia Jimmie. Josephine was born on September 12, 1928 in Kinak, the old village near Tuntutuliak, and she was laid to rest surrounded by friends and family in Tuntutuliak on October 12, 2013.
“The family would like to thank Personal Care Assistant worker Fannie Hernandez and the Home Care program for allowing us to keep Josephine home for as long as we did. They were a big help.”