The police standoff last week on a modest Bensenville street pitted a well-armed SWAT team using homes and trees for cover against a desperate gunman holed up in his house with a loved one.
But this was no ordinary hostage drama. When the suspect finally emerged from his residence after 16 hours, police led an unsteady and confused 82-year-old man to a waiting car.
Edward Pichla told police he had spent most of the past eight years caring for his elderly wife, Josephine, who has Parkinson’s disease. After spending seemingly endless days feeding, bathing and caring for her, he said, he felt depressed enough Labor Day afternoon to speak of ending her suffering forever and taking his own life. He threatened police officers who tried to intervene after they were called by a relative.
Pichla was charged Friday with aggravated assault with a deadly weapon.
Pichla has publicly pledged it will never happen again. More important to experts on aging, Pichla said he will accept help caring for his wife.
As Americans continue to gray, experts say the number of elderly who find themselves caring for a spouse or parent continues to rise. Without outside help, some fear many of those caregivers will wind up in a situation like Pichla’s–ill-equipped to cope with the physical and emotional demands, especially for diseases such as Parkinson’s or Alzheimer’s that usually require round-the-clock supervision.
Advocates for the elderly are heartened that the future of long-term care is being debated in the national arena: President Clinton has proposed a tax credit for elder care, and both presidential candidates are discussing benefits for the elderly.
Locally and statewide, agencies have increased the profile for seniors, including Illinois Atty. Gen. Jim Ryan’s office, which is training police officers to recognize signs of abuse and neglect among the older population, as well as refer them to other services.
But advocates caution that there is an information gap between what is available and what the public is aware of when it comes to long-term care. They also say there are not enough free or low-cost programs.
“There’s no systematic program to reach out to caregivers,” said Rusty Ayers, spokesman for the American Association of Retired Persons’ Midwest Regional Office in Chicago. “If you’re caring for someone 23 hours a day, you don’t have the time to advocate for yourself.”
It’s still unclear exactly how Pichla wound up in his predicament, though his family has indicated his insurance company is at fault. However he wound up bearing the brunt of the responsibility for his 77-year-old wife, experts said he is not alone.
An estimated 25 percent of Americans do some sort of caregiving for an elderly parent, relative or friend, and AARP estimates 12 percent of the caregivers are at least 65.
The number of senior citizens in the country is expected to nearly double in the next 30 years, to 69 million people.
The risks for seniors caring for others are only now being understood. A study published in December in the Journal of the American Medical Association found that caregivers over 65 have a much greater risk of dying or suffering from ailments such as arthritis, heart failure or stroke.
Furthermore, 60 percent of caregivers are clinically depressed, said Bonnie Lawrence, communications manager for Family Caregiver Alliance in San Francisco.
But getting care to the chronically ill isn’t cheap or easy. Medicare, the government insurance program for all seniors, will pay for nursing home care but not for in-home services, such as housecleaning or visits from nurses.
Municipal governments and local councils on the aging offer clearinghouses to refer families to agencies, but that message may not make it to an independent senior couple used to living and caring for themselves.
Barbara Coleman, an AARP researcher in Washington, D.C., agrees that many people don’t know what is available.
“We have a fragmented patchwork of systems that states provide,” Coleman said. “Illinois is pretty good at offering these services. There clearly are not enough of those home-care, publicly funded services.”
Of the nearly 2 million senior citizens in Illinois, about 100,000 are on Medicaid, the government insurance program for the poor. That leaves the vast majority relying on their own incomes or savings to pay the bills. The cost of a nursing home is between $3,000 and $4,000 a month.
For those who can’t afford that–or who do not want to place their loved one in a home–the challenges for a disease like Parkinson’s are endless. The progressive disorder attacks the nervous system, leaving the patient unable to move freely. The caregiver must constantly lift and turn the patient. Many drugs cause hallucinations, leading to emotional stress for the caregiver.
“So many families don’t have that kind of ability to get out of the house and refresh, and get a good night’s sleep,” said Christopher Goetz, director of Parkinson’s Disease Program at Rush-Presbyterian-St. Luke’s Medical Center in Chicago. “How that’s going to be solved, I don’t know.”
Jan Costello, spokeswoman for the Illinois Department on Aging, pointed out that Illinois increased its budget to the department by 8 percent this last year, and she said the state regularly increases funds for senior care.
“We’re hearing more about caregiving,” Costello said. “But we all need to develop a new consciousness about this, like helping our neighbor.”
Advocates admit, however, that the programs often do not go far enough. Coleman said politicians who call for more “personal responsibility” often want people to buy their own costly long-term care insurance. While she said many Baby Boomers can do so, she pointed out there will always be a number of senior citizens who can’t.
And though she is encouraged by gradual changes being made to get the federal government to pay for more in-home services, she said the services fall short. New Jersey and Wisconsin have created hot lines for caregivers to call when they have reached their limits, similar to suicide hot lines, she pointed out–a good idea that has not caught on nationwide. More of those kinds of ideas will be needed in the future, Coleman said.
“The positive side is that people are healthier when they grow older; they are more educated,” she said. “The problem, of course, is, if you are healthy and live to be 100, at some point this breaks down.”
