Beyond Hallmark

Tina Taylor is always well turned out. She has her short, white hair done every week, wears colorful blouses with neatly pressed slacks, and wouldn't dream of leaving her apartment without a coat of Toasted Almond lipstick, carefully applied.

But these days, Mrs. Taylor's daughter, Mary Ann Rinnert, picks out her clothes for her, laying out the next day's wardrobe the afternoon before.

"I go to my closet and can't remember what I'm supposed to do," Mrs. Taylor tells her daughter.

"That's okay, Mom," Mrs. Rinnert replies. "I can do that for you."

Mrs. Taylor is, after all, 100 years old. The centenarian lives at the Beatrice Hover Assisted Living Center in Longmont, Colo. Her daughter, Mrs. Rinnert, lives nearby and visits Mrs. Taylor at least twice a day, sometimes more.

Mrs. Taylor calls Mrs. Rinnert, 65, "my miracle."

"That's because I'm her only child and since she had me at age 35 after 17 years of marriage, I'm still here when she needs me," Mrs. Rinnert said. "She's outlived almost everyone else."

Mrs. Taylor is in the vanguard of a demographic explosion, a surging growth in the number of people living into their 80s, 90s, some beyond. The number of Americans living past age 65 is expected to double within the next 25 years, according to the U.S. Census Bureau. By 2030, almost one in five Americans-some 72 million people-will be 65 years or older. The age group 85-and-older is now the fastest growing segment of the U.S. population.

Among multiple catalysts fueling the increase: erstwhile medical wonders (now taken for granted) like penicillin, routine organ transplants, and the virtual eradication of once-deadly diseases; technologies and medicines that prolong life for people with chronic conditions like diabetes; an overall rise in the American standard of living; and advances in preventive medicine.

Still, age, illness, or both eventually come calling, creating an increasingly common family paradigm: Where Mom was always the caretaker, millions of Americans are now taking care of Mom.

"There's a big shift occurring now in institutional medicine," said Harold G. Koenig, M.D., a professor of psychiatry and behavioral sciences at Duke University Medical Center. "The bottom line is that the system is running out of money. People's hospital stays are shorter and shorter, they go into nursing homes sicker and sicker, and lines to get into good nursing homes are getting longer and longer."

Those trends combined with the growing senior population are pushing health care "more and more into the community, and more and more into private homes, as people try to grapple with parents and grandparents suffering chronic illnesses," Dr. Koenig said.

Estimates vary on the number of people nurturing an aging mother, father, or other relative. A study of family or "informal" caregivers published this year by the National Conference of State Legislatures (NCSL) puts the number at 27 million. In a 2005 report, the AARP estimated that more than 44 million Americans are caring for another adult, age 18 or older. Among those being cared for in the 65-and-older population, about 42 percent suffer from some kind of disability.

Not Tina Taylor-she's just getting on in years. So Mrs. Rinnert, a retired elementary-school teacher, visits with her at Beatrice Hover, drives her on errands, and takes her out to eat. "What she needs from me is just to be there," Mrs. Rinnert said. "She just feels like as you get older, you need the people around that you care so much about."

Mrs. Taylor was born in northern Missouri in 1905 to a family of 10 children, and her father was a farmer. "But not a very good farmer," said Mrs. Rinnert, laughing. "He much preferred writing poetry," an avocation he passed on to his daughter, Tina (pronounced "Ty-nah"). Today, she keeps a book of her own poetry-some of it written more than a half-century ago-in her apartment. She shares it only with special, trusted visitors like Herb Herbert.

Mr. Herbert, 54, is a volunteer with LifeBridge Community Church (LBCC), where Mrs. Rinnert is a member. He is one of four people who bring Mrs. Taylor communion each week. A devout Southern Baptist, she was accustomed to cozy country churches before moving from Missouri to be near her daughter; LBCC's 3,000-soul Sundays overwhelm her. (Then there's all that loud guitar music.)

So Mrs. Taylor worships at Beatrice Hover's chapel and LBCC keeps in touch via weekly communion visits. "I think she really appreciates it because she doesn't have a lot of contact," Mrs. Rinnert said.

William Smith, president and CEO of Aging in America, a Brooklyn-based elder-care program, calls the faith community "the unsung hero of the informal support system."

"Churches and synagogues in our communities give purpose to older people's lives," he said. "They give older people a social and support network as they age into their twilight years."

First Presbyterian Church of Berkeley, Calif., is one of several congregations WORLD found that sponsor caregiver support groups. At North Olmsted Assembly of God in Ohio, the congregation provides free meals and counseling for local hospice patients. And Centenary United Methodist Church in Winston-Salem, N.C., offers DAYBreak, a respite-care program that offers caregivers some much-needed time off while offering activities for its elderly attendees.

But Dr. Koenig says the church universal can do better. A practicing Christian and author of Faith in the Future: Healthcare, Aging, and the Role of Religion, he notes that caregiving can be a marathon spiritual struggle that results in shame and guilt when caregivers' compassion, because they are human, fails them. Biblical confession is important in such cases, he said: "We admit we've blown it and ask God to forgive us so we can keep going."

