Last first...

A few days ago, my father’s last surviving first cousin died.  She was 88, and had suffered a long, slow decline—but the end came quickly. After getting the news, I debated whether I should tell my dad; they were never especially close and hadn’t been in contact for years. But in the end, I decided to let him know, expecting the impact would be minimal.

And, sure enough, he reacted with his usual blend of rational resignation. “Well, she was sick for so long,” he said. “It wasn’t unexpected.” When I offered my understanding that they weren’t very close, but it was still a loss, he replied, “Yes, first cousins, after all.”

His last direct link to the old family is now gone. As a child, Shirley had spent summers visiting with Gene’s family in their small New Jersey town. Other than that, her life was in New York City—literally. Born there, she got married and lived in the same apartment at the northern tip of Manhattan starting in 1946 until two days before she died. The last time I was in New York, about 3 years ago, she wouldn't let me visit. "I'm sorry. Please forgive me," she begged repeatedly. "I'm not the same person."

Shirley had two daughters. When it became clear that she was going downhill (a series of strokes that slowly eroded her faculties), the elder daughter threw up her hands and gave up without ever trying. She stopped visiting, and after a while, didn’t bother phoning her mother. Meanwhile, the younger, busier daughter was left to arrange everything—caregivers, shopping, bills and medical care.

Thanks to the generous option that New Yorkers enjoy (at least for the moment) she was provided with 24-hour care at home, which her daughter chose instead of a nursing facility, all paid for by the Medicaid program.

California doesn’t offer anything like that. If people here run out of money and need constant supervision, they end up in a nursing home even though there are cheaper options that most people would prefer.  But we aren’t given a choice.

Meanwhile, my parents are here, inching toward the precipice. Their failure to plan will collide messily with the lack of options that their future promises. And I can only wonder who will be around to pick up the pieces…