Where will you be living circa 2040 or 2050? 
 
Okay, so if you’re a born-again believer, you’re probably joyfully envisioning Heaven, or are at least adding “if the Lord tarries” to the question. And if you’re not, you may be counting on moving in with your children or enjoying a living arrangement like the Golden Girls’ of 1980s TV fame.  
 
But say none of these alternatives pans out, and you find yourself unable to live on your own. Will a decent nursing home be an option for you? 
 
The truth is that only God knows for sure. If our economy crashes and the Huns 
overrun our country, all bets are off. But let’s keep playing make believe and pretend that America will still be the Beautiful and we will still have some viable financial resources to work with. What’s likely to be available?

It turns out to be a disturbing question.

Consider this alarming statistic: “Approximately 70% of those currently 65 and over will need long-term care at some point,” according to the online information resource Carewindow, “for an average of 3 years.”

To get a sense of the potential magnitude of the need, take a look at a few statistics on the aging of America.

“The Census Bureau predicts that seniors will outnumber children by 2035,” U.S. News pointed out in a report entitled “Aging in America, in 5 Charts.”  In fact, seniors already account for anywhere from 12% to 20% of the total population of these United States, the report said. 

Who will support the aging population?

According to  the Mercatus Center at George Mason University, by 2034, “The best-case scenario is 2.3 workers paying for each retiree, and in the worst-case scenario that ratio is 2 workers per retiree.”

And the news gets worse, because those numbers don't take into consideration the astronomical costs of skilled nursing care.
 
So we are seeing a dramatic growth in our nation’s elderly population, and therefore in the number of people who will need skilled nursing care, at the same time that there will be fewer workers-per-elder to pay for this care.

In the meantime, as demand for nursing-home beds increases, at least in some states, the supply is dwindling.

From what I’ve been told by Julie Ellis, Ph.D. RN, the situation is not getting any rosier here in Wisconsin. A geriatric clinical nurse specialist, nurse educator and researcher, Dr. Ellis said that the number of Wisconsin residents 65 and older is expected to grow by 72% between 2015 and 2040. Yet between 2016 and 2018, 19  nursing homes closed in our state; and in 2019 alone, 17 more permanently shut their doors. Over the past eight years, she said, we've lost more than 6,600 nursing home beds due to closure and downsizing.
 
Why is this happening? Here are some of the forces at work in Wisconsin, according to Dr. Ellis:

• Our state’s low Medicaid reimbursement rates, which cause Wisconsin nursing homes to lose money on patients forced to rely on government funding
• A state initiative to encourage more people to choose in-home or assisted-living options over nursing-home care – an unworkable solution for many
• A dramatic workforce shortage in the long-term-care industry

Let’s connect the dots. A burgeoning elderly population, most of whom will need long-term care for an average of three years, and an alarming decline in nursing home beds: the outlook seems pretty dire to me.
 
Clearly, something has to change. Let’s hope it’s not what’s happening in Europe, with the very elderly being shipped off to countries where care can be delivered far less expensively – nations in eastern Europe, for instance, or countries like Thailand.   
 
What can you do to protect yourself over the long haul? God only knows. But at this point, maintaining some level of long-term-care insurance seems like a sensible option, if you can find something affordable. Otherwise, keep yourself as healthy as possible and pray that you and your loved ones will be among those who never need such care. 

Here is a lovely old poem I found in a book called Heart Throbs: The Old Scrapbook, published in 1905 by National Magazine. My mother was herself an ardent scrapbooker; in bulging looseleaf binders, she collected hundreds of poems, proverbs and essays that appealed to her for one reason or another. And so it's no surprise that she was also the owner of Heart Throbs. Perhaps your mother, or grandmother, or great-grandmother, owned this precious book, too.

Penned sometime after the turn of the last century, the introduction to this poem tells us that it's been around for at least a couple hundred years: "Many will be glad to see reprinted the following poem, which has been a classic for a century. No scrapbook (if such things exist nowadays) is complete without it.--Editor"

Heart Throbs provided no attribution, most likely because its author had been long forgotten. Maybe someday we will meet her in heaven, so we can thank her for the smile she has brought to hearts over the centuries, and even today. And maybe we'll meet her dear mother as well.

My Mother

Who fed me from her gentle breast
And hushed me in her arms to rest,
And on my cheek sweet kisses prest?
My mother.

When sleep forsook my open eye,
Who was it sung sweet lullaby
And rocked me that I should not cry?
My mother.

Who sat and watched my infant head
When sleeping in my cradle bed,
And tears of sweet affection shed?
My mother.

When pain and sickness made me cry,
Who gazed upon my heavy eye
And wept, for fear that I should die?
My mother.

