I have discovered that a lot of elder care is about mothers and daughters. I often see daughters pushing their mothers in malls and stores, shopping for groceries, paying the bills, and generally giving back in some way with assistance that they might have received when they were a child.

My mother raised me to be very independent and is herself this way. Unfortunately, if you live into old, old age, past 85, the physical and mental challenges can sometimes rob you of a quality of life, although you still have a lively spirit within. It is this independent spirit that continues to be a strength but is also sometimes a weakness.

I am now an only child and I knew my Mom and I could not happily live together nor could I offer her end stage type care in our home at the front end of her diminishing physical and mental capacities. From experience I had seen a dozen widows in San Clemente still living alone well into their 90's so I knew solutions for my 86 year old mother's care had to be in the context of a 5-10 year plan.

My husband and my long held dream have always been to move to Kauai upon our retirement. We finished building our home on Kauai and moved here the day after I retired from 31 years as a psychologist. We invited my Mom to move and live in the same areas as us, but she didn't want to interfere with our lives. We proceeded with our plans and moved to Kauai , leaving my Mom to live alone in San Clemente , knowing full well that we risked appearing to others that I was rejecting her and her needs.

After six months of living here on Kauai , reality sunk in for my Mom. My dad had died over five years ago, and my Mom was alone. She decided she would try moving to be near us. The key word here is she decided. I invited, she decided.

I then returned to California at Christmas to pack up her home of 30 years to move her to Kauai into a one bedroom ocean view condo with paid caregivers coming to the home. The first 2-3 months were a very difficult adjustment, but with consistent attention, proper medication, and excellent support and coordination from the Agency on Elderly Affairs she has made amazing improvement.

I hired my friend, a massage therapist, to come every week to massage her feet and lower legs to improve her circulation. A wonderful caregiver from Hawaii Healthcare Professionals comes four days a week to be a companion, clean her home, and take her on outings using her familiar car she no longer drives. Meals are delivered 5 days a week, a nurse comes by once a month, and my husband and I drop in randomly to visit during the week. On the weekends I do her grocery shopping, pay her bills, and fill her medicine box.

This individualized level of care in her own home has allowed us both to still be independent women living our individual lives, retaining our privacy in separate homes with each feeling much more at peace during these very different stages of our lives. We made decisions together to include both our needs, not just to have elder care become the dominating factor. And for me, I believe that a long life often comes down to a room with a view, and if you are lucky, someone you love nearby who can still have and share a life of their own while also supporting and loving yours.

To be deeply honest, my Mom's last stage of life now reminds me of a D.H. Lawrence poem:

The Ship of Death

Have you built your ship of death, oh have you?
Oh build your ship of death, for you will need it.

Now in the twilight, sit by the invisible sea
Of peace, and build your little ship
Of death, that will carry the soul
On its last journey, on and on, so still
So beautiful, over the last of seas.

When the day comes, that will come.
Oh think of it in the twilight peacefully!
The last day, and the setting forth
On the longest journey, over the hidden sea
To the last wonder of oblivion.

Oblivion, the last wonder!
When we have trusted ourselves entirely
To the unknown, and are taken up
Out of our little ships of death
Into pure oblivion.

Oh build your ship of death, be building it now
With dim, calm thoughts and quiet hands
Putting its timbers together in the dusk.

Rigging its mast with the silent, invisible sail
That will spread in death to the breeze
Of the kindness of the cosmos, that will waft
The little ship with its soul to the wonder-goal.

Ah, if you want to live in peace on the face of the earth
Then build your ship of death, in readiness
For the longest journey, over the last of seas.