A recent Johns Hopkins University study of positive adaptation to the caregiver role in cases of Alzheimer's and cancer revealed two main predictors of success: social support and religious faith.

"Religious faith is an enormous resource for caregivers taking care of loved ones," Dr. Koenig said. "The church should play a bigger role in the future as we have more and more elders cared for at home. . . . It's a mandate for the church of the 21st century."

The senior population explosion has given rise to what sociologists are calling the "sandwich generation," baby boomers and busters who now are caring both for their own children and for aging parents. About one in 10 U.S. households with two or more wage-earners ages 30 to 60 cares for both elders and children, according to a Portland State University study.

In Gail McQueen's case, it's a club sandwich of sorts.

Mrs. McQueen, 60, of Sunnyvale, Calif., cares for her dad, Frank Kaufmann, 89, and her mom, Herta, 91, a sturdy German immigrant who fled the Nazis in the 1940s with baby Gail secreted in a backpack.

Every day, she babysits her five-month-old granddaughter at her Sunnyvale home, where she is also caring for her husband, who is recovering from heart-valve replacement surgery. After a morning of bottles, diapers, snuggling, and heart medications, Mrs. McQueen tucks her granddaughter into a car seat and motors to Saratoga, often lugging a pot of homemade stew. She is usually joined by her daughter Bridget, 31, who has rented out her own home and moved in with the Kaufmanns to help care for them.

At the Saratoga house, she chats with her parents in German, orders their medications, fills their daily dosage vials, pays their bills, schedules doctor appointments, taxis to and from, fixes what needs fixing, curls her mother's hair, and takes her grocery shopping.

Mrs. Kaufmann used to have an uncanny knack, Mrs. McQueen said: "At the grocery store, she could tabulate the exact amount of the grocery bill in her head all the way down to the tax, then tell them what the total would be."

Now she has trouble seeing the groceries at all. Suffering from glaucoma, Mrs. Kaufmann sees the world through a narrow tunnel. She also has had cataract surgery, suffers from a slow-moving form of leukemia, and last year tumbled down a flight of stairs and broke her ankle.

"But she never complains," Mrs. McQueen said. "Every time someone asks her how she's feeling, she says, 'Oh, I'm fine; it's just my eyes.'"

Mrs. McQueen isn't complaining, either. She happily retired early from her position as a school secretary so that she could be with her family more. Her decision reflects a new reality unfolding in the workplace as employers realize the steady climb in the number of workers needing time off to care for aging parents.

A 2006 University of Indiana study found that once a woman becomes a caregiver, her likelihood of remaining in the workforce is reduced by half. Though the pace is slow, some companies now are adding employee benefits related to adult caregiving, such as flex-time, long-term care insurance, and unpaid family leave. For example, Prudential Financial Group subsidizes the cost to its employees of home health aides, recouping the expense by reducing absenteeism. Some state legislatures have enacted measures requiring employers to give workers time off above and beyond the federal Family Medical Leave Act.

Theresa DuFresne, a 44-year-old San Diego facilities manager, had no problem using vacation time and weekends to care for her mother, Marjorie DuFresne, 81, and her father, George, 83. Between 2001 and 2005, Mrs. DuFresne suffered two heart attacks and two major strokes. Every weekend for four years, Ms. DuFresne drove the two hours from San Diego to Ontario, Calif., to care for her parents.

Beyond the weekends, "whenever my mother went into the hospital, I would go, too," she said. "If she was in for three weeks, I was in for three weeks." If Mrs. DuFresne was at home, her daughter spent Friday through Sunday in Ontario, prepping the house for the coming week, running errands, and taking her mom to the beauty shop.

"That was her big outing," Ms. DuFresne said. That and slipping out for a root beer float. Ms. DuFresne remembers the time her fun-loving mom put her husband's big wool socks on Theresa and her five siblings when they were small, and danced them around on the hardwood floors to Big Band music. "This way she was able to wax the floor and have fun with all 6 of us at the same time."

In September 2005, Mrs. DuFresne suffered her final major stroke. She died in October, Ms. DuFresne and her siblings at her side. A devout Roman Catholic, her mother's faith was "so strong, unbelievable," that she was ministering to lay ministers from her death bed, Ms. DuFresne remembers.

"I can't even begin to say how thankful I am" to have cared for her for four years, Ms. DuFresne said. "If I hadn't I would've missed so much-all the storytelling, the way my mother appreciated life."

This month will mark Ms. DuFresne's first Mother's Day without her mom. Meanwhile, Tina Taylor, the Colorado centenarian, knows that every Mother's Day may be her last. Nearing life's end, she has begun to yearn for eternity. She prays every night, said her daughter, Mrs. Rinnert, that the Lord will just let her go to sleep and wake up with Him.

In the meantime, though, she remains ever practical. "Do you think," she asked Mrs. Rinnert recently, "that we'll wear lipstick in heaven?"

"No, Mom," Mrs. Rinnert said, smiling. "I think we'll all just be beautiful."

-with reporting by Kristin Chapman