Imagine living with a roommate who stuffed your pillowcases full of trash and then stashed them in the microwave.
Add loud snoring, incontinence, deafness and disorientation to the list of troubles and you've got a picture of Erineo Gonzales' first roommate in the senior board and care home where his life was supposed to be, at long last, easy.
"It was very, very difficult," says Gonzales, 74, of Long Beach. "But I never did complain for the simple reason that I was here for the first time and I didn't know yet what life was like here."
Now he knows. Rocky relationships and mismatched roommate pairings are a common source of trouble and woe for elderly residents sharing mini-suites in board and care homes. They often have little in common, except the cash crunch that forces them to double up with whatever roommate is available. So squabbles and bickering are frequent. Sometimes the tensions and frustrations even explode into abuse.
"We literally have had them hitting each other with their canes, or smacking their wheelchairs into each other," says Pam McGovern, executive director of the Orange County Council on Aging, which runs the ombudsman service that is a watchdog group for such homes and other long-term care facilities.
Most pairings are less calamitous. And with patience, a few compromises on both sides and creativity, most roommates do manage to find a happy middle ground. But it's almost always an awkward beginning.
"It's like going and checking into the Hilton and saying, 'OK, you're going to be in Room 15 with Mabel Jones.' And you go up and you don't know Mabel Jones from the man in the moon. And that's tough for people," says Lee Agnello, a gerontologist and regional coordinator of the Long Beach-South Bay Area of the Los Angeles County Long-Term Care Ombudsman Service.
During college or military service, bunking with just about anyone was usually tolerable, often fun--and always temporary. But for the elderly it feels like another chink in their adult identity, Agnello says. They've bid farewell to homes and neighbors, parted with furniture, pets, cars and some independence. Now they have to wait to use the bathroom.
The problem is more common among women than men. Longevity is on their side but the income to match often isn't. Their Social Security income is generally less than men's, since women nearly always earned less than men or dedicated themselves to children and homemaking. Board and care residents who outlive their savings can fall back on Supplemental Security Income, administered by the Social Security Administration. But one of the requirements for this assistance is that they share a bedroom and bathroom.
"Women are condemned to roommates if they don't have a big retirement," Agnello says.
In a perfect world, board and care homes would be built with a multitude of tiny private rooms encircling a large and homey social area, Agnello says. What residents lost in space, they would gain in affordability and privacy. But economics dictate otherwise. Most are built with mini-suites designed for maximum occupancy, the key to profitability.
So learning to adjust is a fact of life for most residents. Administrators try to make the best possible matches, but usually residents pair up with whoever is available. The best thing families can do is to lend a sympathetic ear and offer gentle suggestions. But unless there is verbal, emotional or physical abuse, it is best to watch and wait awhile, says Mary Fleck, administrator of Crofton Manor Inn Long Beach.
"It's kind of like raising children," Fleck says. "If you get into their battles, they never learn to work it out themselves."
But neither should anyone suffer in silence. Families should encourage residents to take their complaints to the office, Fleck says. Such complaints can spark simple solutions to many common aggravations. Sometimes all that's needed is a privacy screen between beds, a tilted reading lamp that doesn't illuminate the whole room, or a television headset for a night owl rooming with an early bird.
Or a blunt discussion about hygiene. Like Fleck, Elizabeth Switzer, 82, of Orange, is a believer in the solve-your-own-problems approach. When Switzer moved into a home in June, she was paired with a 97-year-old woman who uses disposable undergarments.
"I didn't know for about three weeks. And, of course, I wasn't very polite. I'd say, 'What stinks in here?' I got very angry about it," says Switzer, a white-haired woman with a hearty laugh and smile that belie her trim and frail frame.
Once she learned of the odor's source, she complained to the office. She was told that roommates were generally expected to work out minor problems on their own.
"I thought that was good," Switzer says. "I said, 'Great, that's the way I like it.' "
So they had the talk. The older woman was unaware that she needed to take greater care in disposing of the soiled undergarments. Now she does. Switzer says she has also grown accustomed to her roommate's European accent, which baffled her at first.
"Now she's great. Her eyes just shine when I give her a kiss on the forehead every once in awhile," Switzer says.
Not every rift is so easily resolved. If problems and complaints continue, it may be a sign that one or both of the residents could benefit from talking with a therapist or social worker.
"Sometimes just having someone else to vent to helps them through the transition," says Fleck, who often asks residents to meet with the staff psychologist.
Ombudsman volunteers who visit board and care homes, as well as skilled nursing facilities, can play that role, too, says Charisse Anderson, director of WISE Senior Services in Santa Monica, which runs an ombudsman program.
"Usually you'll find that there are other underlying issues going on that are really the catalyst for the problems," Anderson says. "I call it peeling away the layers and feelings to come to the kernel of what really is going on."
Sometimes the resident may be grieving for the old life or even a pet, Anderson says. They may resent their children for placing them in a home or feel they don't yet need it. Others may accept that they need help, but are angry about it. And the absent-minded roommate who leaves a damp towel or hairbrush on the bathroom counter often gets the brunt of all that anger.
Still, there are instant, almost magical, friendships that arise. Gonzales left his roommate troubles behind for about a year when he went to live with relatives. He came back to Crofton Manor Inn to try again about a year ago and was paired with Henry Gutierrez, 69. The two strangers became fast friends. Gonzales helps Gutierrez, a double amputee, get to his doctor's appointments. They catch the bus to the Lakewood Mall for lunch at their favorite Chinese restaurant. They watch boxing together. They reminisce about 5 Cokes, wartime service and life back in their native Texas. Their biggest difference? Gonzales adores baseball, Gutierrez doesn't.
"We almost think alike," Gonzales says. "Maybe it's because we're the same race, or age. I don't know."
"Maybe," says the quiet but smiling Gutierrez, "it's because we're both from Texas."