Who ran to help me when I fell
And would some pretty story tell,
Or kiss the part to make it well?
My mother.

Who taught my infant lips to pray,
To love God's holy word and day,
And walk in wisdom's pleasant way?
My mother.

And can I ever cease to be
Affectionate and kind to thee
Who wast so very kind to me,--
My mother.

Oh no, the thought I cannot bear; 
And if God please my life to spare
I hope I shall reward thy care,
My mother.

When thou art feeble, old and gray,
My healthy arm shall be thy stay,
And I will soothe thy pains away,
My mother.

And when I see thee hang thy head,
'Twill be my turn to watch thy bed,
And tears of sweet affection shed,--
​My mother.

Everyone needs to hear the gospel, of course; there’s no other way to heaven, no matter what people may want to think. 
 
But the message is arguably most urgent for the elderly. After all, while no one knows exactly when he will die, this life's denouement is drawing near for the very aged.
 
That’s the premise undergirding my novel The Song of Sadie Sparrow  (FaithHappenings Publishers). It’s the story of three women whose lives intersect in a five-star nursing home called The Hickories—three women of different generations, backgrounds, sorrows, hopes and worldviews:

• Sadie Sparrow is a slightly befuddled 86-year-old who has been abandoned here by her oh-so-busy daughter. But she is settling in just fine, thanks to new friends, a loving staff, a heart full of favorite hymns, and a young Bible teacher who is determined to usher her through the narrow gate to eternal life. 

 

• Meg Vogel is a 58-year-old widow, freelance copywriter and committed atheist who has been hired to write resident biographies. She loves her job, except for all the dreary and offensive God-talk—precisely the nonsense that ruined the last months of what had been her perfect marriage. 

 

• Elise Chapelle, a single 32-year old and devout Christian, quit her teaching job to care for her beloved grandfather. But in spite of her efforts, his failing health has landed him in The Hickories. Not a likely place for Elise to find the ideal husband, but the Lord has been known to work in mysterious ways.

 
Editor Keely Boeving described the novel this way: “A beautifully written story of friendship set against the backdrop of life’s twilight years, The Song of Sadie Sparrow explores contrasting views of purpose and pardon, life and afterlife—and faith’s role in shaping those views, now and forevermore.”

And here's a sampling of what other readers have said since its release. 
 
It’s available in both ebook and paperback formats. I hope you'll order The Song of Sadie Sparrow today!

In 2012, a former palliative caregiver published The Top Five Regrets of the Dying: A Life Transformed by the Dearly Departing. The book is still selling extremely well, and not just from the New Age & Spirituality shelf. Perhaps the regrets most frequently expressed in her presence are somewhat universal; that might help explain the book's enduring popularity. Here they are: 
 
1. I wish I'd had the courage to live a life true to myself, not the life others expected of me. 

2. I wish I didn't work so hard.

3. I wish I'd had the courage to express my feelings.

4. I wish I had stayed in touch with my friends.

5. I wish that I had let myself be happier.

“Life is a choice,” the author has said. "It is YOUR life. Choose consciously, choose wisely, choose honestly. Choose happiness.”
 
So that’s what it’s all about?

But what if she and her readers are missing the elephant in the living room?

What if regrets such as these change dramatically one minute after death?

Too bad we can’t ask the philosophers who contributed to this list. 

Oh, but wait: we do have the testimony of the rich man in Luke 16:19-31. His priorities certainly underwent a radical transformation after he'd left this life behind.
 
Wonder what would happen if someone made it a point to read Luke 16:19-31 to the dying before they "slipped the surly bonds of earth"? Might they be a little less interested in the relative happiness of their lives, and a little more interested in where they'll be spending eternity?   

The COVID vaccine is finally on its way, and surely it will soon be safe for nursing-home residents to receive visitors again--and for the elderly with no other options to seek the best possible place to live out their days on this earth. 

Several years ago, the New York Times reported on the Green House Project, which purports to be a new sort of nursing home. Now with nearly 300 licensed homes in 28 states, it’s based on small residences, consistent assignment of aides to residents, and greater flexibility in meeting residents’ preferences for, e.g., when and what they eat and drink. It comes at the cost of higher-than-average monthly bills for residents and/or insurers, but claims better outcomes and significantly lower costs to Medicare. 
 
All of which would certainly make the Green House model worth investigating for anyone seeking a nursing home for himself or a loved one.
  
But hold on a moment. Yes indeed, the Green House model seems to address a number of circumstantial, mental and emotional issues (although except for the small residences, I don't see that they offer anything that's not offered by the nursing homes I'm most familiar with). But aren’t human beings more than the sum of their circumstances, minds and emotions? Are we not also spiritual beings – in fact, primarily so?
 
