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To All:

I volunteer at a Museum. The head of the volunteer department sent this to us with regard to one of our their best volunteers who is in her nineties.

Take care,

A Toast to Independence
By Barbara Brotman
July 15, 2008

I have seen the future, my fellow Baby Boomers. And it is a place where you can't get a drink without a doctor's prescription. The story begins with my personal advance scout on growing old, a.k.a. my mother. When she fell and broke her shoulder recently, she was sent to a short-term rehabilitation unit at a nursing home. Short-term turned out to mean nearly two months, and because she lives in another city, she asked me to bring in provisions. Chocolate mints, fresh grapes�and vodka.??My mother has a bloody mary before dinner every night. Her nightly happy hour has brought her to a certain age�the exact number is not to be discussed, but let's just say there is a 9 in it�in mostly robust health, if poor balance. People who learn of her practice and note her 20-years-younger appearance, her swift mind and the way she lives actively and alone are tempted to go home and pour themselves a drink. ??So when I returned to Chicago, I left her a bottle of vodka and some small cans of vegetable juice. All seemed well, until I got a phone call at work.?
It was the nursing home's social worker. She lowered her voice to break the news.??

"We found vodka in your mother's bedside table," she said.?

?I would hope so.??"

Do you know where she got it?" she asked.??

I did. ??

Silence. A cleared throat.??"Does your mother have a history of alcohol abuse?"??

No, but she does have a history of getting really annoyed at foolishness. I told the social worker that my mother is a social imbiber of a single nightly bloody mary, and that because she was going to be at the nursing home for a while, she was making herself at home. ??

"She can't do that here," the social worker said.??


Not without a doctor's prescription. Alcohol can interact with medications."??

But she wasn't taking any medications that interact with alcohol. ??

That was true, but apparently didn't matter. No alcohol without a doctor's prescription.??

OK, I said cheerfully, or maybe not. Could they please have the nursing-home doctor write a prescription for a bloody mary???

She would get back to me.

The clinical nursing supervisor got back to me, fast. This was impressive, because for 10 days I hadn't been able to get a nurse on the phone, even early in my mother's stay when it looked like she might have pneumonia. ?

The supervisor explained the dangers of vodka in a bedside table. In addition to possible drug interaction, there could be theft. What if someone stole it???

I wondered if maybe they could have a rule against theft instead of vodka. But the rule was against non-prescription cocktails. We needed a doctor. ??
The next day, the doctor met with my mother. Seeing no contraindications to happy hour, she asked my mother how much vodka she would like. ?

My mother had no idea. She mixes by experience, not measurement.

The doctor/barkeep held out two fingers. About that much? Sure.?The doctor wrote down the dosage. And there it was: A doctor's order for a nightly serving of vodka.?And so, happy hour resumed.??

At about 5 p.m. every day for the next five weeks, the medications nurse entered my mother's room with a plastic bottle holding a shot of vodka. I wouldn't say the nursing home happy hour was exactly happy, but it was certainly more cheerful.??

But the lesson for independent-minded people who happen to be old, and those of us who will be, if we're lucky, is not happy at all.?Nursing homes as currently designed are not places for the independent-minded. They are large institutions with strict rules, some of them Medicare requirements and some the institutions' own.?

You don't want dinner at 5 p.m.? You want to hire an aide to walk you down a hallway for an hour? You have no local family to visit but still want to go outdoors once a month or so? You want your TV news channel to be something other than Fox??Tough.??The problem isn't cruelty; it's institutional reality.

Nursing homes that serve large numbers of people are not bastions of individual choice. They deal with old people as groups, and have limited staffing to do otherwise. ??There is an intriguing effort under way to radically reimagine group housing for the elderly.

The Robert Wood Johnson Foundation is supporting an effort begun by a Massachusetts physician to replace traditional nursing homes with small-scale residences called "green houses" for 10 to 12 people. ??Friends, we had better hope they succeed. You can pursue your singular dreams and make your personal choices all you want now. But the self-actualization generation is going to find elderly institutional life as currently constituted a bitter pill to swallow. ??

And I don't know what you foodies are going to do the first time they bring you a tray of what is called Salisbury steak but looks like dog food. Never mind the prescription for vodka; you'll need anesthesia.??Let's get cracking, people. We need to do better�for our parents now, for ourselves later.

My mother and I will drink to that. ??Barbara Brotman is a Tribune writer.?
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