Annals of American health care, up close and personal edition, Part 1

My Aunt Betty died last week. It was no surprise to us. She was 87, and her body had been breaking down for some years now. The last three months were the worst. Her legs gave out and bloated with edema (she'd worked on her feet for 40 years behind a cosmetics counter at Scranton's only swish department store, The Globe). She had colon cancer, and it had spread everywhere.

My mother took care of Aunt Betty at home way past the point she should have. They lived together in my grandfather's house. He was a coal miner, and bought this two-story house on credit during the Depression--the 20th Century one, that is.

You can just imagine. It is more than 100 years old, has bad plumbing, narrow doorways and steep, uneven stairs. I pleaded with my mother, who is 80, to get help. My sister researched and found local caregivers at reasonable cost. But they both stubbornly refused to get assistance, or to move my aunt to a nursing facility. Aunt Betty wanted to stay at home to the very end, and my mother wouldn't let anyone else touch her.

So we were shocked and befuddled when my Aunt informed us in May that she'd decided to go into the hospital for surgery to remove her colon tumor. The cancer had already metastasized. She was sick and weak. Surgery might give her another few weeks of life, if it didn't kill her first. My sister--who used to work in a hospital--and I were both suspicious. What #$%#@ kind of doctor would advise surgery under these circumstances?

But she survived the operation, and her doctor pronounced it "successful" (my sister and I figured that "successful" meant a) she didn't die and b) he gets paid). Afterwards, the doctor moved Aunt Betty from the hospital into another facility to recover.

I visited Aunt Betty's "care center" (we can't call them "nursing homes" anymore, y'know) with my mother last week, to pick up my late Aunt's things. No need to run down the horror stories we've all heard about these places. I'd steeled myself for a nightmare.

But the care center was an absolutely terrific place, Almost like a mountain resort in the Pennsylvania woods, surrounded by gardens with winding paths. Elderly people on foot, in walkers, and wheelchairs, meandered there, enjoying the morning sun.

As we walked in, nurses and orderlies hurried up to my mother, calling her by her name, hugging her and consoling her for her loss. Given that death is business as usual for these people, I was impressed by how genuine they were. Rooms had large windows with wooded views, and the corridors were lively with staff, elderly residents and even some cheerful dogs! My mother showed me the center's beauty parlor, where my Aunt, who was always impeccably coiffed and made-up for her job, enjoyed her last shampoo and blow dry three days before she died.

I chatted up one of the directors, and she (just about everyone who worked there was a "she") told me that the center, follows the principles of Edenization. Sounds like a sort of crunchy-granola New Age approach to elder care. I'd never heard about it, don't know where it fits, politically, into the current health care debate, and I'm certainly going to try to find out more (if you do, please tell me your stories and/or point me to some links).

What I know for sure is that my Aunt spent her last days in a lovely, kind, and gentle place, surrounded by warm and caring people, one of whom (coincidentally, my aunt's former neighbor) was there to hold her hand when, just a half-hour after my weary mother had been shooed home after a 13 hour vigil, she slipped into that good night.

I walked out of the place lighter of foot, relieved to think my aunt's passing truly was a health care fairy tale, with a happy ending.

But oh, there was more to the story, which unfolded slowly, as these family things do, when I went back to the old house with my mother.

(To be continued.)