For more than 25 years, I have witnessed first-hand the positive impact that ardently Christian activities and staff can have on nursing home residents. As I observed several years ago, “Whatever their individual circumstances might be, Christians in long-term care seem to be happier than non-Christians in long-term care.”

My question then: “If this is true, shouldn’t all nursing homes put some major emphasis on feeding the spirit? At least as much as they do, say, entertaining those in their care, and reminding them of the good ol’ gone-but-not-forgotten days?”
 
To which I now add: “Shouldn’t all nursing homes put as much emphasis on feeding the spirit as they do catering to residents’ dining preferences and physical surroundings?”
 
I don’t have any fancy studies to support my observations; I still can’t seem to find any researchers who’ve examined the impact of Christian ministry on the elderly. (I’d love to be wrong about this. If you have evidence to the contrary, please send it to me!)
 
Perhaps the Green House Project does feed the spirit with eternal truth. I certainly hope that this is the case, and that the subject wasn't mentioned by the New York Times or on the Project's website simply because the responsible writers aren't much interested in the subject, or don't feel it's pertinent. 
 
But I do hope that you are interested, and that if you’re looking for a nursing home for yourself, or for a beloved parent, grandparent, spouse, sibling or child, you will put spiritual things at the top of your list of evaluation criteria.
 
If you do, your loved one may be grateful not only for the remainder of this life, but quite possibly for all eternity.

If you're searching for a present for a friend or loved one who lives in a nursing home, it wouldn't be surprising to learn that the perfect gift is not leaping instantly to mind. It can in fact be a real challenge. But as a veteran of nursing-home buying, I have a few suggestions for you. 

Let's start with a few don'ts:

• It should be obvious, but apparently it is not: Don't bring in anything that the recipient can't eat -- no sugary treats for those with diabetes, no nuts or popcorn for those with diverticulitis. If you have any doubts, do your research and check with a nurse.


• Be sensible: don't give a boom box to someone with a roommate -- unless it's accompanied by earphones and instructions for using them.


• Don't give conventional books to someone with failing vision, or books on tape to someone with no means of listening to them. 


• Don't give a gift that could be a fire hazard. That means none of those cute little packages of tea, mug and plug-in cup heater. No hot plates. Nothing that plugs in and heats up.


• Don't give an appliance if it will only cause frustration. A prime problem: phones with built-in answering machines. Younger residents may really appreciate them, but I promise you that they can reduce many old folk to tears in very short order.

There are far better choices available to those who know their residents fairly well. For instance:

• This is the generation that wrote letters, and many still do. Books of pretty stamps are always welcome, as are boxes of stationery or a selection of cards for any occasion -- Get Well, Happy Birthday, Thank You and Thinking of You are perfect.


• Look for wonderful new books or old favorites for a reader, large-print if necessary; I recently discovered a resident with a shared passion for Kathleen Thompson Norris, the highest-paid woman novelist of the early 20th century; she'll be ultra-easy to buy for, since Norris wrote dozens of books and one of the advantages to old age is being hazy about stories read decades ago. 


• Many will welcome reading accessories such as clip-on night lights (with a supply of batteries) or magnifying sheets or glasses.


• If the nursing staff okays it, candy and cookies are always a big hit.  


• How about a jigsaw puzzle, if there's a place to assemble it? And how about personalizing it? I'm currently searching for one featuring turtles for a resident who loves both puzzles and turtles -- if I can find the right one, I think she'll be delighted.

 

• If the home has a beauty shop, you could pay for a shampoo, cut and set for a resident who's low on funds.


• An easy-to-care-for plant may be just the ticket, especially for someone who once enjoyed gardening. Surprisingly, an orchid can be great; it may not live forever, but some of the most common types will bloom for a long time and need only an ice cube a week for moisture. And what an exotic gift!


• For the right resident and the right room, a stuffed toy can turn into a beloved "companion." And there are some very cool, battery-operated cats and dogs available today; but bring extra batteries and make sure there'll be someone available to change them.


• Another nifty gift is a pair of earphones for TV listening. The resident's roommate will appreciate them, and that can help keep the peace for everyone concerned.


• For the resident who has everything, you might want to make a donation in his or her name to a cause that he or she loves -- his or her church, a local humane society, or the Rescue Mission or Salvation Army, for instance.

But the best gift at all for someone living in a nursing home is the gift of time. That can be tough to provide during this era of COVID 19, but perhaps you can telephone frequently, or make special arrangements to visit; ask the home's Activities Director or Administrator for suggestions. Then, once the current crisis is past, make up for today's limitations, lavishing your time on him or her every month of the year! 

I was just reminded of this haunting poem. It seems to convey an important truth: the dementia patients who have the greatest peace are those whose children and friends continue to visit and love them even as deep confusion sets in. 

How sad that current fears of covid 19 have made such visits nearly impossible for those who are institutionalized. We really need to lobby to change this situation, even if it puts our loved ones at some risk; after all, staying physically healthy is not necessarily the most important thing in this life.
 
In the meantime, I hope we'll each do what we can to comfort those afflicted with any form of dementia; even sending them cards and letters to be read to them by caregivers can provide a few moments of happiness. The Lord will be pleased; after all, "Pure and undefiled religion before God and the Father is this: to visit orphans and widows in their trouble ...”  (James 1:27a, NKJV). If we can't do it in person, we can at least try to make up for it via the USPS.

Like virtually all American nursing-home volunteers, I've been banished from visiting my closest friends since mid-March, thanks to covid. And so I'm left with communicating with them by phone and email, and with longing for a soon return to normal.

​And, just as important, with simply remembering the many happy times we've shared.

That means I've spent a lot of time lately thinking about my dear Doris, who died three years ago this month, just shy of her 98th birthday.  
 
Over the last six years of her life, Doris and I spent a great deal of quality time together, lunching weekly with her amazing daughter, visiting and singing and jabbering, sifting through thousands of her family photos, and wrapping up nearly every Friday afternoon with a spirited scrapbooking session during which we tried to artfully arrange the best of those photos – some dating back to before the turn of the last century.
 
Being so immersed in this photographic history, I got to know Doris and her family very well over the years. I learned all about the courage of her mother Lydia, widowed at an early age; about the love and humor of her husband Frank; and about the extraordinary kindness of her mother-, father- and sister-in-law.
 
Of special note were loving characters like Uncle Gus’s wife Aunt Coddle. She insisted on hand-making young Doris’s special-occasion dresses for such events as her First Communion. These dresses weren’t exactly fashionable, as the photographs demonstrated. In fact, the prospect of having to wear them out in public sent Doris to her mother in tears, hoping that she’d be told she could wear something else.

But no dice. Lydia invariably said, “Oh, I know it’s awful, Doris dear, but Aunt Coddle would be so hurt if you didn’t wear it. You’re just going to have to.” And so she did.
 
Maybe it was being raised by a mother like Lydia that gave Doris such a compassionate heart. Because in my eyes, at least, she was the epitome of the Christian woman – a doer of the word, not just a hearer (James 1:22).
 
Perhaps most telling, I never once heard her say an unkind word to anyone, or about anyone. Never. On the contrary, she always greeted staff and residents with the friendliest “Hello!” you’ve ever heard, and the brightest smile. And she often commented on what terrific people they were when they were out of earshot.
 
Nor did I ever hear her complain about anything. Not once. Not when a neighbor was ear-splittingly noisy, a staffer was cross, a fellow resident gobbled down all her chocolates, or an aide was painfully slow to respond to a call light. Not even when reflooring the hallways necessitated detours that were inconvenient for all and a trial for a 90-something woman relying on a walker; rather than complaining about it, she lauded the workers, complimenting them enthusiastically on their efforts.
 
What’s more, Doris seemed to be obsessed with your comfort, especially when you were sitting in her room. She wanted you to take the best chair. She wanted the temperature to be set at your comfort level. She wanted you to have just the right amount of the right kind of light, incandescent or fluorescent, for the task at hand.
 
The foundation of it all: a heart filled to overflowing with gratitude.
 
“I’ve had such a wonderful life,” Doris said more than once. And indeed, it was clearly a life filled with love and simple pleasures – her lovely extended family, a relatively modest but well-built and tidy home, long lists of girlfriends who got together regularly, family vacations at rented cottages in northern Wisconsin, volunteer work at a local hospital.
 
This gratitude continued into the last years of her life. Even though her daughter made repeated efforts to persuade her mother to come live with her, Doris kindly refused. She found her final earthly home beautiful, loved the staff and her fellow residents, nested happily in a room filled with family photos and favorite knickknacks, appreciated the food and courtyard garden and thoroughly enjoyed the constant slate of activities, all tailored to the interests and abilities of her generation.
 
And now I wonder: If this splendid woman found so much to love about this fallen world, even while dealing with the infirmities of great old age, how do you suppose she’s finding heaven?
 
Doris was one of a kind, and I will never forget her. Happily, thanks to our Lord and Savior Jesus Christ, that won’t ever be necessary; we’ll both be in that happy, heavenly throng, singing our hearts out in worship (and, she and I always hoped, doing so with far more beautiful voices than those we had in this life).

Until we meet again, my beloved friend.